Effective Bleeding Control After Tooth Extraction: Tips and Insights

Post-extraction bleeding issues?

Hello Doctor, I would like to ask how I can effectively stop bleeding after tooth extraction? Or is there something wrong with my body...
(I have anemia).
My dental clinic replied that as long as there is bleeding control, it is fine, but I have to extract two more teeth in two weeks and I don't want to spend so much time stopping the bleeding again.
Below are my bleeding situations after two extractions: During the first extraction when dealing with the remaining tooth root, I bit down on gauze to control the bleeding.
I changed the gauze three times that day (each time biting for over an hour) but it still didn't stop bleeding...
In the end, I fell asleep with the gauze in my mouth, and when I woke up the next morning and removed it, I found that the bleeding had stopped.
I estimate that it took at least 4 hours to achieve hemostasis.
Yesterday, I had two first premolars extracted, and I followed the doctor's instructions: I didn't talk, bit down tightly on the gauze, and swallowed my saliva.
Because last time, as soon as I removed the gauze, it kept bleeding, I waited two hours before taking it out this time.
I also applied ice to my cheek, but when I removed the gauze, there was still bleeding...
Later, I bit down on the gauze while sleeping, and when I woke up at 6 AM after falling asleep at 1 AM, the bleeding started again when I took out the gauze...
I had to change the gauze again and bite down until 8 AM before it finally stopped bleeding.
This means it took almost 10 hours from the time of extraction until I successfully stopped the bleeding.

Amy, 20~29 year old female. Ask Date: 2020/04/11

Dr. Huang Tingfang reply Dentistry

Dear Ms.
Amy,
Hello! Actually, tooth extraction and hemostasis are continuous processes.
After anesthesia, there is a two-hour window during which there is no pain.
Therefore, the entire procedure (tooth extraction and hemostasis) should be completed within two hours.
For example, if the extraction takes 1.5 hours, there will only be 30 minutes left for hemostasis, which could lead to bleeding! Additionally, please be aware of your own platelet count; if it is too low, it may also cause prolonged bleeding.

If you are still bleeding two hours after the extraction and find it painful to bite down on the gauze, making it difficult to maintain pressure, you should return to the clinic for further management.
Otherwise, at home, you can only hold ice water to help with hemostasis.

Take care! Wishing you all the best and a smooth recovery!
Sincerely,
Dr.
Huang Ting-Fang, Dentistry

Reply Date: 2020/04/11

More Info

After a tooth extraction, especially wisdom teeth, it's not uncommon to experience prolonged bleeding. The bleeding can be influenced by various factors, including the complexity of the extraction, the patient's overall health, and any medications they may be taking. Here are some effective strategies for managing and controlling bleeding after a tooth extraction, along with insights into potential underlying issues that may affect healing.

Immediate Post-Extraction Care
1. Bite on Gauze: After the extraction, your dentist will typically place a piece of gauze over the extraction site. It's crucial to bite down firmly on this gauze for at least 30 to 60 minutes. If bleeding continues, you may need to replace the gauze with a fresh piece and continue biting down.

2. Avoid Disturbing the Site: Refrain from sucking on straws, spitting, or rinsing your mouth vigorously for the first 24 hours. These actions can dislodge the blood clot that forms in the socket, leading to further bleeding.

3. Ice Packs: Applying ice packs to the outside of your cheek can help reduce swelling and constrict blood vessels, which may help control bleeding. Use the ice pack for 15-20 minutes at a time, allowing breaks in between.

Monitoring and When to Seek Help
If bleeding persists beyond a few hours or becomes heavy, it's essential to contact your dentist. Continuous bleeding may indicate that the blood clot has been dislodged or that there is an underlying issue, such as a blood vessel that needs to be addressed.

Factors Influencing Bleeding
1. Medications: Certain medications, particularly anticoagulants or antiplatelet drugs, can affect your blood's ability to clot. If you are on such medications, inform your dentist before the extraction, as they may need to adjust your treatment plan.

2. Underlying Health Conditions: Conditions such as anemia, liver disease, or clotting disorders can also affect bleeding and healing. If you have a history of these conditions, discuss them with your dentist.

3. Smoking: If you smoke, it can impair healing and increase the risk of complications, including prolonged bleeding. It's advisable to avoid smoking for at least 48 hours post-extraction.

Additional Tips for Effective Bleeding Control
- Stay Hydrated: Drink plenty of fluids, but avoid hot beverages and alcohol, as they can increase bleeding.

- Soft Foods: Stick to a diet of soft foods for the first few days to avoid irritating the extraction site.

- Rest: Ensure you get adequate rest and avoid strenuous activities for a few days post-extraction to promote healing.

Long-Term Care and Follow-Up
If you find that bleeding is a recurrent issue after extractions, it may be worth discussing with your dentist or a specialist. They can evaluate your clotting function and overall health to determine if there are any underlying issues that need to be addressed.

In conclusion, while some bleeding after a tooth extraction is normal, prolonged bleeding should not be ignored. By following proper post-operative care, monitoring your condition, and communicating with your healthcare provider, you can effectively manage bleeding and promote healing. If you have concerns about your health or the healing process, don't hesitate to reach out to your dentist for personalized advice and treatment options.

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