Managing Post-Wisdom Tooth Extraction: Heat Application and Bleeding Concerns

Bleeding after applying a warm compress on the third day post-wisdom tooth extraction?

Hello Doctor, on March 1 (Tuesday), I had my upper and lower right wisdom teeth extracted.
The upper wisdom tooth was straight and easier to remove, while the lower wisdom tooth was horizontal and required surgery.
The lower wound was stitched, and the upper wound had one stitch.
After returning home, I applied ice and took medication.
On March 2 (Wednesday), my face became very swollen, and swallowing was painful.
I later visited another dental clinic because I couldn't open my mouth.
The doctor advised me to get an anti-inflammatory injection and prescribed anti-inflammatory and pain relief medications.
After returning home, the swelling decreased a bit, but after eating some porridge, my face swelled again.
I took my medications on time and continued to apply ice.

On March 3 (Thursday), after 48 hours, I was supposed to switch to warm compresses.
After taking my morning medication, I started the warm compress, but suddenly experienced heavy bleeding and rushed to the dental clinic for an examination.
The doctor said the upper wound was bleeding.
Since opening my mouth was painful, the doctor applied petroleum jelly and helped me open it slightly to control the bleeding, but it continued to bleed.
Because my face was still very swollen, I received another anti-inflammatory injection.
The doctor mentioned that if the bleeding didn't stop, I would need another stitch, so I ended up getting one more stitch.
The doctor advised me to continue warm compresses, but I was a bit scared after the sudden bleeding today.
I would like to ask the doctor if I should continue with the warm compresses? I need to have my stitches removed next Tuesday; what should I pay attention to? Thank you, Doctor.

Ru Ru, 20~29 year old female. Ask Date: 2016/03/03

Dr. Zhang Xiangyuan reply Dentistry

Dear netizen, based on your description, experiencing bleeding on the third day after wisdom tooth extraction following a warm compress is not uncommon.
Generally, after wisdom tooth extraction, there may be localized swelling for several days to a week.
It is advisable to monitor the swelling and pain to see if they gradually improve over time, and to take medications as directed by your physician.
If you feel that the wound is unusually painful or if bleeding occurs again, it is recommended that you return to the dentist for appropriate management.
The bleeding after the warm compress may be due to increased local temperature and blood flow, which can lead to bleeding.
If you are concerned, you may temporarily stop the warm compress.
Observe the condition of the wound, and if bleeding recurs, please return to the dentist for further evaluation.
Thank you for your inquiry.

Reply Date: 2016/03/03

More Info

After wisdom tooth extraction, managing post-operative care is crucial to ensure proper healing and minimize complications. Your experience of swelling, pain, and bleeding after the procedure is not uncommon, especially following the extraction of impacted teeth. Here’s a comprehensive overview of what you should consider regarding heat application, bleeding concerns, and general post-operative care.

Understanding the Healing Process
After a wisdom tooth extraction, it is normal to experience some swelling and discomfort. The swelling typically peaks around 48 hours post-surgery and should gradually subside thereafter. The bleeding you experienced, particularly after applying heat, can be attributed to increased blood flow to the area, which may disrupt the clot that forms in the extraction site. This is why it is essential to follow your dentist's post-operative instructions carefully.

Heat Application and Its Effects
Heat application is generally recommended after the first 48 hours post-surgery to promote healing and reduce stiffness. However, if you experience significant bleeding after applying heat, it is advisable to stop using heat immediately. The warmth can cause blood vessels to dilate, potentially leading to increased bleeding. Instead, you should revert to cold compresses to help constrict blood vessels and reduce swelling.

Managing Bleeding
If you encounter persistent bleeding, here are steps you can take:
1. Bite on Gauze: If you haven't already, place a clean piece of gauze over the extraction site and bite down firmly for about 30 minutes. This pressure can help form a clot.

2. Avoid Disturbing the Area: Refrain from sucking, spitting, or using straws, as these actions can dislodge the clot.

3. Stay Upright: Keeping your head elevated can help reduce blood flow to the area and minimize bleeding.

4. Avoid Heat: As mentioned, if heat application leads to bleeding, discontinue its use.

5. Return to Your Dentist: If bleeding persists despite these measures, return to your dentist for further evaluation. They may need to apply additional treatment or stitches to control the bleeding.

Post-Operative Care Tips
- Medications: Continue taking any prescribed pain relievers and anti-inflammatory medications as directed. This will help manage pain and reduce swelling.

- Diet: Stick to soft foods and avoid anything that requires chewing for the first few days. Foods like yogurt, applesauce, and smoothies are good options.

- Oral Hygiene: Maintain oral hygiene but be gentle around the extraction site. Avoid rinsing vigorously for the first 24 hours. After that, you can gently rinse with warm salt water to keep the area clean.

- Signs of Infection: Watch for signs of infection, such as increased pain, swelling, fever, or pus discharge. If you notice any of these symptoms, contact your dentist immediately.

Preparing for Suture Removal
As you approach your suture removal appointment, ensure you:
- Monitor Healing: Keep an eye on the extraction site for any unusual changes.

- Communicate with Your Dentist: Inform your dentist about any ongoing issues, such as pain or bleeding, during your next visit.

In conclusion, while it is normal to experience some discomfort and swelling after wisdom tooth extraction, persistent bleeding should be addressed promptly. Adjust your post-operative care based on your symptoms, and do not hesitate to seek professional help if you have concerns. Your dentist is your best resource for managing your recovery effectively.

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