Hemostatic Tampon to Reduce Bleeding following Tooth Extraction

Dear Editor, Bleeding following tooth extraction is of concern to patients. Bleeding due to tooth extraction causes discomfort for patients. Proper control of bleeding is thus important. Postextraction oozing is common. However, bleeding usually stops after gauze is placed over the socket and compressed by biting down on the gauze for 30-60 min. In some patients oozing persists. A combination of local antifibrinolytic therapy and a local hemostatic agent has been shown to be effective in preventing postoperative bleeding after oral surgery. We assessed the effect of a hemostatic tampon in 50 patients (34 men and 16 women) after tooth extraction. A split-mouth study was done on healthy patients (without congenital bleeding disorders, systemic disease, drug use etc) chosen randomly from patients referring for extraction. Patients requiring at least two symmetrical teeth in one jaw were chosen. Ethics committee approval was obtained, and all patients gave written informed consent. Data included the duration, tooth (molar or premolar), complications, as well as the patient’s gender and age. On one side, a hemostatic tampon was used after extraction (the case group) and on the contralateral side dental gauze impregnated with normal saline was used. The type and amount of anesthetic (3% mepivacain HCl) was identical. Extractions were carried out atraumatically. Simple forceps removal was used; after extractions, the sockets were covered with either normal saline soaked gauze or hemostatic cellulose tampon (Dental Cell, Chitotech, Iran; Figure 1). Pressure was then applied by having the patient bite down on the sponge for 2 minutes. All of extraction sites evaluated for bleeding at 2 and 5 minutes after extractions and then the dressing was removed. If bleeding persisted, the gauze was retained and the patient was sent home and contacted the next morning. The duration of active bleeding was assessed both after the first tooth extraction and after the second tooth extraction on the contralateral side (the next week). Both teeth were extracted by one practitioner. The acquired variables (duration of active bleeding, continued bleeding, cessation of bleeding, gender and age) were analyzed (SPSS software, Version 11, USA) and compared by T-test, the Exact Fisher and Chi-Square tests (Values of p≤0.05 were considered significant).