OPTION 1

֍ The symptoms of excessive bleeding post extraction are easily recognized.
֍ In a normal case scenario, and assuming the patient has followed the instructions given to him or her by the dental professional, there should be no bleeding at an excessive rate or heavy flow.
֍ If bleeding from the extraction site is heavy, unaffected by compression, and lasts up to two hours, the patient needs to be aware that this reaction is not within normal limits and further steps must be taken to resolve this potentially dangerous situation.
Medically Uncompromised Patients
֍ After a routine dental extraction, patients should be given instructions on how to manage bleeding and other side effects.
֍ These instructions include no exercise for 12 to 24 hours after surgery, lying down with the head elevated for several hours, and placing gauze over the tooth socket and applying pressure for at least two hours.
֍ Application of pressure is considered the most effective way to control bleeding, and another option in place of plain gauze is to moisten a tea bag with water, wrap it in gauze, place it over the socket, and apply pressure by biting on it.
֍ Tea contains tannic acid, which may help to reduce bleeding for some patients. There are also a variety of materials, such as hemostatic collagen products, cellulose products, or hemostatic bandages, that can be placed into the tooth socket by the oral surgeon post surgery.
֍ Although it is normal for some blood to ooze from the site for 12 hours, it is not normal for the bleeding to be a steady flow.
Use of tea bag following extraction.
֍ If the patient follows these instructions and bleeding is still occurring at a steady or heavy rate, follow-up treatment is indicated.
֍ Patients who note excessive bleeding or other unusual side effects such as a fever, hypotension, or hematoma should call their dentist or oral surgeon immediately. If the dental professional cannot be reached, patients should proceed to a hospital emergency department for care.
⸙ Key Concept:     
Types of bleeding after dental extractions
Normal bleeding
֍ Normally persists for up to half an hour
֍ Oozing and blood tinged saliva for up to 8 hours
֍ Controlled by pressure pack
Primary
֍ Occurs during and immediately after extraction
֍ Typically presents as blood filling up the mouth
֍ Usually due to infection or trauma to blood vessels
֍ Often controlled by local techniques like pressure packs, haemostatic agents, etc
Post-extraction bleeding Reactionary
֍ Begins two to three hours post extraction, after the vasoconstrictor effect of local anaesthesia wears off
֍ Usually due to underlying systemic conditions such as bleeding or clotting disorders
֍ Not controlled by local measures and may require systemic interventions
Secondary
֍ Usually begins 7 to 10 days post extraction
֍ Mainly due to secondary infection
֍ Rare in dental extraction, compared to the other two types of post-extraction bleeding