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Who’s at risk for increased bleeding after an extraction?

The following circumstances could interfere with the proper healing of the tooth and may lead to more bleeding.

 

People with Bleeding Disorders

At the top of the list of people prone to serious bleeding from an extraction or other surgical procedure are those suffering from some form of bleeding disorder. The bleeding disorder may be acquired, inherited or drug-induced (see below). Common inherited bleeding disorders include Von Willebrand’s disease, known for affecting proper platelet function and Hemophilia A and Hemophilia B Thrombocytopathy and Von Willebrand which can be inherited or acquired (more rarely). Other acquired disorders that can lead to problematic bleeding issues include Vitamin K deficiency, severe liver disease and some rare disorders such as mandibular arteriovenous malformation.

 

People on anticoagulant drugs

Always make sure your dentist or oral surgeon is aware of you taking anticoagulant drugs. Commonly known as “blood thinners” these drugs are often taken by people who have cardiovascular problems. Examples of people using anticoagulants are those who have mechanical heart valves or suffer from secondary myocardial infarction, cerebral vascular accidents, or thrombophlebitis. Commonly prescribed anticoagulants include Coumadin, Plavix or Heparin. Another category of people at risk are those on anti-platelet therapy for cardiovascular disorders or inflammatory joint disorders.

 

People on Aspirin and other NSAID’s

It is a well-known fact that aspirin thins the blood and can cause excessive bleeding during and after a surgical procedure. If you are taking aspirin or other NSAID’s, let your dentist know. These medications take a while to get out of the bloodstream so stopping them just the night before will not suffix. According to Ear, Nose and Throat Alliance Hearing & Balance Centre, these drugs may have effect for even 1 to 2 weeks! Please see the list on the above website for a list of medications you should avoid taking 10 days prior to surgery. There are several medications such as Pepto-Bismol and sinus or migraine medication that contain aspirin. Always inform your dentist or oral surgeon about any medications you are taking before the procedure.

 

People on Supplements

Supplements may seem innocuous because over the counter, but several may cause increased bleeding. According to Ear, Nose and Throat Alliance Hearing & Balance Centre you should avoid taking any of these supplements at least one week prior the procedure: chondroitin, echinacea, ephedra, garlic, ginger, ginkgo biloba, ginseng, glucosamine, goldenseal, kava, milk thistle, niacin, saw palmetto, St. John’s Wort and high doses of vitamin E. Also, turmeric may interfere with proper blood clotting and should be stopped several days prior to any surgical procedure, consult with your dentist.

 

People who do not Follow Directions

There is a reason why the dentist office gives you post-op directions after your instructions. Following the directions will help prevent problems. It’s very important to follow these directions which aren’t that difficult to follow. Those who follow them are gifted with shorter recovery times and less complications. One of most important directions to follow is to consult with your dentist if the bleeding seems to persist and is in copious amounts despite your attempts to minimize it. A piece of advice: It’s best to have extractions done early in the morning so you have all the rest of the day to contact your doctor if you are concerned. Also, best to avoid Friday’s as you’re then left with the week-end when most offices are closed. Always keep an emergency dentist number handy for after hours.

 

Reducing bleeding after a tooth extraction

Everybody will bleed after an extraction, this is inevitable. However, some may bleed more and some may bleed less. There are people who stop bleeding just a few minutes after leaving the dentist’s office after putting pressure on the gauze for a few minutes, there are people who despite the pressure will continue to bleed for hours and the area will still weep days later. In some cases, the bleeding may stop and then resume later. According to Studio Dentaire, it’s not unusual to wake up the next morning with a little blood in your mouth. Generally, bleeding should stop after 6 hours, and seeing small amounts of blood in the first 48 hours is normal. If the bleeding is consistent though or comes out like a water valve, it should be checked out immediately.