A patient calls the day after an extraction reporting persistent bleeding from the socket. What is the most appropriate initial management?

Correct answer: B. Ask the patient to come to the clinic for evaluation

• A. Gauze pressure can be instructed over the phone as a temporary measure, but the primary action is clinical evaluation to determine the cause of persistent bleeding.
• B. CORRECT. Bleeding persisting into the next day after extraction is not within normal limits and warrants clinical evaluation. The dentist cannot adequately assess the socket, the nature of bleeding, or any underlying cause over the phone. The patient should come in so the socket can be examined and appropriate intervention (gauze pressure, sutures, hemostatic agents) can be applied.
• C. Some oozing (pink-tinged saliva) the first day can be normal, but active bleeding the next day is not normal and requires evaluation, not reassurance.
• D. Stopping anticoagulant medication without physician authorization is dangerous. Apixaban discontinuation could place the patient at risk for thromboembolic events and should not be advised unilaterally.