Dental haemorrhage

Persistent bleeding from a tooth socket after dental extraction may be due to:

• reactionary haemorrhage - seen after 2-3 hours as the local anaesthetic wears off
• secondary haemorrhage - seen after 48-72 hours, if the clot becomes infected. This is more likely if the previous dental hygiene has been bad.

Check:

• that the bleeding is coming from a tooth socket
• pulse, BP and for signs of shock if the bleeding has been significant - transfusion is sometimes required
• predisposing factors, to be followed up later, include:
  • hypertension
  • drugs such as warfarin or aspirin
  • blood dyscrasia, haemophilia or ITP

Reference

1. Prashanti E et al. Interventions for treating post-extraction bleeding. Cochrane Database Syst Rev. 2018 Mar 04;3(3):CD011930