The sight of persistent bleeding after wisdom teeth removal can be alarming, though some bleeding is a normal and expected part of the healing process following oral surgery. The body must form a protective blood clot in the socket where the tooth was removed to initiate tissue repair. When bleeding seems heavy or does not slow down, it signals that the natural clotting process has been disrupted, and intervention is necessary to protect the surgical site.
Defining Normal vs. Excessive Bleeding
A small amount of blood mixed with saliva is normal and often makes the mouth appear much bloodier than it actually is. This is known as “oozing,” and the saliva may look light pink or slightly streaked with red. This mild bleeding will significantly slow down within the first three to four hours after the procedure and may continue minimally for up to 24 hours.
Excessive bleeding involves a continuous flow of bright red blood that rapidly fills the mouth, requiring constant changes of saturated gauze. If the bleeding shows no signs of slowing down after several hours of consistent pressure, or if it suddenly restarts, it suggests the protective clot has failed to form or has been dislodged. Recognizing this difference is the first step toward managing recovery.
Common Reasons for Persistent Bleeding
The most frequent reason bleeding continues is the mechanical disruption of the newly formed blood clot, which is the body’s temporary seal for the socket. This clot acts as a barrier, preventing further blood loss and protecting the underlying bone and nerves. Dislodging this fragile clot, often unintentionally, is the primary cause of renewed or persistent bleeding.
Every action that creates suction or pressure changes inside the mouth can pull the clot out of place. Activities such as spitting, vigorous rinsing, or using a straw create negative pressure that can easily compromise the healing site. Smoking also involves a strong sucking motion that can ruin the clot and expose the socket.
Improper application of the gauze can also contribute to the issue. The gauze must be positioned directly over the extraction site and bitten down firmly to apply direct pressure necessary to encourage clotting. If the gauze is loosely placed or changed too frequently, it fails to exert the required pressure or pulls the clot away before it has had time to solidify. Engaging in strenuous physical activity or elevating the heart rate increases blood pressure, which can cause the wound to bleed again.
Immediate Actions to Control Bleeding
The most effective immediate action is to apply continuous, firm pressure to the surgical site. Fold a piece of fresh, sterile gauze into a thick pad and place it directly over the socket. Bite down with sustained, firm pressure for at least 30 to 45 minutes without checking it. Removing the gauze too soon can disrupt the early stages of clot formation.
If standard gauze is not working, a black tea bag can be used as an alternative pressure pack. Black tea contains tannic acid, which functions as a natural astringent to promote clotting. The tannic acid works by causing the small blood vessels to constrict, effectively tightening the tissue around the wound.
To prepare the tea bag, moisten it with cool water, squeeze out the excess liquid, and place it directly over the bleeding socket. Bite down firmly for 30 minutes, using the same continuous pressure technique as with the gauze. Sit upright or keep your head elevated, as this helps reduce blood flow to the head area. Applying a cold compress to the outside of the cheek can also help constrict the blood vessels and reduce localized bleeding.
Underlying Medical Factors and Emergency Care
When home management fails to slow the bleeding, the cause may be related to systemic factors rather than mechanical clot disruption. Certain medications interfere with the body’s complex clotting cascade, which involves platelets and various proteins. For instance, Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) like aspirin, ibuprofen, and naproxen can inhibit platelet aggregation, extending the bleeding time.
More significant interference comes from prescribed blood thinners, such as warfarin (Coumadin) or newer direct-acting oral anticoagulants. Patients taking these medications are at a higher risk for prolonged bleeding because the drug is specifically designed to prevent clotting. It is important to discuss these medications with the surgeon and prescribing physician prior to the procedure.
If continuous pressure with gauze or a tea bag fails to slow heavy bleeding after several hours, seek professional attention. Bleeding that persists beyond 24 hours, or a continuous flow that does not slow after three to four hours of direct pressure, is concerning. Any sign of excessive blood loss, such as feeling dizzy or faint, or rapidly worsening pain or swelling, warrants an immediate call to your oral surgeon or an emergency dental clinic.