A tooth extraction involves removing a tooth from its socket in the bone. While some bleeding is a normal part of the healing process, persistent or excessive bleeding can be a concern. Understanding normal bleeding and when it signals a problem helps manage recovery effectively.
Understanding Normal Post-Extraction Bleeding
After a tooth extraction, some bleeding is expected as the body heals. A blood clot forms in the empty socket, protecting exposed bone and nerves and facilitating new tissue growth. This initial bleeding usually appears as light oozing or pink- or red-tinged saliva for several hours.
Bleeding should gradually diminish within the first few hours. While mild oozing can continue for up to 8 hours, heavy, continuous bleeding that quickly soaks gauze is not typical. By the second day, any bleeding should be minimal or stopped, with only slight spotting possible when brushing.
Immediate Actions to Control Bleeding
If bleeding persists after a tooth extraction, immediate steps can help control it. Apply firm pressure to the extraction site. Fold a clean piece of gauze into a small square and place it directly over the socket, biting down firmly for 15 to 30 minutes. If the gauze saturates, replace it with a fresh piece, repeating until bleeding slows. Avoid actions that dislodge the blood clot, such as vigorous rinsing, spitting, or using straws, especially for the first 24 to 72 hours.
Keeping the head elevated, even while resting, minimizes blood flow to the head, which reduces bleeding. Applying a cold compress or ice pack to the cheek near the extraction site also constricts blood vessels. Do this for 15 minutes on and 15 minutes off to help reduce swelling and slow blood flow.
Common Causes of Persistent Bleeding
Factors can lead to prolonged bleeding after a tooth extraction. The most common reason is dislodgement or disruption of the protective blood clot in the socket. Actions like vigorous spitting, forceful rinsing, or the sucking motion from a straw can pull this clot out.
Smoking or vaping soon after an extraction can hinder healing and promote bleeding. Inhaling creates suction that may dislodge the blood clot, and chemicals in tobacco products constrict blood vessels, reducing blood flow and oxygen to healing tissues. Strenuous physical activity or heavy lifting too soon can increase blood pressure and heart rate, leading to renewed or prolonged bleeding. Consuming hot liquids or certain foods can also promote bleeding by dilating blood vessels around the surgical area.
Medical Factors Affecting Bleeding
Underlying medical conditions or certain medications can impact the body’s ability to form clots, contributing to prolonged bleeding. Patients taking anticoagulant medications (blood thinners) or antiplatelet drugs, such as aspirin, have a higher risk of extended bleeding. These medications prevent blood clots elsewhere but also affect clotting at the extraction site.
Bleeding disorders like hemophilia or Von Willebrand disease impair natural clotting mechanisms, leading to excessive bleeding. Systemic diseases such as severe liver disease, kidney disease, or uncontrolled diabetes can also compromise clotting and overall healing. Certain herbal supplements, including ginkgo, ginseng, or high doses of Vitamin E, possess anticoagulant properties that can increase bleeding risk. Disclose all medications and medical conditions to the dentist before any extraction.
When to Seek Professional Dental Care
While some bleeding is normal, specific signs indicate professional dental care is necessary. Contact your dentist immediately if bleeding does not slow or stop after several hours of continuous pressure with gauze. Persistent bleeding lasting beyond 24 hours, even if light, warrants prompt assessment.
Excessive blood loss, such as soaking multiple gauze pads quickly or experiencing large, continuous clots, signals urgent care. Signs of infection, including worsening pain or swelling after initial improvement, fever, pus, or a foul taste or smell from the extraction site, also require immediate attention. Difficulty breathing or swallowing, or severe, worsening pain not managed by prescribed medication, are additional warning signs to contact a dental professional.