Right after the wisdom tooth extraction, your dentist will put gauze in your mouth and tell you to bite down on it. “The pressure will help stop the bleeding” he says and you’re supposed to swap it out every 30 minutes until the bleeding ceases.
Next, they proceed to tell you the four most important don’ts for the aftercare:
You nodded in understanding but when you got home, there was an excessive amount of blood in your mouth. You forget for a moment and you do what you weren’t supposed to do. You accidentally spit after a wisdom tooth extraction.
Uh oh, what’s going to happen to you? Are you going to suddenly bleed to death or will you end up with a dry socket? Our purpose here today is to guide you through this crisis and help you navigate your accidental blunder.
Consequences of spitting after tooth extraction
If you accidentally spit after an extraction, either one of two things can happen.
- Bleeding worsens. Immediately after spitting, the tooth socket starts oozing out blood. It is almost as if someone turned the facet back on and the wound reopened. Prior to spitting, the bleeding was slowing down but now it has reversed.
- Nothing happens. Surprisingly, absolutely nothing happened after expectorating. You were waiting for something to occur but nothing ever did. Now aren’t you lucky?
Expectorating may increase risk of bleeding
Spitting too soon after the surgical extraction of a tooth may lead to more bleeding. The pressure that is created from vigorous expectorating or discharging spit can potentially dislodge the blood clot which is forming.
During the first few hours after the procedure, the clot that develops is unstable. It is usually not until the next day or 24 hours later that the it stabilizes enough to withstand spitting pressure.
If you expectorate before the blood clot has stabilized, it will come out and that is when you resume bleeding again. However that is usually not a problem if it has been given enough time to stabilize. For this reason, we recommend abstaining from spitting until the next day.
The clotting process (hemostasis) occurs over many hours:
- Blood vessel constriction. Within 30 minutes of an extraction, vascular spasms ensue which leads to vasoconstriction. Constricting them leads to less outward bleeding.
- Platelet plug formation. The platelets arrive and adhere to one another. They form a temporary platelet plug that can stop the bleeding but is not very stable.
- 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. The blood clot stabilization happens during this stage.
Can it cause a dry socket?
Contrary to popular misconception, spitting after an extraction does not lead to a dry socket (alveolar osteitis). Although it is unknown as to what causes this painful condition, but what we do know is that it is a biological process and not a mechanical one. That is why activities which may forcefully expel the blood clot (spitting) do not lead to it.
Why spitting did not make the bleeding worse
Sometimes you can get lucky and your spitting did not make the bleeding worse. Perhaps the blood clot has stabilized just enough to withstand the intraoral pressure. Alternatively, maybe you only spit lightly so the pressure wasn’t enough to dislodge the clot.
Disappointment or a sigh of relief? Consider yourself lucky but, don’t you dare do that ever again. You may not be so fortunate the next time you try to expel blood.
How to deal with accidentally spitting
What you should do afterwards to correct your mistake would depend on what happened. Is the wisdom tooth hole bleeding or is it not bleeding? We’ve created a decision tree diagram to help you decide your next course of action.
If the socket has resumed bleeding, you must start biting on gauze again.
- Take two pieces of gauze.
- Fold them in half twice.
- Place gauze over extraction socket.
- Bite down with firm pressure.
- Remove after 30 minutes.
- Repeat steps #1-5 until it stops bleeding.
If you’ve run out of gauze, you can use a wet black tea bag as a substitute. The tannins in it have hemostatic properties which actually makes it more effective for stopping the bleeding.
- Wet the black tea bag.
- Place it over extraction site.
- Bite with firm pressure.
- Switch out to a new one every 30 minutes.
It’s not bleeding
If the socket isn’t bleeding then consider yourself lucky because you don’t have to do anything. Just make sure that you don’t do it again please. It may not turn out as favorably the next time you expectorate.
As a reminder, you’re also not supposed to rinse, drink through a straw, smoke, or french kiss. All of those three create the same effect as spitting. They generate a lot of intraoral pressure that can potentially dislodge the unstable blood clot.
When can I spit again?
It is safe to resume spitting the next day or 24 hours after the wisdom tooth extraction. By that time the blood clot should’ve stabilized enough to withstand the pressure of forcibly expelling saliva from your mouth.
In fact, once you’re able to spit again, you should try to rinse with salt water as vigorously and frequently as possible. There are many benefits to rinsing with saline.
- Decrease inflammation.
- Prevents food from getting stuck in the wisdom tooth hole.
- Keeps the area clean of food, debris, and bacteria.
- Decreases chances for dry socket
Patients who accidentally spit after their extraction are not uncommon. After all they’ve had a long day that was both physically and mentally traumatizing. They did have their wisdom teeth surgically removed so can you blame them if they forgot for a moment?
The good news is that you can redeem yourself by correcting your mistakes. Usually by using gauze again it will mitigate the bleeding which may reoccur. You were supposed to have been biting on gauze for about 3 hours but now you have to do it once more. You’re most likely going to have to use gauze or tea bags for an another 3 hours.
Essentially you’d have been putting pressure on the socket for a grand total of 6 hours… But hey, it was your fault and now you have to deal with it! Just make sure you don’t do it again and remember to review all of the wisdom tooth aftercare instructions.