The removal of wisdom teeth is a common surgical procedure. The presence of blood in the mouth can appear more significant than it truly is because it mixes with saliva. Understanding the difference between expected post-operative oozing and true, uncontrolled hemorrhage is crucial for a successful recovery. This guide outlines how to manage typical post-extraction bleeding and identifies situations that require professional attention.
Understanding Expected Bleeding vs. Concern
Following the surgery, the body initiates the formation of a blood clot within the extraction site to control initial bleeding. A small amount of continued “oozing” or “weeping” is normal, often appearing as pink or reddish saliva. This slow seepage from the wound edges is not active bleeding and can persist for up to 48 hours after the procedure.
True active bleeding is a consistent flow of bright red blood that quickly fills the mouth despite sustained pressure. While initial bleeding may be slightly heavier, the flow should significantly slow down within four to six hours. If gauze is fully saturated with fresh blood and needs changing every 30 minutes or less, this indicates a cause for greater concern.
Immediate Steps for Controlling Bleeding at Home
The most effective action for stopping post-extraction bleeding is applying firm, sustained pressure directly to the surgical site. Fold a sterile gauze pad into a thick cushion and place it over the socket, biting down on it. Maintain consistent pressure for a full 45 to 60 minutes without frequently checking or changing the gauze, allowing the clotting cascade to complete.
If bleeding persists, use a moist black tea bag as an alternative. Black tea contains tannic acid, a natural astringent that helps shrink local blood vessels and accelerate clotting. Moisten the tea bag, wrap it in gauze, and bite down for 30 minutes with firm pressure. Elevating your head with extra pillows when lying down also helps by reducing blood pressure in the head and neck region.
It is crucial to avoid any activity that creates suction or pressure in the mouth, which could disrupt the fragile blood clot. This includes spitting, vigorous rinsing, and drinking through a straw for several days. Refrain from smoking, as the sucking motion and chemicals severely hinder healing and can initiate fresh bleeding.
Why Bleeding May Persist or Increase
Bleeding that continues or suddenly returns is frequently a result of the blood clot being dislodged from the socket. This disruption occurs from mechanical forces like aggressive cleaning, forceful spitting, or chewing near the site. The clot acts as a protective seal and a scaffold for new tissue growth, making it highly susceptible to being dislodged.
Engaging in physical activity or overexertion too soon after the procedure is another common factor. Strenuous exercise elevates overall blood pressure, which can lead to increased blood flow at the surgical site and subsequent bleeding.
Certain medications can also contribute to prolonged bleeding by interfering with the body’s natural clotting ability. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen have a blood-thinning effect that prolongs clot stabilization. Patients taking prescribed anticoagulants may also experience more persistent bleeding, a factor that should have been managed by the surgeon before the procedure.
Urgent Warning Signs and When to Call the Doctor
While home care manages expected oozing, certain signs require professional medical intervention. Contact your oral surgeon immediately if bleeding remains heavy and cannot be controlled after several hours of consistent, firm pressure with gauze or a tea bag. This suggests a significant issue beyond simple compression.
Increasing or severe pain that does not respond to prescribed pain medication, especially if it begins a few days after the surgery, should be reported. This could signal the development of a dry socket or a localized infection, both of which require professional treatment. Other urgent warning signs include:
- A high fever above 101°F.
- The presence of pus or foul-smelling discharge from the socket.
- Swelling that increases dramatically after the first three days.
- Difficulty breathing or swallowing, which requires immediate emergency medical attention.