Bleeding after dental extraction: no evidence from randomised trials


Tooth extraction is one of the commonest surgical procedures undertaken and the incidence of post extraction bleeding is reported to be between 0 to 26%. In most circumstances it is easily controlled however it sometimes can result in life-threatening situations. The causes of post-extraction bleeding can be local systemic disease or medication here you and a wide array of techniques have been suggested for the treatment of post-extraction bleeding

The aim of this Cochrane review was to assess the effects of interventions for post-extraction bleeding.


Searches were conducted in the Cochrane oral health trials register Cochrane Central register of controlled trials(Central), Medline, Embase, CINHAL, the US National Institute of health trials registry (Clinical and the WHO International clinical trials registry databases. Randomised controlled trials (RCTs) evaluating any intervention (surgical or non-surgical) for post-extraction pleading of any tooth type were considered.  Three pairs of reviewers screened titles and abstract for eligible studies. Standard Cochrane methodological approaches were to be used for data abstraction and analysis.


No RCTs were identified.


The authors concluded: –

We were unable to identify any reports of randomised controlled trials that evaluated the effects of different interventions for the treatment of post-extraction bleeding. In view of the lack of reliable evidence on this topic, clinicians must use their clinical experience to determine the most appropriate means of treating this condition, depending on patient-related factors. There is a need for well-designed and appropriately conducted clinical trials on this topic, which conform to the CONSORT statement.


This Cochrane review is an update of the same topic initially reported in 2016 (Dental Elf – 14th Jun 2016) unfortunately despite an updated search no randomised trials were identified. While a number of interventions are commonly used to arrest post extraction bleeding it is disappointing that despite affected the fact that post extraction bleeding it Is a common occurrence no randomised controlled trials are available to assist the coalition in determining the most effective treatment.

This topic was identified as a priority area during a Cochrane Oral Health Group prioritisation exercise undertaken in 2014. So it is disappointing that no published or ongoing trials on this topic could be identified so the authors conclusions clearly call for well-designed and appropriately conducted clinical trials on this topic, which conform to the CONSORT statement.


Primary Paper

Kumbargere Nagraj S, Prashanti E, Aggarwal H, Lingappa A, Muthu MS, Kiran Kumar Krishanappa S, Hassan H. Interventions for treating post-extraction bleeding. Cochrane Database of Systematic Reviews 2018, Issue 3. Art. No.: CD011930. DOI: 10.1002/14651858.CD011930.pub3.

Other references

Cochrane Oral Health Group blog – No evidence from randomized controlled trials on how to treat bleeding after tooth extraction

Dental Elf – 14th Jun 2016


Prolonged bleeding after tooth extraction – no evidence on treatment from trials

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Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

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