Healthy gums are not easy to bleed when brushing your teeth . If you brush your teeth frequently and bleed , there must be a problem with your gums. Clinically, the color, shape and quality of the gums can be used to identify whether the gums are ” unharmed “. Healthy gums should be pink in color, firm and elastic. If the gums are congested , edematous or dark red, and feel soft, it indicates that the gums are in a condition. For gum problems, patients should actively cooperate with the treatment and insist on self-control of plaque, in order to save their teeth for a long time or for life.
There are two types of bleeding gums . One is when they are slightly stimulated, such as brushing, eating, and sucking. This bleeding can stop on its own, and the amount of bleeding is less. Another situation is automatic bleeding without any stimulation, the amount of bleeding is large, and there is no self-limitation. The former is related to situational factors; the latter is often caused by systemic factors.
Comprehensive diagnosis of bleeding gums:
(1) Gingivitis and inflammatory hyperplasia: unclean gingivitis , interdental papillitis and gingival inflammatory hyperplasia are common causes of gingival bleeding. Bleeding often occurs when brushing, biting hard food, flossing, or other stimuli, and usually stops on its own. Treatment: First of all, the cause should be removed. If the cause is the irritation of calculus, scaling must be done. If food impaction is involved, food impaction should be corrected. If it is a bad restoration, it should be removed. Followed by the necessary drug treatment to control the infection.
(2) Periodontal disease: The gums of patients with inflammatory periodontal disease are prone to bleeding. In addition, there are still symptoms such as periodontal pocket formation and thickening, alveolar bone resorption, tooth loosening and other symptoms. Although degenerative periodontal disease generally does not have obvious inflammation However, in some cases, there is no obvious periodontal pocket and alveolar bone attraction in the early stage, that is, the chief complaint of bleeding, these patients often cannot find obvious local irritants, only gingival edema, easy to bleed. Treatment can be carried out according to the principles of periodontal disease treatment.
(3) Necrotizing gingivitis: It is a mixed infection of Fusobacterium and oral spirochete. The main manifestations are ulceration of the interdental papilla, necrosis, putrefaction, pain and bleeding gums. During treatment, the oral hygiene should be improved first, gargle with local 3% hydrogen peroxide solution, vitamin C, and antibiotics if necessary.
(4) Pregnancy gingivitis and pregnancy tumor: During pregnancy, the gums are hyperemia, edema, and easy to bleed when touched. After 3-4 months of pregnancy, gestational tumors are prone to occur on the gingival papilla, showing tumor-like hyperplasia, which is easy to bleed when touched. Oral hygiene should be maintained. Pregnancy gingivitis can usually heal itself after childbirth. Pregnancy tumors can shrink or stop growing after pregnancy, and gingival tumor resection can also be performed postpartum.
(5) Liver disease: It can reduce prothrombin or fibrinogen, resulting in poor blood coagulation. When the oral cavity is damaged, persistent bleeding may occur. On examination, hepatomegaly, abnormal liver function, and prolonged coagulation time and prothrombin time were seen. It can be treated with intramuscular injection of thrombin or heparin and injection of vitamin K.
(6) Thrombocytopenic purpura: After the oral mucosa or gums are damaged, the bleeding may not stop; extensive spontaneous bleeding of the gums may also occur. In addition to the oral cavity, ecchymosis may also appear on the skin and internal organs, and the platelet count decreases during the test , Bleeding time is obviously prolonged, whole blood or platelet transfusion can be used during treatment, cortisone, or ACTH, etc. can be used.
(7) Leukemia: The oral gums are swollen and festering with foul-like symptoms, and may suddenly bleed and exudate in small amounts for a long time. In addition, systemic anemia, leukocytosis and immature leukocytes often occur. During treatment, blood transfusion, cortisone, prednisone and other systemic therapy should be taken.
(8) Hemophilia: seen only in males, persistent oozing often occurs after tooth extraction or minor oral injury, and blood coagulation is often prolonged due to lack of thromboplastin. During treatment, whole blood or fresh plasma can be used for transfusion. Thrombin or thromboplastin, etc.
(9) Aplastic anemia: It can also be characterized by extensive bleeding of the gums. It is a group of syndromes caused by marked reduction of red bone marrow and low hematopoietic function, mainly manifested as pan-leukopenia, often with anemia as the first symptom. Blood transfusion can be used.
(10) Tumors: Some tumors that grow on the gums, such as hemangiomas, gingival tumors, etc., are more prone to bleeding. Some tumors that transfer from the actual body to the gums may also cause massive gum bleeding, such as chorioepithelial cancer. Cancer treatment should be started.
