[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Dentistry](https://durgical.com/en/dentistry/) › [Dental emergencies and trauma](https://durgical.com/en/dentistry/areas/emergencies/) › Bleeding after a tooth extraction # Bleeding after a tooth extraction - Emergency Most bleeding after an extraction stops with firm pressure on gauze. Bleeding that does not stop needs a look for local causes and for clotting problems. Updated Nov 12, 2026 ## Key points - Bite on damp gauze, firm, twenty to thirty minutes. - Tranexamic acid locally; sutures and packing by the dentist. - Do not stop anticoagulants without the prescriber. ## What it is Some oozing is normal for several hours after an extraction. Persistent or recurrent bleeding usually has a local cause: the patient rinsing or spitting and dislodging the clot, poking the socket, a torn gum or a bleeding vessel in the bone. Systemic causes include anticoagulants and antiplatelet drugs, inherited bleeding disorders (von Willebrand disease, haemophilia), liver disease, thrombocytopenia and leukaemia. Bleeding that restarts a day or more later can be due to infection of the socket. ## How to recognise it - First-line: firm, continuous pressure with a folded damp gauze bitten on the socket for twenty to thirty minutes, without checking. - Tranexamic acid, as a soaked gauze or mouthwash, helps local haemostasis. - Local measures by the dentist: haemostatic packing in the socket and sutures. - Ask about anticoagulants, antiplatelets, liver disease, family history and easy bruising. - First unexplained heavy bleeding after an extraction can reveal von Willebrand disease or mild haemophilia. ## What to do at once - Sit the patient up, clear clots from the mouth gently and find the bleeding point. - Place a folded damp gauze over the socket and ask the patient to bite firmly for twenty to thirty minutes. - If bleeding continues, use gauze soaked in tranexamic acid and repeat the pressure. - Check vital signs and estimate loss; obtain a blood count and coagulation tests (INR if on warfarin) if bleeding is heavy, persistent or unexplained. - Arrange packing and suturing of the socket by a dentist or oral surgeon. ## Costly mistakes - Stopping an anticoagulant on one's own to prevent dental bleeding risks stroke or thrombosis; local measures usually suffice. - Large volumes swallowed can cause vomiting of blood that looks like a gastrointestinal bleed. - Haemophilia patients need factor replacement planned with haematology, not only local measures. ## Next step / Initial management - Advise no rinsing, spitting, hot drinks, smoking or exercise on the first day; soft food on the other side. - Persistent bleeding despite pressure: refer to the dentist or emergency department for packing and sutures; check INR and blood count. - Suspected bleeding disorder: refer to haematology; plan future extractions with them. - Heavy bleeding with haemodynamic changes: emergency referral. ## Test yourself Think of the answer, then tap the question to see it. ## What is the first step to control bleeding after an extraction? Firm continuous pressure with damp gauze bitten over the socket for twenty to thirty minutes. ## Which local agent helps control post-extraction bleeding? Tranexamic acid, on gauze or as a mouthwash. ## Which inherited disorder is commonly first revealed by bleeding after an extraction? Von Willebrand disease (or mild haemophilia). [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/dentistry/bleeding-after-a-tooth-extraction/) ## Connections ## Related 3 - [Anticoagulants and antiplatelets before dental extraction](https://durgical.com/en/dentistry/anticoagulants-and-antiplatelets-before-dental-extraction/) - [Blood disorders in the mouth: leukaemia, anaemia and bleeding](https://durgical.com/en/dentistry/blood-disorders-in-the-mouth-leukaemia-anaemia-and-bleeding/) - [Dry socket (alveolar osteitis)](https://durgical.com/en/dentistry/dry-socket/) ## Related conditions 3 - [Haemophilia A and B](https://durgical.com/en/conditions/haemophilia-a-and-b/) - [Von Willebrand disease](https://durgical.com/en/conditions/von-willebrand-disease/) - [Immune thrombocytopenia (ITP)](https://durgical.com/en/conditions/immune-thrombocytopenia/) ## In Pharmacology 7 - [Tranexamic acid](https://durgical.com/en/pharmacology/tranexamic-acid/) - [Warfarin](https://durgical.com/en/pharmacology/warfarin/) - [Apixaban](https://durgical.com/en/pharmacology/apixaban/) - [Rivaroxaban](https://durgical.com/en/pharmacology/rivaroxaban/) - [Dabigatran](https://durgical.com/en/pharmacology/dabigatran/) - [Clopidogrel](https://durgical.com/en/pharmacology/clopidogrel/) - [Acetylsalicylic acid](https://durgical.com/en/pharmacology/acetylsalicylic-acid/) [← All of dentistry](https://durgical.com/en/dentistry/) Educational content; it does not replace assessment by a dentist or doctor and is not a clinical instruction. For facial or neck swelling with difficulty swallowing or breathing, a knocked-out tooth or bleeding that will not stop, go to an emergency department at once. Sources: [Oral Surgery, Extraction of Teeth](https://www.ncbi.nlm.nih.gov/books/NBK589654/) (StatPearls Publishing (NCBI Bookshelf), 2023); [Bleeding Disorders](https://www.ncbi.nlm.nih.gov/books/NBK541050/) (StatPearls Publishing (NCBI Bookshelf), 2023); [Von Willebrand disease](https://medlineplus.gov/ency/article/000544.htm) (MedlinePlus, US National Library of Medicine, 2026); [Warfarin](https://medlineplus.gov/druginfo/meds/a682277.html) (MedlinePlus, US National Library of Medicine, 2026). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/dentistry/bleeding-after-a-tooth-extraction/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/dentistry/bleeding-after-a-tooth-extraction/