Bleeding That Would Not Stop on Motzei Shabbat

Quick answer: Most bleeding that continues after an extraction is not a bleeding disorder — it is a clot that keeps being disturbed. Twenty minutes of firm, continuous pressure on damp gauze, without checking, stops the large majority. If it is still flowing after two proper attempts, you need to be seen.

The call

Motzei Shabbat, about 8:30pm. Chaya, 44, from Nofei Aviv, had had a lower molar extracted on Friday morning. It had settled well. During Shabbat lunch it started oozing again, and by havdalah her mouth was filling with blood every few minutes. She was frightened, and her husband was more frightened.

What we found

She met us at the clinic within the hour.

The picture was clear once we looked. The socket held a large, soft, dark jelly-like clot standing well proud of the gum — what we call a liver clot. It looks alarming and it is entirely counterproductive. A clot of that size cannot retract or organise; it sits there acting as a wick, and the bleeding continues underneath it.

The history explained how it got there. She had rinsed her mouth vigorously several times on Friday evening "to keep it clean". She had eaten a hot fleishig meal on Shabbat. She had checked the socket repeatedly with a mirror, each time pulling the lip and disturbing the forming clot. And every time it bled, she rinsed again.

That cycle — bleed, rinse, disturb, bleed — accounts for most post-extraction bleeding we see. Genuine bleeding disorders are rare and almost always already known about.

She was not on anticoagulants, had no bleeding history, and was not light-headed. Blood pressure was slightly raised, which anxiety explains.

What we did

Removed the liver clot with gauze and gentle suction — the essential first step, because pressure applied on top of it does nothing.

Then irrigated the socket, packed an absorbable haemostatic sponge into it, placed a suture across the socket, and applied firm pressure on damp gauze for twenty minutes by the clock. No peeking.

Bleeding stopped completely. We kept her for another twenty minutes and checked before she left.

The instructions afterwards were the same ones that would have prevented it: nothing hot, no rinsing for 24 hours, no probing with tongue or mirror, sleep with an extra pillow, and soft cold food.

The outcome

No further bleeding. The suture came out at a week and the socket healed normally.

What to do if this happens to you

1. Roll a piece of clean damp gauze (or a folded handkerchief — not tissue, which shreds) into a firm pad, place it directly over the socket, and bite hard for twenty full minutes.
2. Do not check it. Every look restarts the clock. Set a timer.
3. Sit upright, do not lie flat, and stay calm — raised blood pressure makes it worse.
4. A damp black tea bag works as a substitute pad. The tannins help clot formation, and it is a genuinely useful trick.
5. Repeat once if needed. If it is still flowing after two proper twenty-minute attempts, phone for help.
6. Go to hospital if you feel faint or dizzy, if blood is running rather than oozing, or if there is significant swelling.

Bleeding after an extraction in Beit Shemesh or RBS? Call Ramat Beit Shemesh Urgent Dental Care on 055-985-8845 or WhatsApp https://wa.me/972559858845. Harav Kook 28/1, Beit Shemesh.

Based on real cases treated at the clinic. Names have been changed.