Most teeth extractions will involve bleeding to some degree, however generally, the application of pressure via a damp gauze will suffice to ensure haemostasis is achieved. However in general dental practice, the most common local anaesthetic used in the UK is lidocaine 2% with 1:80,000 adrenaline, which acts as a vasoconstrictor. This helps with haemostatic during and shortly after the procedure, but after patient’s leave the practice, the adrenaline can wear off, resulting in post-operative bleeding.

The majority of the time, the application of simple measures such as damp gauze and pressure will suffice. Patients who are on anticoagulation or antiplatelet therapy, and patients with clotting deficiencies (e.g. haemophilia, blood dyscrasia, von willibrand disease etc) are more at risk of bleeding (and are often more difficult to achieve good haemostasis).

There is some debate about risk factors for dry socket. A systematic review concluded age, difficult extraction and history of previous infection were risk factors, however consensus was lacking on whether smoking, alcohol and oral contraceptive pill contributed

Reference Taberner-Vallverdu M, Sanchez-Garces MA, Gay-Escoda C. Efficacy of different methods used for dry socket prevention and risk factor analysis: A systematic review. Med Oral Patol Oral Cir Bucal. 2017 Nov 1;22(6):e750-758

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