The gauze placed immediately after a tooth extraction encourages hemostasis, the process of stopping blood flow. Biting down applies continuous, direct pressure to the extraction site, initiating a stable blood clot. This clot acts as a biological bandage over the empty socket, protecting the underlying bone and nerve endings. Timely and correct removal of this initial material is a fundamental step in the healing process.
When and How to Remove the Initial Gauze
You should remove the initial gauze placed by your dental professional approximately 30 to 60 minutes after the extraction procedure. Maintaining firm, consistent pressure during this entire time is necessary to allow the clotting cascade sufficient time to solidify the wound seal. Do not repeatedly check the gauze, as this disrupts the pressure and restarts the delicate clotting process.
When the time has passed, wash your hands thoroughly before attempting removal. Remove the gauze slowly and gently, pulling it straight out without creating suction or side-to-side motion that could pull on the forming clot. Inspect the gauze pad for a dark, heavy clot material, which indicates a successful initial clotting effort. If the gauze is only lightly stained with reddish-tinged saliva, the primary bleeding has likely stopped, and you may not need to apply new gauze.
What to Do If Bleeding Continues
After removing the initial gauze, it is normal to see mild oozing or pink-tinged saliva for up to 24 hours. This is not typically a cause for concern and does not usually require additional gauze. If you observe active, heavy bleeding that quickly saturates a new gauze pad, you must intervene to manage it.
Fold a fresh piece of sterile gauze into a small, thick pad sized to cover the extraction socket. Place the pad over the socket and bite down with firm, continuous pressure for 30 to 45 minutes. Repeat this process with a fresh gauze pad every 30 to 45 minutes until the active bleeding subsides. Reusing saturated material is ineffective because it loses its necessary absorption and pressure qualities.
As an alternative, a slightly moistened black tea bag can be used. The tannic acid it contains is a natural vasoconstrictor that helps shrink blood vessels and promote clotting. If active, heavy bleeding persists and cannot be controlled after three hours and multiple changes of fresh gauze, contact your dentist or oral surgeon immediately for further instruction.
Protecting the Clot and Recognizing Complications
Once the blood clot has formed, the focus shifts to protecting it, as it is the foundation for the entire healing process. For the first 24 hours, strictly avoid any action that could dislodge the clot. Do not rinse your mouth, spit forcefully, or use a straw, as the suction created can pull the clot out of the socket.
Refrain from smoking for at least 72 hours, as the physical act of inhaling and the chemicals in smoke impair healing. When eating, opt for soft, non-chewy foods and chew on the side opposite the extraction site. Dislodging the clot results in alveolar osteitis, commonly known as dry socket.
Dry socket is characterized by throbbing, severe pain that typically begins two to four days following the extraction. This pain is significantly more intense than normal post-operative discomfort and may radiate to the ear or neck. If you experience this escalating, unmanageable pain, or if heavy bleeding resumes, contact your dental provider.