Here is a topic that is relevant for extractions, especially upper (maxillary) wisdom teeth.
Bleeding is normal after a tooth extraction. However it should stop later that day. A non-wisdom tooth will typically ooze blood for under an hour, then form a clot. An upper wisdom tooth may ooze blood for several hours, even into the evening. However, it is important to understand that gauze will frequently have blood on it even though the bleeding has stopped. This is because the gauze picks up blood from the blood clot.
There are several key steps to facilitating clot formation:
1. Apply firm (slightly uncomfortable) pressure with gauze. The gauze must be directly over/under the extraction site. Pressure should be applied for 15 minutes continuously. The gauze must be the proper size to apply pressure (not too small), while enabling the mouth to be closed most of the way so the jaw doesn’t get fatigued (not too big).
2. “Bleeding has stopped” doesn’t mean there is no more blood in the mouth or saliva. It is normal to have some blood in saliva for a few days after an extraction. The key is blood is not welling up or dripping and making it difficult to talk, eat, breathe. Often the gauze will be somewhat pink but not deeply red and saturated. If it is somewhat pink this indicates bleeding is well controlled.
3. Maintain the blood clot. Once a clot has formed it is important to not disrupt it. This is accomplished by avoiding vigorous rinsing, sucking through a straw, or spitting. If bleeding resumes you can apply pressure again and the clot will re-form.
4. Black tea bag. Dipping a black tea bag in cold water, rolling it in a gauze or paper towel, and applying over an extraction socket can facilitate clot formation due to the tannin in tea.
5. If you run out of gauze you may use a paper towel cut to appropriate size.
If after trying these things you are still concerned about post extraction bleeding you should contact your doctor. If your doctor isn’t available or if you develop symptoms of lightheadedness, shortness of breath, dizziness, chest pain, or other concerning symptoms, you should go to the Emergency Department.
This blog topic is meant to be a source for educational material on bleeding after a dental extraction. It is not intended to be clinical advice. Real clinical scenarios require doctor-patient discussion, exam, and assessment.
– The Doctors of A.O.S.