A tooth extraction is a common surgical procedure performed to remove a tooth due to decay, damage, or crowding. Following the removal, some bleeding is a normal and expected part of the initial healing process. The body forms a stable blood clot within the empty socket, which acts as a protective barrier for the underlying bone and nerves. This clot is the foundation for proper healing and preventing complications.
The Initial Bleeding Phase
The most significant, active bleeding should begin to slow down or stop entirely within the first three to four hours after the procedure. Applying steady, firm pressure to the site is crucial during this initial phase to encourage the formation of a secure clot. The duration of this heavier flow can be influenced by the difficulty of the extraction, with more complex or surgical removals sometimes requiring a slightly longer period for initial clot stabilization. The goal remains the same: a dense, stable barrier of clotted blood that covers the wound.
Distinguishing Active Bleeding from Oozing
It is important to differentiate between true active bleeding and the lighter seepage that follows clot formation. Active bleeding is typically bright red and flows continuously, often rapidly saturating gauze. Oozing, in contrast, presents as a pinkish or red-tinged saliva, which is a mix of blood and normal oral fluid. This slight drainage is common and can persist for up to 24 hours, and sometimes even 48 hours, as the body continues the healing process.
Actions to Control and Prevent Bleeding
Applying Pressure
Managing bleeding effectively involves applying direct pressure to the extraction site to promote clotting. Immediately following the procedure, the patient should bite down firmly on a folded piece of sterile gauze placed directly over the socket. This pressure should be maintained for at least 30 to 45 minutes without interruption before checking the site. If bleeding continues after the initial gauze application, a moistened black tea bag can be used as an alternative pressure pack. Black tea contains tannic acid, which is a natural astringent that helps constrict small blood vessels and encourages faster blood coagulation.
Clot Preservation
Patients must avoid behaviors that generate negative pressure or turbulence in the mouth, which can easily dislodge the clot. This includes refraining from drinking through a straw, spitting, or rinsing the mouth vigorously for the first 24 hours. Smoking should also be avoided, as the sucking action and chemicals in smoke can break down the clot and impede healing. To minimize bleeding, avoid strenuous physical activity or heavy lifting for 24 to 48 hours, as this increases heart rate and blood pressure. Maintaining an elevated head position and avoiding hot liquids are also recommended, as heat can dilate blood vessels and interfere with coagulation.
Warning Signs Requiring Professional Help
While some bleeding is normal, volume and duration are the indicators for when to seek professional assistance. Bleeding that is profuse and continuous, soaking through a gauze pad in less than an hour, is considered excessive and warrants immediate attention. This is true if the heavy flow persists for several hours despite following the recommended pressure techniques. Another sign of concern is any bright red bleeding that continues past the 24-hour mark, or certainly beyond 48 hours. If the mouth is constantly filling with blood, making it difficult to control or swallow, patients should contact their oral surgeon or dentist immediately.