Problems After Tooth Extraction:
An Essential Expert Guide

What happens if bleeding doesn’t stop after tooth extraction?

Please note – in this section, bleeding refers to bleeding following extraction which will not stop. This does not refer to bleeding gums (for instance following brushing).

If you notice profuse bleeding that is oozing intensively, you ought to seek urgent dental/medical care.

In some patients, bleeding may not stop following extraction. This could be because:

• of the medication the patient takes (for instance blood thinners such as Warfarin)
• the patient has an underlying genetic condition which means there is a higher risk of bleeding

If you suspect any of the above, always notify your dentist before any dental treatment.

Self-help advice

• Use swabs/gauzes/towels to apply pressure to the bleeding area for 20-30 minutes whilst sitting still
• Avoid rinsing out mouth following extraction for at least 24 hours
• Revise/read the guidance given to you by the dentist following extraction

Professional treatment available (following detailed history and examination)

• Applying pressure to the area to stop the bleeding
• Dressing the socket with an agent that will help form a stable blood clot
• Stitching the wound together
• Cauterisation – rarely carried out

How do you stop bleeding after tooth extraction on blood thinners?

If you’re on blood thinners and have undergone a tooth extraction, it is important to take the extra precautions below to stop bleeding and prevent complications:

1. Apply pressure: Immediately after the tooth extraction, bite down on a piece of gauze for at least 30 minutes to help form a clot and stop bleeding. If bleeding persists, you can change the gauze and apply more pressure.
2. Use ice packs: Applying ice packs to the affected area can help reduce swelling and bleeding. Wrap a cold compress in a towel and apply it to the cheek for 10 to 20 minutes at a time.
3. Avoid rinsing or spitting: For the first 24 hours after the tooth extraction, avoid rinsing your mouth or spitting, as this can dislodge the blood clot and prolong bleeding.
4. Avoid smoking or drinking alcohol: Smoking and drinking alcohol can increase bleeding and delay healing. Avoid these activities for at least 24 hours after the tooth extraction.
5. Take medication as prescribed: If your dentist or doctor has prescribed medication to manage bleeding, pain, or swelling, be sure to take it as directed.
6. Follow up with your dentist: It is important to follow up with your dentist after the tooth extraction to monitor healing and ensure there are no complications.

If bleeding persists for more than a few hours or is excessive, contact your dentist or doctor immediately.

In some cases, they may need to take additional steps to stop the bleeding, such as applying a topical medication or placing a suture.

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Pain/swelling after an extraction

Pain and/or swelling following extraction can often be expected. If you are particularly worried, then revisit the dentist who carried out the extraction

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Dry socket (Alveolar Osteitits)

One of the more common reasons for pain after extraction includes ‘dry socket’. This results following extraction whereby the blood clot fails to form or is dislodged.

The pain (or the worst of it) will often come on a few days after the extraction and will be very severe.

Some of the things that increase the chance of dry socket include smoking and rinsing out immediately following the extraction.

If you suspect dry socket we would advise you see your dentist.

Self-help advice

• Pain killers – paracetamol/ibuprofen. Please ensure you read the label, are not allergic to the medication and do not exceed the maximum dosage.
• Applying cold pressure to the area
• Rinsing with warm (not hot) salt water rinses
• Avoid smoking and alcohol
• Maintain good oral hygiene and gently rinse after eating

After following the self-help advice, if the bleeding persists or you are taking blood thinners then seek urgent medical or dental care.

Professional treatment available (following detailed history and examination)

• Review to ensure there is no serious issues/complications and to assess how the healing is going
• Stitching the wound together
• Rinsing out the socket with saline
• Dressing the wound/socket