Wisdom teeth removal is one of the most common surgical procedures. Post-operative bleeding is a normal and necessary stage of the healing process. The bleeding that occurs immediately after the extraction allows a protective blood clot to form in the empty socket. This clot serves as the foundation for new tissue growth and successful recovery. Understanding the expected timeline and how to manage the initial flow ensures a smooth healing experience.
The Expected Bleeding Timeline
The most active bleeding occurs immediately following surgery and typically slows down significantly within the first few hours. During this initial period, the body works to form a solid blood clot within the extraction site to seal the wound.
After approximately four hours, the flow should transition from active bleeding to a much lighter, passive oozing. This lighter discharge often continues as blood-tinged saliva or a dark, reddish-brown stain on the gauze for up to 24 to 48 hours.
Saliva mixes with the small amount of blood, which can make the overall volume appear much greater than it actually is. If the bleeding is only a slight pinkness in your saliva, it is not a cause for concern and is part of the expected healing process.
Managing Bleeding Immediately After Surgery
The most effective way to control initial bleeding is by applying continuous, firm pressure directly over the surgical site. The oral surgeon will place a gauze pad over the socket before you leave the office. Maintain biting pressure on the gauze for at least 30 to 60 minutes to compress the blood vessels and allow the clot to solidify.
When the initial gauze is removed, if bleeding persists, replace it with a fresh, sterile piece folded into a thick pad and bite down firmly for another 30 to 45 minutes. If the bleeding still appears active after several attempts, a moistened black tea bag can be used in place of gauze. The tannic acid within the tea aids in blood coagulation.
Avoid any activities that create negative pressure within the mouth, as this can dislodge the newly formed blood clot and restart the bleeding. For at least the first 24 hours, do not spit, rinse your mouth vigorously, or use a straw. Limit strenuous physical activity and keep your head elevated with pillows while resting to help manage blood flow. Keep all food and drinks cool or lukewarm during this initial phase, as hot liquids can increase blood flow.
Signs of Excessive or Prolonged Bleeding
While some bleeding is expected, specific signs indicate the flow has become excessive and requires attention. Normal bleeding should always slow down and become lighter over the hours following the procedure, not increase or remain constant. Contact your oral surgeon if the bleeding is bright red, continuous, and appears to be actively gushing.
Excessive bleeding is indicated when you consistently soak a fresh gauze pad completely through within 15 to 20 minutes after several attempts at control. If heavy bleeding persists beyond the first 24 hours, or if you are passing large, solid blood clots, this is considered abnormal. These signs suggest the blood clot is not forming or is being repeatedly dislodged, which compromises the healing process.