The Principles And Practice of Tooth Extraction And Local Anesthesia of the Maxillae

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Traumatism.
2. Loosening or disintegration of the primary clot.
Hemorrhage 107 3. Sloughing- of a blood vessel.
4. Lack of coagulative power of the blood.
The first type would constitute primary hemor- rhage, the second and third type secondary hem- orrhage, and the fourth type may be either pri- mary or secondary in character.
Excessive hemorrhage following tooth extrac- tion is caused by, first, local conditions; second, systemic conditions.
Local Conditions 1. An unusual, large alveolar vess
...el.
2. By forcing the alveolar plates asunder while extracting, and thus having a "gaping" vessel.
3. Having a fractured root in the socket acting as a wedge and keeping the alveolar plates apart.
4. Injury of larger vessel. Inferior dental artery in the bicuspid region.
The first step is the careful irrigation of the bleeding socket, removing all traces of blood clot which may partially fill the same.
The alveolus is then probed for fractured root- ends or loose pieces of process. These must be removed.


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