The method of pain control has already been discussed. That is, choosing techniques and injection sites least likely to result in hematoma formation causing airway obstruction. Consideration may be given to alternative or adjunctive means of pain control to limit or avoid injection into vulnerable areas. Examples of this are sedation techniques or even general anesthesia. Hypnosis has been used as an adjunct in pain control in these circumstances
Some suggestions in this regard are:
• minimize trauma (e.g., elective sectioning of difficult extractions, limiting the number of teeth to be removed at a time depending on the severity of the bleeding defect)
• avoid flaps, as they provide a much greater bleeding area that is harder to control with local measures
• choose surgical and closure techniques that permit easy access for packing, suturing, cautery, etc.
• strive to obtain primary surgical closure
• remove all granulation tissue from areas of chronic inflammation.