The experience of seeing blood after a deep dental cleaning, known as scaling and root planing, can be unsettling. While bleeding is often associated with injury, in this context, it is frequently a temporary and expected outcome of a necessary treatment. A deep cleaning is not a routine dental hygiene appointment; it is a therapeutic procedure specifically designed to address periodontitis, an advanced form of gum disease.
What Scaling and Root Planing Involves
Scaling and root planing is a non-surgical intervention performed on inflamed gum tissue that has pulled away from the teeth, creating pockets. The scaling portion involves meticulously removing hardened bacterial deposits, called calculus or tartar, from the crown and below the gum line into these periodontal pockets. This process necessarily involves disruption to the diseased tissue, which is already tender and prone to bleeding due to chronic inflammation. The root planing step follows, where the tooth roots are smoothed to remove bacterial toxins and make it more difficult for new plaque to accumulate.
Understanding Normal Healing Expectations
Bleeding immediately following the procedure is normal and generally subsides quickly, often within the first several hours after the local anesthetic wears off. For most patients, a mild pink tint in the saliva or slight spotting on the toothbrush is common for the first 24 to 72 hours following treatment. This minor oozing is part of the initial wound closure phase as the gums begin to reattach to the newly cleaned root surfaces.
The gums, previously swollen and red from infection, will start transforming into a healthier, firmer, and pinker state over the following days. During this initial healing phase, it is important to practice gentle post-operative care to avoid dislodging forming blood clots. Patients should avoid aggressive rinsing or spitting for the first day, as the negative pressure can provoke renewed bleeding. A soft diet and gentle brushing with a soft-bristled brush will minimize trauma to the delicate, healing gum margin.
If the bleeding is managed correctly, it should show a clear, steady reduction in volume each day. While the first few days represent the acute healing phase, the gums may take several weeks to reattach completely. Continued slight pinkness when brushing, especially in areas with deeper initial pockets, may persist for up to a week as residual inflammation fully resolves.
Specific Reasons for Prolonged Bleeding
When bleeding persists or seems heavier than mild spotting after the first three days, it suggests a factor is interfering with the natural clotting and healing cascade. One frequent cause is patient non-compliance with post-operative instructions, particularly the use of tobacco products. Smoking severely restricts blood flow to the gums, which delays healing and increases the risk of prolonged bleeding and infection.
Systemic health factors can also play a significant role in delayed clotting and tissue repair. Patients taking certain medications, such as anticoagulants (blood thinners) like warfarin or antiplatelet drugs like aspirin, will naturally experience prolonged bleeding time. These patients must have discussed their medication regimen with their dentist before the procedure, and they should never stop these medications without consulting their prescribing physician.
Uncontrolled underlying medical conditions, such as diabetes, can also impair the body’s ability to heal efficiently. High blood glucose levels negatively affect blood vessel function and immune response, making the gum tissue more vulnerable to persistent inflammation and slower recovery. Locally, persistent bleeding may also be a sign of residual calculus that was not completely removed during the initial deep cleaning. Even a small piece of remaining tartar can act as an irritant, continuously preventing the gum tissue from fully sealing the pocket.
When Immediate Dental Attention Is Necessary
While minor, transient bleeding is normal, certain signs indicate a potential complication that requires immediate contact with the dental professional. Excessive bleeding that is heavy and continuous, requiring you to change gauze every few minutes, is a warning sign. Any bleeding that worsens after the first day or continues unabated past the 72-hour mark should be reported promptly.
Immediate attention is also warranted if you notice signs of infection or uncontrolled bleeding. These symptoms include:
- The presence of large, solid blood clots.
- Bleeding that cannot be controlled by applying firm, gentle pressure with clean gauze for 15 to 20 minutes.
- Severe swelling that extends beyond the gum line.
- Sharp, throbbing pain that is not relieved by over-the-counter medication or a fever.