View source for Bleeding dental socket

==Background==
[[File:Enamel.png|thumb|Diagram of the tooth displaying the enamel, dentin, and pulp]]
{{Dental numbers}}

==Clinical Features==
*Bleeding from dental socket

==Differential Diagnosis==
{{Template:Dental Problems DDX}}

==Evaluation==
*Clinical diagnosis
*Slight oozing normal for up to 24 hours post-extraction <ref> Hupp J, Tucker MR, Ellis E. Contemporary oral and maxillofacial surgery.6th ed. Mosby, 2013. </ref>
*Evaluate for bleeding disorder if bleeding not controlled with simple pressure (post-extraction bleeding often initial manifestation of coagulopathy) <ref> Tintinalli, Emergency Medicine, 4th edition, pg. 1109 </ref>
**CBC
**PT/INR

==Management==
*Direct pressure on site of bleeding (can have patient bite on gauze or tea bag)
**Pressure should be applied for 20 minutes
**Smaller gauze with focal pressure better than larger gauze that covers adjacent teeth occlusal surface
**Large clots should be wiped away prior to applying gauze
*If direct pressure unsuccessful:
**Lidocaine with epinephrine injection; reapply gauze
**Apply small piece of absorbable gelatin sponge (e.g. - Surgicel)
**Consider [[Tranexamic acid]] (TXA): soak gauze in solution and apply to socket, with pressure
**Flaps may be sutured closed

==Disposition==
*Discharge

==See Also==
*[[Dental problems]]

==References==
<references/>

[[Category:ENT]]
[[Category:Trauma]]
[[Category:Symptoms]]