Tobias K. Boehm (December 10, 2024)
Applying gauze to stop bleeding after oral surgery (Boehm)
How to stop bleeding after oral surgery or minor mouth injuries:
- Roll up a clean piece of 2×2 gauze. If not available, a wet black tea bag also works. If neither available, a clean napkin or similar material will do.
- Apply on area that is bleeding with firm pressure.
- Hold pressure for at least 5 minutes. If area was bleeding a lot, keep pressure on for 10-15 minutes.
- Gently remove gauze. Repeat steps 1-3 if it still bleeds
- Check with your surgeon if bleeding persists. If not available, seek care at an urgent care center or emergency department.
When should you seek emergency care?
Immediately seek medical attention if you feel severely dizzy or have trouble staying awake, or develop difficulty breathing. Also seek immediate care if you develop large soft tissue swelling in the neck or floor of the mouth, making it difficult to breathe or swallow.
What is normal bleeding after oral surgery?
Typically, surgeons check that bleeding has stopped after surgery. You may taste blood or see red-tinged spit (‘saliva’) for 24 hours after oral surgery and after removal of stitches (‘sutures’).
What causes severe bleeding after oral surgery?
Generally, bleeding after minor oral surgeries such as tooth removal (‘extraction’), gum surgery, bone grafting, implant placement and biopsies should stop on its own within 24 hours after the surgery, if not right afterward. Bleeding from these surgeries comes from injured small tissue blood vessels (‘capillaries’) that usually can close off on their own.
Severe bleeding can develop if a large blood vessel is cut by accident during surgery. However, this type of injury is uncommon because surgeons typically avoid cutting across areas that contain larger blood vessels. This type of injury is more likely to occur with unusual anatomy that places blood vessels in areas where they are not expected by surgeons. Sometimes, unusual blood vessels are discovered by chance on dental xrays and imaging (‘Cone beam CT scans’)
Prolonged bleeding or excessive bruising after oral surgery can also suggest an undiagnosed mild bleeding disorder, or be caused by blood-thinning medications. Typically, surgeons will discuss this possibility if you take blood-thinning medications such as the following common medications:
- Aspirin
- Ibuprofen (Motrin, Advil) and other non-steroidal anti-inflammatory drugs (NSAIDs)
- Clopidogrel (Plavix)
- Ticagrelor (Brilinta)
- Apixaban (Eliquis)
- Rivaroxaban (Xarelto)
- Dabigatran (Pradaxa)
- Warfarin (Coumadin)
If you are not taking blood-thinning medications, but experience prolonged bleeding or severe bruising after oral surgery, ask your primary physician about testing for bleeding disorders, especially if you also experience a heavy menstrual cycle, easy bruising after minor bumps, or prolonged bleeding after minor cuts and scratches.
Why can black tea bags help with stopping bleeding?
Black tea contains a family of chemicals called tannins that tend to help bleeding control (1). From what I have been told by the few patients who used them, it seems black tea bags produce this effect more than green tea bags. It probably also helps that tea bags have the right size to fit small oral surgery wounds, and the loose leaves inside the bag adapt well to a wound with pressure.
About the author:
Tobias K. Boehm, DDS, PhD, MBA, PC, DABP, DICOI, FGDIA is the founder of The Dental Institute, executive director at The Defeating Epilepsy Foundation and a professor at Western University of Health Sciences where he teaches and practices a periodontal specialist.
References:
(1) Marcińczyk N, Gromotowicz-Popławska A, Tomczyk M, Chabielska E. Tannins as Hemostasis Modulators. Front Pharmacol. 2022 Jan 13;12:806891. doi: 10.3389/fphar.2021.806891. PMID: 35095516; PMCID: PMC8793672.