Bleeding dental socket: Difference between revisions
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==Evaluation== | ==Evaluation== | ||
*Clinical diagnosis | *Clinical diagnosis | ||
*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== | ==Management== | ||
Revision as of 18:04, 22 May 2021
Background
Clinical Features
- Bleeding from dental socket
Differential Diagnosis
Dentoalveolar Injuries
Odontogenic Infections
- Acute alveolar osteitis (dry socket)
- Acute necrotizing ulcerative gingivitis (trench mouth)
- Dental abscess
- Periapical abscess
- Periodontal abscess
- Ludwig's angina
- Pulpitis (dental caries)
- Pericoronitis
- Peritonsillar abscess (PTA)
- Retropharyngeal abscess
- Vincent's angina - tonsillitis and pharyngitis
Other
Evaluation
- Clinical diagnosis
- Evaluate for bleeding disorder if bleeding not controlled with simple pressure (post-extraction bleeding often initial manifestation of coagulopathy) [1]
- 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
- Large clots should be wiped away prior to applying gauze
- If direct pressure unsuccessful:
- Lidocaine with epinephrine injection if unsuccessful; 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
References
- ↑ Tintinalli, Emergency Medicine, 4th edition, pg. 1109