What is the recommended management for a heavy bleeding episode during dental extraction?

• A. Apply firm, continuous direct pressure with gauze for 5-10 minutes; if bleeding continues, check coagulation status and escalate to EMS; avoid NSAIDs that may worsen bleeding if possible
• B. Apply ice only
• C. Use hot compress
• D. Stop treatment and leave patient

Answer: (A)

When heavy bleeding occurs during a dental extraction, the priority is to achieve hemostasis by mechanical means at the source. Pressing firmly and continuously with gauze for several minutes physically tamponades the wound, helping the clot to form and stabilise. This direct pressure creates the initial barrier that stops the bleeding and buys time for the body to fix the vessel.

If bleeding continues after this, it’s important to assess systemic factors that could be contributing. Checking the patient’s coagulation status helps identify an underlying issue or anticoagulant effect, and escalation to EMS or appropriate medical care ensures there are additional measures and monitoring available for more controlled control of the hemorrhage.

NSAIDs should be avoided because they can impair platelet function and worsen bleeding, so use safer analgesia if needed.

Ice alone is not sufficient for stopping a heavy dental extraction bleed, a hot compress would worsen the bleed, and stopping treatment without addressing the bleeding is unsafe.