Classification of postoperative bleeding severity by general dental practitioners in the National Dental Practice-Based Research Network: a survey-based assessment

Quintessence Int. 2025 Sep 18;56(8):668-679. doi: 10.3290/j.qi.b6376527.

Abstract

Objective: The objectives of this study were to: (1) describe how general dental practitioners (GDPs) in the National Dental Practice-Based Research Network ('Network') classify the severity of postoperative bleeding; and (2) examine the association between bleeding severity classification and whether the GDP had residency training.

Method and materials: An electronic questionnaire was developed to assess GDPs' classification of bleeding severity for various scenarios following scaling or a single-tooth simple extraction, and to collect information about respondents' experience with bleeding scenarios. A total of 1,815 GDP members of the Network were invited to participate.

Results: A total of 866 GDPs responded. Strong agreement (low variability) was observed for scenarios that were classified as 'severe bleeding' (94.7% to 96.8%), and lower agreement (higher variability) was observed for scenarios classified as 'moderate bleeding' (53.2% to 65.2%). The GDP's classification of bleeding severity was not correlated with training in a General Practice Residency (GPR) or Advanced Education in General Dentistry (AEGD). A minority of respondents had experience with 'major bleeding' that may lead to hemodynamic emergency (15.5%) or a referral to an emergency department (4.8%).

Conclusion: This study identified scenarios for which there is high agreement and low agreement regarding bleeding severity classification among GDPs in the US. A small percentage of respondents had actual experience with major bleeding in their patients. Based on these results, a new tool is proposed to assess the severity of oral bleeding, intended to foster better communication between dental professionals. The new tool may assist GDPs to standardize documentation and communication with other health care professionals. (Quintessence Int 2025;56:668-679; doi: 10.3290/j.qi.b6376527).

Keywords: anticoagulant agents; bleeding; classification; dental; hemostasis; scaling; tooth extraction.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Female
  • General Practice, Dental* / education
  • Humans
  • Internship and Residency
  • Male
  • Postoperative Hemorrhage* / classification
  • Severity of Illness Index
  • Surveys and Questionnaires
  • United States