Wisdom teeth, the “uninvited guests” in the oral cavity, often cause pain, inflammation and even affect the health of adjacent teeth due to poor growth positions and insufficient space, which leads many people to choose to have them extracted through surgery. However, the bleeding situation after the surgery worries many patients: How long will the bleeding last after tooth extraction? What constitutes normal bleeding? What should be done if the bleeding doesn’t stop? Next, we will provide a detailed answer to the issue of bleeding after wisdom tooth surgery for everyone.
Normal bleeding phenomena and Time Range after wisdom tooth surgery
(1) Immediately after the operation to 1 to 2 hours
Wisdom tooth extraction is an invasive surgery. During the process of tooth extraction, tissues such as the gums and alveolar bone may be damaged, leading to blood vessel rupture and bleeding. Therefore, it is a normal phenomenon for there to be obvious blood leakage in the mouth within 1 to 2 hours immediately after the wisdom tooth is extracted. At this point, doctors usually ask patients to bite a piece of sterilized gauze or cotton ball and promote blood coagulation by applying pressure to stop bleeding. During the process of biting the gauze or cotton ball, the patient may feel a bloody taste in the mouth, and the saliva spat out may be mixed with blood streaks or appear light red. These are all normal manifestations.
(2) 2 to 24 hours after the operation
After biting a gauze or cotton ball for 1 to 2 hours, the bleeding in the mouth of most patients will be significantly reduced. Within 2 to 24 hours after the operation, there may still be a small amount of bleeding in the mouth, and the saliva may have faint blood streaks. This is because the blood clot within the tooth extraction wound is still gradually forming and stabilizing, and there may still be a small amount of blood oozing out from some tiny broken blood vessels. However, the amount of this bleeding will be very small, and there will be no situation of spitting blood in large mouthfuls or blood clots falling off. If at this stage, the patient only occasionally spits out saliva with blood streaks, there is no need to worry too much. It is a normal postoperative recovery process.
(3) 1 to 3 days after the operation
One to three days after the operation, the blood clot in the tooth extraction wound has basically formed and begun to organize, and the bleeding will further decrease. However, at this stage, patients still need to be cautious, as some improper behaviors may cause the blood clot to fall off, thereby triggering rebleeding. For instance, rinsing the mouth forcefully, spitting frequently, and engaging in vigorous exercise can all cause changes in the pressure within the mouth, leading to the loosening or detachment of blood clots. At this point, there may still be a small amount of bloody secretions in the mouth, and the color of the saliva may be light red or light yellow. This is also a normal sign of recovery. As long as the blood clot does not fall off and there is no obvious increase in pain or swelling at the wound site, there is no need to be overly nervous.
Factors Influencing the Bleeding Time after Wisdom Tooth Surgery
(1) The patient’s own physical condition
Hematological diseases: If a patient already has hematological diseases, such as thrombocytopenic purpura, leukemia, hemophilia, etc., these diseases can affect the blood’s coagulation function. Insufficient platelet count or deficiency of coagulation factors can lead to prolonged bleeding at the tooth extraction site, and in severe cases, continuous bleeding may occur. Before undergoing wisdom tooth surgery, doctors usually require patients to have a blood routine and coagulation function test, which is to understand the patient’s blood condition in advance and assess the surgical risks.
Hypertension: Patients with hypertension are also more prone to bleeding problems after tooth extraction. Because elevated blood pressure increases the pressure inside the blood vessels, it makes it difficult to stop the bleeding after the blood vessels at the tooth extraction site rupture. If a patient’s blood pressure is unstable before tooth extraction or if their blood pressure rises due to emotional tension during the extraction process, it may lead to prolonged postoperative bleeding time. Therefore, patients with hypertension must keep their blood pressure within an appropriate range before tooth extraction and inform the doctor of their history of hypertension.
Long-term use of anticoagulant drugs: Some patients, due to suffering from cardiovascular diseases such as coronary heart disease and valvular heart disease, need to take anticoagulant drugs for a long time, such as aspirin and warfarin. These drugs can inhibit platelet aggregation or affect the function of coagulation factors, thereby increasing the risk of bleeding after tooth extraction. For patients who have been taking anticoagulant drugs for a long time, it is necessary to adjust the dosage of the drugs or stop taking them for a period of time under the guidance of a doctor before tooth extraction to reduce the possibility of bleeding. However, the specific adjustment plan needs to be determined based on the patient’s condition and physical state, and the medication should not be stopped at will on one’s own.
The growth condition of wisdom teeth
The location and shape of wisdom teeth: If the growth location of wisdom teeth is complex, such as impacted wisdom teeth that are completely embedded in the alveolar bone, or if the root shape of wisdom teeth is abnormal, such as multiple roots or curved roots, more operations such as gingival incision and alveolar bone removal will be required during the extraction process. This will lead to larger wounds, more severe tissue damage, and thus prolong the bleeding time relatively. Compared with those wisdom teeth that are located relatively shallower and have normal root shapes, complex wisdom teeth have a higher risk of bleeding and a longer recovery time after extraction.
The degree of trauma during tooth extraction: The surgeon’s operational skills and experience can also affect the bleeding situation after tooth extraction. If the doctor operates skillfully and gently during the tooth extraction process, minimizing damage to the surrounding tissues, the risk of bleeding can be reduced and the bleeding time can be shortened. On the contrary, if the operation is improper, such as over-pulling the gums or repeatedly prying the teeth, it can lead to more vascular rupture and tissue damage, increasing the possibility of postoperative bleeding.
Postoperative care situation
The time and method of compression hemostasis: Biting a gauze or cotton ball for compression hemostasis after the operation is a very crucial step. If the pressure is not applied for enough time and the blood clot has not fully formed, and the gauze or cotton ball is removed too early, it may cause rebleeding. Generally speaking, it is necessary to hold onto a piece of gauze or cotton ball for 30 to 60 minutes, but the specific duration may vary from person to person. At the same time, the pressure should be moderate. If it is too light, it will not achieve the hemostatic effect; if it is too heavy, it may cause discomfort to the patient and even damage the oral mucosa.
Dietary and oral hygiene habits: Postoperative dietary and oral hygiene habits also have a significant impact on bleeding conditions. It is generally not recommended to eat within 2 hours after the operation. After 2 hours, you can have some warm, cool and soft foods, such as rice porridge, noodles, yogurt, etc. Avoid eating overly hot, hard, spicy and irritating foods. Because overly hot food can dilate blood vessels and increase the risk of bleeding; Hard food may rub against the tooth extraction wound, causing the blood clot to fall off. Spicy and irritating foods can irritate the wound, causing pain and bleeding. In terms of oral hygiene, do not brush your teeth or rinse your mouth within 24 hours after the operation to avoid disrupting the blood clot. After 24 hours, you can gently rinse your mouth with a light salt water solution or mouthwash prescribed by your doctor to keep it clean, but avoid rinsing your mouth forcefully.
Rest and activity situation: Postoperative patients need to pay attention to rest and avoid strenuous exercise and overwork. When engaging in intense exercise, the body’s blood circulation speeds up and blood pressure rises, which increases the risk of bleeding from the tooth extraction wound. At the same time, excessive fatigue can lower the body’s resistance and affect the healing of wounds. Therefore, it is recommended that patients have appropriate rest and ensure adequate sleep after the operation, which is conducive to the recovery of the wound.
How to Determine if bleeding after wisdom tooth surgery is abnormal
(1) Judgment of the amount of bleeding
Under normal circumstances, the amount of bleeding after wisdom tooth surgery gradually decreases, and there will be no situation of spitting blood in large mouthfuls. If after the operation, the patient frequently vomits out a large amount of bright red blood, or there are obvious blood clots constantly forming and falling off in the mouth, or even swallows a large amount of blood, this is considered abnormal bleeding and requires prompt treatment. Generally speaking, if the amount of bleeding exceeds 50 milliliters within 24 hours after the operation, it is necessary to pay attention and contact the doctor as soon as possible.
(2) Judgment of bleeding time
Although the recovery conditions of different patients may vary, if there is still significant bleeding at the tooth extraction site more than three days after the operation, or if a wound that has already stopped bleeding experiences heavy bleeding again, it is also considered an abnormal situation. Under normal circumstances, about three days after the operation, the bleeding at the tooth extraction site should have basically stopped, leaving only a small amount of bloody discharge. If the bleeding does not stop after this time, it may be caused by reasons such as wound infection or the shedding of blood clots.
(3) Judgment of accompanying symptoms
In addition to the amount and duration of bleeding, abnormal bleeding can also be determined through some accompanying symptoms. If, at the same time as bleeding, the patient experiences obvious symptoms such as increased pain, significant swelling around the tooth extraction wound, and fever, it is very likely that the wound has become infected, causing continuous bleeding. In addition, if a patient experiences systemic symptoms such as dizziness, fatigue, and palpitations, it might be due to excessive bleeding, causing anemia or other complications, and they also need to seek medical attention promptly.
Treatment Methods for Abnormal Bleeding after Wisdom Tooth Surgery
(1) Self-handling methods
If the patient finds abnormal bleeding at the tooth extraction site, they can first try some self-treatment methods. First of all, don’t panic. Keep calm. Then, use a clean gauze or cotton ball to bite the tooth extraction wound and apply appropriate pressure. The pressure should generally last for 30 to 60 minutes. During the compression process, try not to speak or spit to avoid changes in oral pressure affecting the hemostasis effect. At the same time, an ice pack can be applied to the face on the side where the tooth was extracted. Each cold compress should last for 15 to 20 minutes, with an interval of 1 to 2 hours. Cold compresses can cause blood vessels to concontract and reduce bleeding. If the bleeding does not improve or becomes more severe after the above treatment, it is necessary to go to the hospital as soon as possible for medical treatment.
(II) Hospital Handling methods
When the patient arrives at the hospital, the doctor will first examine the tooth extraction wound to determine the cause of the bleeding. If the bleeding is caused by the detachment of a blood clot, the doctor will rinse the wound with normal saline or other disinfectant solutions to remove the blood clot and other foreign substances such as food residue inside the wound. Then, the hemostatic material, such as gelatin sponge or Yunnan Baiyao powder, will be replaced, and the gauze or cotton ball will be bitten again to apply pressure to stop the bleeding. If the bleeding is caused by a ruptured blood vessel, the doctor may use suturing to stop the bleeding. By suturing the wound and ligating the ruptured blood vessel, the purpose of stopping the bleeding can be achieved. For some bleeding caused by blood system diseases or other systemic diseases, in addition to local hemostasis treatment, doctors will also invite doctors from relevant departments for consultation based on the specific condition of the patient to jointly formulate a treatment plan and adjust the patient’s overall condition to control the bleeding.
Precautions for Preventing Bleeding after Wisdom Tooth Surgery
(1) Preoperative preparation
Truthfully inform the doctor of the medical history: Before undergoing wisdom tooth surgery, patients must truthfully inform the doctor of their medical history, including whether they have systemic diseases such as blood system diseases, hypertension, and diabetes, and whether they have been taking anticoagulant drugs, antihypertensive drugs, hypoglycemic drugs, etc. for a long time. Doctors will assess the surgical risks based on the patient’s medical history and formulate corresponding surgical plans and preventive measures.
Complete relevant examinations: Conduct blood routine tests, coagulation function tests, blood pressure measurements and other related examinations as required by the doctor to ensure that your physical condition is suitable for tooth extraction surgery. If the examination results show any abnormalities, the doctor will handle the situation based on the specific circumstances. If necessary, the doctor will advise the patient to treat the relevant disease first and then have the tooth extraction surgery after the patient’s physical condition stabilizes.
(2) Intraoperative cooperation
During the operation, the patient should actively cooperate with the doctor’s operation and follow the doctor’s guidance. Keep a relaxed state of mind and avoid excessive tension, as tension may lead to elevated blood pressure and increase the risk of bleeding. If you feel unwell or in pain during the operation, inform the doctor in time and do not move around at will.
(3) Postoperative care
Strictly follow the doctor’s advice: After the operation, you should strictly follow the doctor’s instructions for care, including the time to bite the gauze or cotton ball, dietary restrictions, and precautions for oral hygiene, etc. Don’t remove the gauze or cotton balls by yourself in advance, nor brush your teeth or rinse your mouth too early. If a doctor prescribes medication, it should be taken on time and in the prescribed dosage, such as anti-inflammatory drugs and painkillers, to prevent infection and relieve pain.
Pay attention to rest and diet: After the operation, ensure adequate rest and avoid staying up late and overwork. In terms of diet, follow the principles mentioned earlier and choose warm, cool and soft foods, gradually transitioning to a normal diet. At the same time, it is necessary to pay attention to supplementing nutrition and eat more foods rich in protein and vitamins, such as eggs, milk, fresh vegetables and fruits, which are beneficial to the healing of wounds.
Avoid bad behaviors: After the operation, avoid rinsing your mouth forcefully, spitting frequently, smoking, drinking alcohol and other bad behaviors. Rinsing the mouth vigorously and spitting frequently can increase the pressure inside the mouth, causing blood clots to fall off. Smoking and drinking can affect the blood circulation and healing ability of wounds, increasing the risk of bleeding and infection.
Conclusion
Although the bleeding situation after wisdom tooth surgery worries many patients, as long as they understand the normal bleeding time range, the factors affecting bleeding, learn to judge abnormal bleeding, and master the correct treatment and prevention methods, they can effectively deal with the postoperative bleeding problem. Throughout the entire recovery process, if you have any questions or concerns about bleeding, it is essential to communicate with your doctor in a timely manner to receive professional guidance and assistance, ensuring that the tooth extraction wound heals smoothly.
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