Bleeding Tooth Socket - developinganaesthesia



BLEEDING TOOTH SOCKET

Introduction

Post tooth extraction bleeding may be:

● Primary, within 24 hours.

Or

● Secondary, delayed for several days. This will usually be due to infection.

Clinical Assessment

● Assess the degree of blood loss.

● Consider the possibility of an underlying coagulopathy

● Is the patient on warfarin?

Investigations

None will be “routinely” necessary, unless the patient is significantly compromised by the blood loss and/or there is suspicion of an underlying coagulopathy or infection.

The following will need to be considered:

● FBE

● CRP

● Coagulation profile

● Group and cross match.

Management

1. Kaltostat

Cophenylcaine forte spray is useful for anesthesia and vasoconstriction.

Following this, the socket may be packed with Kaltostat, (consists of an absorbent fibrous fleece composed of the sodium and calcium salts of alginic acid in the ratio of 80:20) with the patient biting down to provide pressure.

2. Alternatively gauze soaked in 1:10,000 adrenaline solution may be used.

3. Antibiotics

● Will be necessary for secondary infections.

4. Suture:

● If bleeding continues or is severe a silk suture may be placed to close the socket.

Disposition

Admission will depend on the degree of clinical compromise, co-morbidity factors or the presence of an underlying coagulopathy

Dental review

Dr J. Hayes

1 November 2004

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