Bleeding gums

Introduction Gingival bleeding is one of the common symptoms in dentistry. In general, gum bleeding is common in the early stages of periodontitis - gingivitis. Gum bleeding does not only occur in dental diseases, it also occurs in other diseases of the body, which may indicate other system diseases, such as leukemia, exposure to radioactive radiation, autoimmune diseases, etc. In recent years, periodontal disease and The relationship between diabetes is increasingly recognized by the medical community.

Cause

Causes of bleeding gums

When the plaque in the oral cavity is formed on the surface of the tooth, if it is not removed in time, it can gradually harden and form calculus. The calculus is located at the junction of the tooth and the gum. This hard tartar has a continuous stimulating effect on the gums. When the normal gums are stimulated by inflammation, the capillaries of the gums increase, become hyperemia, and the gums become darker. But if you are stimulated, your gums will easily bleed. This is the cause of gum bleeding. Since gingivitis is an early stage of periodontitis, regular gingival (washing) to remove tartar from the tooth to relieve inflammation of the gums can restore gingivitis.

In periodontitis, not only the gums are bleeding, but also the teeth begin to loosen. Only regular scaling (washing) can not restore the lesions. Only by scaling and other periodontal treatment or periodontal surgery can the symptoms be alleviated.

The general oral theory believes that gum bleeding is caused by the lack of vitamin C in the gum tissue, which triggers the breeding and outbreak of an anaerobic bacteria. This statement is only explained by the surface phenomenon, and actually does not find the root of the problem.

In fact, modern physiological studies have found that bleeding gums is a premature physiological degradation of the gum tissue, which in turn leads to gingival dystrophies. Therefore, simply taking a large amount of vitamin C is a temporary solution. In addition, there are many health care theories that the bleeding of the gums is caused by the fire. There is also a misunderstanding, which is the interpretation of the concept of getting angry. It is widely understood that the 'fire on the fire' belongs to the Western medicine theory, and the traditional Chinese medicine said that 'internal fire' 'wet fire' is completely different concepts. Gum bleeding belongs to the latter's theoretical category, so the majority popular in the market Oral hygiene products, with disinfection and sterilization as a means, have no fundamental effect on the treatment of gum bleeding. There are also some dental products that confuse gum bleeding with traumatic bleeding, and it is far-fetched to say that hemostasis and anti-infection.

To completely solve the problem of bleeding gums, it is necessary to start from the roots, to supplement the nutrition of the gums, to find and provide nutrients that can directly absorb the gums, so that the degraded gum tissue can re-improve the immunity, in order to fundamentally solve the bleeding of the gums. Brought a series of dental problems.

an examination

Related inspection

Oral endoscopic oral X-ray examination of middle-aged male physical examination

Examination of bleeding gums

There are two cases of bleeding gums. One case is mild irritation such as brushing, eating, sucking, etc., which can stop on its own and has less bleeding. Another case is automatic bleeding without any stimulation, the amount of bleeding is more, there is no self-limiting, the former is related to the situational factors; the latter is often caused by systemic factors, the diagnosis of the comprehensive gum bleeding is as follows:

(1) sputum inflammation and inflammatory hyperplasia: unclean gingivitis, interdental papillitis and gingival inflammatory hyperplasia, etc., is a common cause of bleeding gums. Often when you brush your teeth, bite hard food, pick up your teeth or other irritations, you can stop yourself. Treatment: First, the cause should be removed. If the disease is caused by tartar stimulation, it must be treated with scaling. If the food is invaded, the food impact should be corrected. If it is a bad restoration, it should be removed. Second, give the necessary medication to control the infection.

(2) Periodontal disease: The gums of patients with inflammatory periodontal disease are prone to bleeding. In addition, there are symptoms of periodontal pocket formation and overflow, alveolar bone resorption, loose teeth, etc., although degenerative periodontal disease is generally not obvious. However, in some cases, there is no obvious periodontal pocket and alveolar bone attraction in the early stage, that is, the main complaint of bleeding, these patients often can not find obvious local stimuli, only gingival edema, easy bleeding. Treatment can be treated according to the principle of periodontal disease treatment.

(3) necrotizing gingivitis: a mixed infection of Clostridium and oral spirochetes. Mainly manifested as ulcers, necrosis, rancidity, pain and gum bleeding in the interdental papilla. At the time of treatment, the oral hygiene should be improved first, and 3% hydrogen peroxide solution should be used topically, and vitamin C should be given, and antibiotics should be given if necessary.

(4) gingivitis and pregnancy tumor during pregnancy: during pregnancy, the gums are congested, edema, and easy to bleed. After 3 to 4 months of pregnancy, the pregnancy tumor is prone to occur on the gingival nipple, showing tumor-like hyperplasia, which is easy to hemorrhage. The oral cavity should be kept clean and hygienic. The gingivitis of pregnancy can be self-healing after delivery. The pregnancy tumor can be reduced or stopped after pregnancy, and the tumor can be resected after delivery.

(5) Liver disease: It can reduce prothrombin or fibrinogen, resulting in poor blood coagulation, and continuous bleeding can occur when the oral cavity is damaged. Hepatic enlargement, abnormal liver function, clotting time and prolonged zymogen time were observed during the examination. Intramuscular injection of thrombin or heparin can be administered by injection of vitamin K.

(6) thrombocytopenic purpura: after the oral mucosa or gums are damaged, bleeding can be more than; can also occur extensive bleeding of the gums, in addition to oral cavity, skin and internal organs can also appear ecchymosis, platelet count decreased during the test The bleeding time is obviously extended. You can use whole blood or platelet input during treatment. You can use cortisone, or ACTH, etc.

(7) Leukemia: Oral gingiva is now a swollen, swollen, festering, and sudden large bleeding can be exfoliated for a long time. In addition, systemic anemia often occurs, white blood cells and immature leukocytes increase. When treated, blood transfusion, cortisone, prednisone and other systemic treatments should be taken.

(8) hemophilia: only seen in men, more frequent oozing after tooth extraction or slight oral injury, often due to lack of thromboplastin caused by prolonged blood coagulation, treatment can take whole blood can be fresh plasma input, local Thrombin or thromboplastin can be used.

(9) Aplastic anemia: It can also be counted as extensive bleeding of the gums. It is due to the obvious reduction of red bone marrow and a group of syndromes caused by hematopoietic function. The main manifestation is the reduction of whole white blood cells, often with anemia as the first symptom. Blood transfusion can be taken.

(10) Tumors: Some tumors that grow on the gums, such as hemangioma, gingival tumors, etc., are more likely to bleed. Some tumors that are transferred from the body to the gums may also cause bleeding in the gums, such as chorionic epithelial cancer. The treatment of the tumor should be initiated.

Differential diagnosis

Congestive symptoms of gingival bleeding

1. The gum tissue is red, swollen, bleeding and burning. If the mouth of the periodontal pocket is closed and the drainage of the pus is not smooth, the periodontal abscess may occur and the symptoms such as pain and body odor may occur. Initial diagnosis: periodontitis.

2, bleeding gums, or accompanied by nasal skin and mucous membrane bleeding, ecchymosis, accompanied by loss of appetite, nausea, vomiting, abdominal fullness, weight loss, fatigue, pigmentation, dark complexion, palm texture and skin wrinkles, etc. , or have jaundice fever, ascites, hepatosplenomegaly and so on. Initial diagnosis: cirrhosis of the liver.

3, bleeding gums, early polyuria, nocturia, oliguria in the late stage, or even no urine, loss of appetite, nausea, vomiting. In the middle and late mouth, there are ammonia smell, diarrhea, elevated blood pressure, dizziness, headache, memory loss, sleep disorders, and loss of libido, anemia, and bleeding. Initial diagnosis: chronic renal failure.

4, anemia, bleeding, fever, easy infection, etc., patients with palpebral conjunctiva and nail bed pale, bleeding gums, or accompanied by skin and mucous membrane bleeding and visceral bleeding, such as hematemesis, blood in the stool, hematuria, uterine bleeding, fundus hemorrhage and intracranial hemorrhage, etc. Fever and serious infection, body temperature is often above 39 °C. Initial diagnosis: aplastic anemia.

5, bleeding gums, or nosebleeds, skin and mucous membrane bleeding or visceral bleeding, fever, anemia, hepatosplenomegaly, swollen lymph nodes, or headache, vomiting, chest pain, bone and joint pain. Initial diagnosis: leukemia.

6, bleeding gums, tooth pain, gums overflowing. Or both have fundus hemorrhage, or with cardiovascular and cerebrovascular disease, urine sugar or blood glucose positive. Initial diagnosis: diabetes.

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