After your tooth extraction, you should be biting down into gauze with firm pressure for about 3 hours on average. At that point, you can stop using gauze if it has stopped bleeding or the oozing has slowed down significantly.
If neither of the above has happened after 3 hours, then you’ve an extraction complication. However that is rare and shouldn’t happen if you followed the directions on how to use gauze properly.
We will teach you the proper way to bite into gauze and explain to you why it is so important to do so. Yes, it seems very simplistic but therein lies the beauty of it.
How to use gauze after a tooth extraction
Your dentist should’ve given you a stack of 2×2 gauze to take home. In case you forgot what you were supposed to do with it, here are instructions on how to use them.
- Take two pieces of gauze.
- Fold them in half twice. It should end up as a small square.
- Place gauze over extraction socket.
- Bite down with firm pressure.
- Remove after 30 minutes.
- Repeat steps #1-5 until it stops bleeding or 3 hours have passed.
To keep it simple, all you have to remember is: Take, Fold, Place, Bite, Remove, and Repeat until it stops bleeding. If you do better with visual instructions, here is a video demonstrating how to use gauze:
What do I do with the blood and saliva in my mouth?
As you’re biting into the gauze you may have noticed that blood and saliva has started to pool in your mouth. You have two options on how to deal with this excessive amount of spit.
- Swallow it. There is absolutely nothing wrong with swallowing it because it is your own saliva and blood. Dr chen says it’s really no different from having a rare steak. Although if you prefer well-done steak or blood grosses you out, then swallowing it may not be the best option for you.
- Let it dribble out. For the vegetarians and vegans, letting the blood slowly dribble out of your mouth may be the better option. The key is to let gravity pull it out of your mouth. Do NOT by any means spit with force because you may dislodge the blood clot that we’re trying to form. If that happens you’ll continue to bleed.
Is it different for wisdom teeth?
The instructions on how to use gauze for a wisdom tooth extraction is no different from a regular tooth removal. You can follow the same exact set of instructions above. Basically just treat them as if they were the same.
However there is one slight nuance and that is if you’ve had multiple wisdom teeth extracted. If you’ve had the top and bottom one taken out, you may need to use more than two pieces of gauze. It would be better to fold 3-4 pieces of gauze together prior to biting into it.
The reason is because 2 pieces may not be thick enough for you to bite down into it properly since you’re missing both the top and bottom tooth. For a single tooth extraction, you still have the opposing tooth to put pressure into the socket. However when you’re missing two teeth, you need additional gauze height to be able to apply proper pressure.
Purpose of biting into gauze
Biting into gauze will apply firm pressure into the fresh extraction socket. The pressure will slow down and eventually stop the bleeding.
- Slows down bleeding. Direct pressure into any type of open wound will occlude the flow of blood. Bleeding will slow down while pressure is being applied. It is similar to squeezing a punctured hose to stop water from coming out.
- Provides time for clot formation. The clotting process does not happen immediately because all of the components need to travel to the extraction socket. That takes time for it to happen. The purpose of applying pressure is to buy time until your body is able to form a full blood clot.
For your information, it’s not just extraction sockets which you should apply pressure to because the concept is valid for ALL types of wounds. In fact, applying pressure is the first step for the Stop The Bleed campagin.
That campaign is a grassroots movement started by the department of homeland security to train bystanders in saving lives. Well it specifically aims to prevent people from bleeding to death. By applying enough pressure, it may buy enough time for EMS to come and take over.
Does it really take 3 hours?
In our experience, 3 hours is about the average time it takes for our patients to stop bleeding after their extraction. Please be aware that is the average amount of time. Every individual is different because they may clot and heal at different rates depending on their medical history.
- Younger and healthier individuals without any bleeding disorders may stop bleeding after 2 hours.
- Older patients with more health problems may require 4 hours for it to stop.
It all depends on how healthy you are and if you have any bleeding disorders. If you take blood thinners, that will certainly affect the clotting time as well. Hopefully you told your dentist that you were on them before you had the treatment done!
In summary, 3 hours is basically how long it takes for your blood clot to fully form. The individual clotting factors need to first travel to the extraction site. Then it takes time for it to build a clot.
The clotting process
The clotting process is referred to as hemostasis which stops the bleeding in 4 stages:
- Blood vessel constriction. Within 30 minutes of an extraction, vascular spasms ensue which leads to vasoconstriction. Your blood vessels narrow so less blood can flow out.
- Platelet plug formation. Platelets arrive and adhere to one another, forming a temporary platelet plug.
- Activate coagulation cascade. The cascade leads to activation of platelets which strengthens them.
- Fibrin clot formation. The final step of the coagulation cascade leads to fibrin deposition. Once this happens the blood clot will become stabilized.
What if it doesn’t stop bleeding?
After about 3 hours of biting into gauze, the bleeding should either stop or slow down significantly. It is still fairly normal to see some specks of blood here and there. What you should not have is blood gushing out of there.
If that description isn’t working for you, another thing which we look for is a trend. What you want to see is that with each passing hour, you should be bleeding less. If you are trending in the positive direction, then all you have to do is continue applying pressure.
If the bleeding is worsening or not improving then you have a complication. The first thing you need to do is call your dentist or seek medical help. They will advise you on what to do. You may need to return and see them.
However in the meantime, you should try replacing the gauze and biting into a wet black tea bag. Black tea is high in tannic acid which has hemostatic properties. In other words, it may help the clotting process.
How to use a black tea bag for a tooth extraction:
- Wet the black tea bag.
- Place it over extraction site.
- Bite with firm pressure.
- Switch out to a new one every 30 minutes.
If you notice an improvement then you’re on the right track. If not then you should follow through with your dentist.
Common causes for persistent bleeding after an extraction
- Not biting into gauze properly. You must bite with firm pressure. Biting loosey goosey into the gauze isn’t going to stop the bleeding.
- Spitting or rinsing. Both of these actions create pressure in the mouth that can dislodge the blood clot. The end result is continued bleeding. This is the most common cause for persistent bleeding after an extraction. We have patients who come in stating that the bleeding is not stopping and the first thing they do is spit into the bowl. Culprit identified.
- Drinking through a straw. Straws will also create a lot of pressure in the mouth which can dislodge the blood clot. Lose the straw and just drink out of a cup please.
- Taking blood thinners. If you’re taking this medication you should expect the bleeding to take longer to stop. The blood thinners interfere with the clotting process.
- Blood clotting disorders. Alternatively your bleeding may not be stopping because you’ve an undiagnnosed clotting disorder. After you get through this ordeal, you should consult your physician to get a proper diagnosis.
Using gauze after a wisdom tooth extraction
Just to reiterate, there is no difference in what you do with gauze if you’ve had a wisdom tooth extraction. You would follow the exact same steps and protocols as an extraction of any other tooth in your mouth.
An extraction socket is an extraction socket. What we’re trying to say is that a wisdom tooth extraction socket is no different. The only thing that is “different” about it is that it is located at the back of your mouth. Aside from that it is practically the same for all intents and purposes.
On average you can probably stop using gauze after about 3 hours. That is usually how long it takes for the bleeding to stop or for it to slow down to a mild ooze.
However, healthier individuals may clot faster and may not require that amount of time. Older patients with more health problems can expect the clotting process to take a little bit longer.
Ultimately whenever it stops bleeding is when you can stop using the gauze! Last but not least, don’t forget the rest of the extraction aftercare. It’s more than just biting on gauze.