Liver clot in dentistry

Liver clots are poor clots that continues to bleed and protrudes from the surgical site.  It looks like liver tissue, thus the name.  Another name for these clots is a currant jelly clot. Typically the patient is on a blood thinner.

Treatment of the liver clot

First of all you should assure the patient that this is not a big deal and can be taken care of quickly and easily. Now the first step is to remove the the clot. In order to do this comfortably you will need to get the patient numb. Once the patient is numb you can remove the clot in any method you want, a large curette or forceps work well. My personal favorite is the salvin currette that has serrations. The clot will mostly stay together. Next use firm pressure or other means to stop the bleeding. If the patient is on a blood thinner, which is a good chance, then use local measures to stop the bleeding. We use a product that is 20$ ferric sulfate. Then allow to heal.

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When do they occur?

After any type of dental surgery a liver clot can form. Different periodontal surgeries, dental extractions and dental implants can all trigger a these clot formations. We have seen them after dental implants and extractions, but they are rare. They are more common in people on blood thinners.

The above photo is an example of a liver clot from a patient that had a dental extraction. After 3 days the patient came in with an area that was still oozing blood. The patient was afraid to touch the area as we tell them not to disturb the blood clot. We remove the clot after getting numb and as you can see the clot grew to the size of a tooth.

Liver clot from a dental flap

Even a simple procedure like a dental flap can cause a liver clot. In this case the clot dissolved the keratinized tissue under the clot. This ultimately resulted in root exposure. This patient was on blood thinner and the tissue was friable, likely the cause of the tissue loss.