Post Extraction Bleeding (PEB)

Clinical Description

• Commonly due to disturbing the blood clot by the patient through rinsing or inadequate
• Compression on the gauze, though at times may be due to bony/tooth remnants.
• Bleeding socket can be primary (occurring within first 24 hours post extraction) or secondary
• Occurring beyond 24 hours post extraction.

Signs and Symptoms

• Prolonged bleeding 8-12 hours after extraction
• No blood clot on the socket

Investigations

• FBC
• LFT
• Bleeding time, PTT, TT

Non-pharmacological

• Instruct a patient to avoid spitting and rinsing

Pharmacological

• Stop any treatment with aspirin
• Personally press adrenaline pack for 15−30 minutes
• If persistent − give Vit. K 10 mg IM STAT and maintain the pack or consider the following:
• Suturing, bone wax, gelatin sponge

Note: give antibiotics as a prophylaxis preferably Metronidazole