What to do if you have excessive bleeding after a tooth extraction

Bleeding after tooth extractions is a complication that can occur from time to time. If severe, it can lead to excessive blood loss and become a medical emergency. If you have any concerns about bleeding, do not hesitate to contact your dentist or even your local emergency department. It is better to be safe than sorry.

What you can do at home

The only practical thing that you can do at home to assist in stopping the bleeding is application of pressure to the extraction site. This is by using the gauze that your dentist gave you and biting firmly onto it for 30 minutes before replacing it with a new one. To apply extra pressure, use more than one gauze at a time.

If you run out of gauze, a freshly used tea bag is a good substitute.

What is the cause?

There are a handful of main reasons for excessive bleeding after a tooth extraction. These are:

• Blood thinning medications

  Medications such as aspirin, warfarin, or anticoagulants like apixaban and rivaroxaban reduce the blood’s ability to clot. While these drugs are important for preventing strokes and heart attacks, they can make it more difficult for a blood clot to form at the extraction site. Make sure you inform your dentist of your medical history. In general, it is not advised to cease taking these medications, as the cardiovascular risk is higher than the bleeding risk of the extraction. The dentist can take extra precautions and procedures to help decrease the bleeding.

• Injury to surrounding tissue

  During an extraction, the gum, cheek, or nearby soft tissue may accidentally be bruised or torn, particularly if the tooth was difficult to remove. This additional trauma can cause bleeding from small blood vessels, not just the extraction socket itself. Proper post-operative care—such as avoiding hard foods or vigorous rinsing—help minimize this risk and allow the tissue to heal quickly.

• Strenuous exercise

  Physical exertion shortly after a tooth extraction can raise blood pressure and dislodge the fragile blood clot that is forming in the socket. Activities like running, heavy lifting, or even bending over can increase circulation to the head and mouth, causing renewed bleeding. For this reason, patients are advised to rest and avoid strenuous activity for at least 24–48 hours of healing time. Walking and daily tasks are generally fine to do.

• Periodontal disease

  Gum disease, or periodontal disease, causes inflammation of the tissues surrounding the tooth. When a tooth is extracted in an area affected by this condition, the surrounding tissues will bleed more easily and may take longer to heal. Infection can also interfere with clot formation.

• A difficult extraction

  Some extractions, particularly those involving impacted or broken teeth, require more force or surgical intervention. This may necessitate a more aggressive approach, creating a larger wound surface and exposing more blood vessels. Such cases are more prone to bleeding afterward.

• A dislodged blood clot

  After extraction, a blood clot normally forms in the socket to protect the underlying bone and nerves. If this clot becomes dislodged—through vigorous rinsing, sucking through a straw, smoking, or poking at the site—bleeding can restart.

• Multiple tooth extractions

  When several teeth are removed at once, the total wound area is much larger, which naturally increases the chance of prolonged bleeding. The body must form several clots at once, placing extra strain on the clotting system. The amount of bleeding would be proportional to the number of teeth that were extracted.

• High blood pressure

  Elevated blood pressure can increase the force of blood flow to the extraction site, making it more difficult for a stable clot to form. Even mild hypertension may contribute to prolonged oozing or renewed bleeding after initial clotting. Managing blood pressure through medication and avoiding stress or caffeine before the procedure can help reduce this risk.