Is it normal to bleed after a tooth extraction

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What you should cover
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What to expect after a tooth extraction
Bleeding should continue for up to 24 hours
Visit a dentist for bleeding that lasts beyond two days
Additional tips for tooth extraction aftercare
Reach out today
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A bleeding socket...
A bleeding socket after tooth extraction

Practice 10-Minute Consultation BMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j1217 (Published 03 April 2017) Cite this as: BMJ 2017;357:j1217

Isabelle J Moran, specialty trainee in paediatric dentistry1 2,
Libby Richardson, dental core trainee2,
Manolis Heliotis, oral and maxillofacial surgery consultant1,
Alex Bewick, emergency medicine registrar3

1Oral and Maxillofacial Surgery, Northwick Park Hospital, London HA1 3UJ, UK
2Barts Health Dental Hospital, London E1 1BB, UK
3Royal London Hospital, London, UK

Correspondence to: I J Moran isabellemoran{at}nhs.net

What you need to know

Low level oozing from a tooth socket in the first 12-24 hours after extraction is normal
Any active bleeding beyond this point requires investigations and treatment
To minimise the chances of post-extraction bleeding, patients should be advised not to rinse their mouth, smoke, or undertake strenuous activity for 24 hours and to reduce contact of the socket with the tongue

A fit and well 25 year old man attends his local emergency department concerned about a bleeding tooth socket after having had a lower wisdom tooth extracted earlier that morning.

Postoperative bleeding is a recognised complication after tooth extraction, with an incidence of up to 1.4% of patients undergoing lower wisdom tooth surgery.1 It can be difficult to achieve complete haemostasis within the oral cavity because of the highly vascular nature of the tissues and exposure of the open socket to the patient’s exploring tongue and fingers.2

In healthy patients, a low level ooze for 12-24 hours after extraction is normal as an organised clot forms in the tooth socket.23 The patient will have mildly bloodstained saliva that will decrease over time. Any active bleeding beyond this point often indicates a haemostatic problem and requires investigations and treatment.4

What you should cover

Significant, active haemorrhage must be addressed before taking a comprehensive history. It …

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Bleeding is a normal symptom after a tooth extraction, but if it continues for too long then it may become more of a concern. It is helpful to understand how long bleeding should continue after tooth extraction and what to do if bleeding continues beyond what is considered normal during recovery.

What to expect after a tooth extraction

Tooth extractions are never pleasant, but the recovery process can be more tolerable by knowing what to expect and taking the proper steps to minimize symptoms. The following is an overview of what to expect after a tooth extraction, particularly as it relates to bleeding and how to control the bleeding.

Bleeding should continue for up to 24 hours

It is normal for bleeding to exist for up to 24 hours after the tooth extraction. However, the bleeding should be minimal and tolerable, and excessive bleeding that causes a major distraction or that causes major discomfort that is not tolerable is a concern. Nevertheless, minor bleeding in the area where the extraction took place is nothing to worry about as long as it is within the first day after the extraction took place.

Visit a dentist for bleeding that lasts beyond two days

If bleeding persists for more than 24 hours, then monitoring the bleeding for another day may be enough. However, if the bleeding gets worse after 24 hours, then scheduling a dental visit is likely necessary. Any minor bleeding that continues for more than two days requires a dental visit to ensure there are no concerns that need additional dental service. If there is ever a concern with the amount or length time of the bleeding, consult with a dentist.

Additional tips for tooth extraction aftercare

The dentist may provide gauze to allow the clot to form properly after an extraction. Be sure to leave the gauze in for several hours, and then continually change the gauze to keep the affected area as clean as possible. Additionally, avoid any actions that may irritate the area, such as brushing the area, consistently rinsing the mouth or touching the area.

To control the pain, take pain medications as recommended by the dentist and use a cold compress several times a day. Patients should also avoid tobacco and alcohol use during recovery and try to get as much rest as possible for the first 24 to 48 hours. Additionally, it is strongly encouraged to eat a diet of soft foods that contain little to no sugar until the mouth has made a full recovery following the extraction.

Reach out today

Recovering from a tooth extraction is relatively simple. However, if there is persistent bleeding after 24 hours, it is necessary to see the dentist for an evaluation. Bleeding could indicate a serious problem that should not be ignored. Nonetheless, it is important to remain calm and collected until getting to the dentist. To learn more or to ask questions, reach out today!

Request an appointment here: https://www.stgeorgedentalcare.com or call St. George Dental Care at (435) 628-9099 for an appointment in our St George office.

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