A New Scale to Classify Post-Operative Bleeding

• Publications Highlights

Authors: Sharon Elad, Greg Connolly, Rita Cacciato, Rebekah Boy, Michael C Leo, William Calnon, Suzanne Gillespie, Denis Nyongesa, Gregg Gilbert, and Cyril Meyerowitz

Post-operative bleeding is a common concern in dental practice, but until now, there has been no standardized way for dentists to classify its severity.

Bleeding after dental procedures, especially extractions and scaling, can range from mild oozing to emergencies requiring hospital care. Yet, definitions of “mild,” “moderate,” and “severe” bleeding vary widely in the literature. This lack of consistency can hinder communication between providers and complicate clinical decision-making.

Led by Dr. Sharon Elad and published in Quintessence International (July 2025), the study surveyed 866 general dentists from the National Dental PBRN. It aimed to:

• Understand how general dentists in the Network classify bleeding severity.
• Explore whether residency training (AEGD or GPR) influences classification.

Survey Highlights

• Participants: 866 general dentists responded to the electronic questionnaire.
• Scenarios: Dentists were asked to classify bleeding events following common procedures such as simple tooth extraction and scaling and root planing.
• Experience: The survey also gathered information on dentists’ experiences with different levels of bleeding complications in their clinical practice.

Key Findings

• High agreement on severe bleeding: Nearly all respondents classified scenarios involving emergency referral or blood transfusion as “major bleeding.”
• Moderate agreement with moderate bleeding: Scenarios such as bleeding lasting 21–30 minutes or resuming after 2 hours showed less consensus.
• High agreement on mild bleeding: Only one scenario (pinkish saliva 24 hours post-extraction) was consistently classified as “minor.”
• No significant correlation was found between bleeding severity classification and completion of AEGD or GPR programs.
• Only 15.5% of dentists had encountered a patient with signs of hemodynamic distress due to bleeding.

A New Severity Scale for Dental Practice

Based on the survey results, the authors propose a four-stage bleeding severity scale, designed to improve documentation, facilitate referrals, and support future research in community dental settings.

What This Means for Your Practice

Having a clear, shared understanding of bleeding severity helps improve patient care. This scale can guide treatment decisions and ensure more-consistent documentation in patient records and research studies. By adopting a standardized classification, dental teams can respond more efficiently to bleeding events and better communicate their observations. We encourage you to review the new bleeding severity scale and consider using it in your practice. Standardizing how you classify bleeding can enhance care quality and contribute to ongoing Network research.

For more details, access the full study here.

Reference