This is an interactive guide on what to do when wisdom teeth won’t stop bleeding after they’ve been removed.
- First, we need to determine whether or not your condition is actually a problem.
- Second, we need to understand what is causing the persistent bleeding in the socket.
- Thirdly, we need a solution on how to stop the wisdom teeth bleeding.
Hopefully, you’ll have a better idea of your own condition and what you need to do by the end of this article. Now, let’s get to the bottom of this shall we?
How much bleeding is normal?
After having your wisdom teeth removed, bleeding from the socket is to be expected. Your tooth was literally separated from the jawbone and disconnected from its blood supply. As a consequence of that, blood will be oozing out of the wisdom tooth hole.
However, the question is, “how much bleeding is considered normal?”
Signs of normal bleeding:
- Decreased rate of bleeding after every hour.
- Small residual specks of blood after using gauze for 3 hours.
- Tasting trace amounts of blood in food during first 2-3 days.
Signs of abnormal bleeding:
- No change in rate of bleeding with each passing hour.
- Significant amounts of blood even after using gauze for 3 hours.
- Blood is profusely oozing out of the socket.
Why wisdom teeth won’t stop bleeding
There are many different potential causes as to why you may still be bleeding after having your wisdom teeth extracted.
- Dislodged blood clot. The blood clot is extremely delicate and unstable during the first 24 hours of its formation. It can be easily dislodged via mechanical means such as rinsing, spitting, drinking through a straw or even smoking.
- Incorrectly using gauze. There is the right way to use gauze and then there is the wrong way. If you’re doing it wrong, it may be why your hemostasis is delayed or not stopping.
- Clotting disorder. A pre-existing or undiagnosed clotting disorder can potentially be the reason as to why you’re still bleeding despite following all of the aftercare properly.
- Taking blood thinners. Those who are actively on blood thinning medication will have a more difficult time getting the wisdom teeth socket to stop bleeding.
We will go further into depth for each of these conditions and explain how they affect your ability to stop bleeding after the extraction.
Blood clot was dislodged
Immediately after the wisdom tooth extraction, your body will proactively try to form a blood clot over the socket to stop the bleeding. However, it takes time for the clot to mature and stabilize so during the first 24 hours, it can be easily dislodged if you’re not careful.
How the clot can get dislodged:
- Rinsing. Innocently rinsing your mouth to rid it of excess blood can dislodge it.
- Spitting. A lot of blood pooling in the mouth can reflexively make you want to spit.
- Drinking with a straw. Some people prefer to drink with straws.
- Smoking. Smoking creates pressure in the mouth and will also delay healing since the nicotine constricts blood vessels. Vasoconstriction equates to less nutrients going to the surgical site to help it recover.
All 4 of the above ways will mechanically dislodge the blood clot by generating immense intraoral pressure. It is due to the pressure in the mouth that loosens the clot which causes it to fall out of the wisdom tooth hole.
The consequence of a dislodged blood clot is a wisdom tooth socket that won’t stop bleeding.
Not using gauze properly
The primary means of achieving hemostasis is by biting on gauze over the extraction socket. It is a simple technique that will stop the bleeding and you can even do it at home. You don’t have to sit at the dentist office until the oozing stops before you can go home.
However, if you don’t use gauze properly the bleeding may not stop or it can take a lot longer for it to finally stop.
Signs of using gauze incorrectly:
- All of your teeth are touching. When you’re biting on gauze, all of your teeth are touching. That is not a good sign because your teeth should be wedged open by the gauze. That is an indication that you’re applying enough pressure to the socket.
- No pressure in the socket. You may be biting with gauze but you don’t feel an ounce of pressure in the wisdom tooth hole.
- Rate of bleeding is not decreasing. You should be switching out the gauze every 30 minutes but you don’t notice the amount of bleeding decreasing. That is a bad sign because it should be slowing down every time you change gauze.
If you notice any of the above signs, there is a chance that you may be using gauze improperly. That could very well be the reason why the surgical site is still bleeding.
You’ve a clotting disorder
An often unnoticed reason for why your wisdom teeth holes may still be bleeding could be due to a clotting disorder. If your body naturally has difficulty forming blood clots, you can bet that you’ll most likely have trouble stopping the socket bleeding after removing the third molars.
Inherited blood clotting disorders:
- Common clotting disorders
- Factor V Leiden mutation – 5% of people of European descent.
- Prothrombin G20210A mutation (factor II mutation) – affects 2% of population.
- Rare clotting disorders
- Deficiencies in blood clotting proteins – protein C, protein S, & antithrombin
- Hyperhomocysteinemia – greater than 15 micromol/L of homocysteine in blood
- Sticky platelet syndrome – increased in vitro platelet aggregation in response to low concentrations of ADP and/or epinephrine.
Acquired blood clotting disorders:
- Antiphospholipid syndrome (APS) – most common acquired clotting disorder. It is an autoimmune condition where body creates antibodies which attacks phospholipids.
- Disseminated intravascular coagulation (DIC) – a result of an infection or injury.
There are times were patients don’t even know that they have a clotting disorder until after the fact. In other words, they’ve an undiagnosed clotting condition and finally find out after having their wisdom teeth removed.
Blood thinning medication
If you’re presently taking a blood thinner, you will have difficulty forming a stabilized blood clot. The ultimate result is delayed clotting with a prolonged time before the bleeding stops.
These anti-clotting medications can be broadly categorized into anticoagulants and antiplatelet agents.
Anticoagulants
| Type of Anticoagulant | Drugs (Brand name) |
|---|---|
| Coumarins and Indandiones | warfarin (Coumadin, Jantoven) |
| Factor Xa inhibitors | apixaban (Eliquis), edoxaban (Savaysa), fondaparinux (Arixtra), rivaroxaban (Xarelto) |
| Unfractionated heparins | heparin (Hep-Lock) |
| LMWHs | dalteparin (Fragmin), enoxaparin (Lovenox) |
| Heparinoids | heparinoid (Hirudoid) |
| Direct thrombin inhibitors | argatroban (Acova), bivalirudin (Angiomax), dabigatran (Pradaxa), desirudin (Iprivask) |
Antiplatelet agents
| Type of Antiplatelet agent | Drugs |
|---|---|
| Glycoprotein platelet inhibitors | abciximab, eptifibatide, tirofiban |
| Platelet aggregation inhibitors | aspirin, cangrelor, cilostazol, clopidogrel, dipyridamole, prasugrel, ticlopidine, ticagrelor |
| Protease-activated receptor-1 antagonists | vorapaxar |
If you’re taking any of the above medications, it is of no surprise that you’re probably still bleeding from the third molar hole even after 2-3 hours of using gauze.
How to stop wisdom teeth bleeding
The key to stopping the wisdom teeth from bleeding after your extraction is to identify the cause and tailor a strategy around it. Therefore, what you need to do will differ depending on why your socket didn’t stop oozing.
How to manage a dislodged blood clot
- Do NOT rinse, spit, or drink with a straw for 24 hours.
- Do NOT smoke for 3-5 days.
- Restart using gauze until it stops bleeding (2-3 hours).
You are forbidden to smoke during the first 24 hours due to the risk of bleeding. The next 2-5 days of no smoking are to decrease the chances of getting a dry socket. That time period is the most likely time to develop the painful dental condition.
If you run out of gauze, you can use a black tea bag instead.
- Wet it and place it directly over your socket.
- Bite down with firm pressure.
- Switch to a new black tea bag every 30 minutes until it stops bleeding (2-3 hours).
Biting on black tea bags is beneficial to stopping the bleed since it contains tannic acids which have hemostatic properties. In fact, using tea bags is what you’re supposed to do if you have moderate to severe bleeding.
Alternatively, you can return to your dentist and ask them for more gauze.
If you see an improvement after doing all of this then you’re on the right track. However, if there is still no improvement, you should contact your dentist immediately.
How to use gauze properly
Knowing how to fold gauze and using it correctly is the key to achieving hemostasis after wisdom teeth removal. The technique is super simple because it only takes a few seconds but it is incredibly effective when used properly.
How to use gauze:
- Take 2-3 pieces of gauze.
- Fold it in half once.
- Fold it in half again.
- Place the newly folded square directly over the wisdom tooth hole.
- Bite down with firm pressure for 30 minutes.
- Replace with new gauze every 30 minutes until it stops bleeding.
Common pitfalls:
- Not using enough gauze. A single piece of gauze is not enough, you need at least 2-3 pieces depending on the size of your molar socket.
- Not applying enough pressure. You should be feeling pressure into the socket when biting down. A good sign is if your teeth don’t touch because it means that most of the pressure is being applied into the socket.
If you run out of gauze we recommend switching to a black tea bag instead.
How to manage a clotting disorder
If you truly have a blood clotting disorder, you should NOT attempt to manage this at home all by yourself. You need to contact your dentist immediately and there is a chance you may need to go to the hospital depending on the severity of the bleed.
With that being said, all of the previous tips that we’ve stated about stopping the bleeding from the socket will still apply to your situation.
This is what you should do while you’re on your way to get professional help:
- Do NOT rinse, spit, drink through a straw, or smoke.
- Continue biting on gauze and switching to a new one every 30 minutes.
You should definitely continue to adhere to the above two instructions while you get help. It makes no sense for you to let the wisdom tooth socket bleed without you doing anything.
How to manage bleeding while on blood thinners
Bleeding after an extraction due to being on blood thinners is not as common because your dentist will usually plan the extraction around discontinuing your medication.
In other words, they usually have you stop taking it a day or so before the procedure before you have your wisdom tooth removed. Stoppage of the blood thinner helps a lot in controlling the bleed after the tooth has been removed.
However, there can be mix ups such as forgetting to stop taking the medication or an emergency extraction forces you to proceed ahead of schedule.
What to do if you were on blood thinning medication after the extraction:
- Use a wet black tea bag instead of gauze.
- Switch out to a new one every 30 minutes until it stops bleeding.
- Do NOT take the next dose of your blood thinner until the bleeding has stopped.
- Contact your dentist and let them know of your situation.
Wisdom teeth removal aftercare
It is good practice to follow the generally prescribed aftercare for wisdom teeth removed. This includes if you’re recovering normally or if you encountered a hiccup along the way.
- Refrain from spitting, rinsing, or drinking through a straw for 24 hours.
- No smoking for at least 3-5 days.
- Start rinsing with salt water 24 hours after your procedure to prevent food from being stuck in the wisdom tooth hole.
- Take all prescribed medications as directed.
- Stick to a soft food diet for at least 2-3 days. After that you may progress to harder and harder foods depending on your condition.
- If you have wisdom teeth stitches, do not play around with them and leave them alone. They should dissolve in 10-14 days and fall out on their own.
Overall, you can expect the wisdom tooth hole to fully close after 4-6 weeks.
When to see a dentist
If you are ever in doubt or something feels off about the recovery process after wisdom teeth removal, you should contact your dentist. It is better to inform them and let them know of your situation. They may even have additional tips for you since they were the ones who did the procedure so they know your condition the best.