Treatment for Post Dental Bleeding
The primary treatment for post dental bleeding is to apply direct pressure to the bleeding site using gauze or cotton, which is highly effective in controlling bleeding. 1, 2
First-Line Management
- Clean the bleeding wound with saline solution or tap water to remove debris and clots 1, 2
- Apply direct pressure to the bleeding site using gauze or cotton for at least 15-20 minutes 1, 2
- If bleeding persists after initial pressure application, replace the gauze and continue applying pressure 2, 3
- For patients with continued bleeding, tranexamic acid mouthwash (5-10 mL of a 5% solution) can be applied directly to the bleeding site 2, 4
Advanced Hemostatic Measures
When local compression fails to control bleeding, more advanced measures may be required:
- Apply local hemostatic agents such as Tabotamp® (oxidized cellulose) directly to the bleeding site 3, 5
- Suture the bleeding site if there is a visible wound that can be closed 3, 5
- For persistent bleeding, consider using Floseal® (human thrombin) which is highly effective for stopping bleeding quickly 3
- In severe cases, systemic tranexamic acid may be administered according to appropriate dosing guidelines 5
Special Considerations for Patients on Anticoagulants
- For patients on vitamin K antagonists (VKAs), continue the anticoagulant therapy but co-administer tranexamic acid mouthwash rather than interrupting anticoagulation 2, 6
- For patients on antiplatelet medications, continue therapy during dental procedures as stopping carries significant risk of thrombotic events 2, 6
- Patients on anticoagulants have a higher risk of requiring complex hemostatic measures (odds ratio 2.047) 5
- Tranexamic acid mouthwash is particularly effective for patients on warfarin and should be used 3-4 times daily for 1-2 days after the procedure 2, 7
When to Seek Advanced Care
- Refer for specialized management when there is significant hemodynamic instability 2
- Seek emergency care when bleeding causes a hemoglobin decrease ≥2 g/dL 2
- Consider advanced care if bleeding occurs at a critical site or is life-threatening 2
- If bleeding cannot be controlled with local measures after 30-45 minutes of proper application, professional dental or medical assistance should be sought 3, 5
Prevention of Recurrent Bleeding
- For patients at high risk of recurrent bleeding, prophylactic use of tranexamic acid mouthwash at home is recommended 2
- Avoid rinsing the mouth vigorously, spitting, or using straws for the first 24 hours after dental procedures 8
- Soft diet for 24-48 hours after dental procedures to prevent dislodging of blood clots 8
- Avoid smoking and alcohol consumption which can interfere with clot formation 8