Gingival Bleeding

Frequently Asked Questions

1. QUESTION:
   DENTISTS / DENTAL SCHOLARS, could you please comment on my clinical dentistry exam question?
   Dentists / Dental Scholars and or Specialists,

   I would really like a host of professional opinions on the following exam question taken from my final Clinical Dentistry exam. It’s a no-brainer, but for some bizarre reason 4/6 points were scored ‘incorrect’. I wish to consult my examiner and discuss.

   The question was: “List the intra-oral signs of an incorrect brushing technique” (4).

   My answer:
   - evidence of cervical abrasion
   - receeding gingiva
   - inflamed gingiva
   - gingival bleeding
   - plaque buildup
   - calculus

   The examiner marked 4 of those incorrect, however, after researching further I’ve found all of the above to be intra-oral signs of incorrect brushing technique. Please would you comment / confirm below? Thank you in advance. Jon

   • ANSWER:
     Cervical abrasion – excessive forces or brush that is too stiff will wear in the dentinal area near the CEJ, especially in someone with recession

     Receding gingiva – again, excess force with a brush can wear the gingiva

     Inflamed gingiva, Gingival bleeding, plaque buildup – obvious signs that there has been inadequate plaque removal

     Calculus – Inadequate removal of plaque can lead to calculus formation – Although, there are individuals that have impeccable oral hygiene that still have calculus buildup.

     So I agree with your answers. The only one that I see as somewhat questionable is Calculus.

2. QUESTION:
   I don’t know why my aPTT is elevated to 34, and my platelet count is elevated to 392?
   I am a 34 year old women, have never had children, I am not on any blood thinners, I don’t do drugs, I don’t drink. I am an epileptic with an VNS and on Felbatol 600mg four times a day, and my levels are usually low on my Felbatol. I do have some side effects from my med which are pitichea, gingival bleeding. Recently I had galstones, and I frequently get constipated. Occassionally have right quaderant sharp pain. I have been getting out of breath lately, and more tired than usual. My H&H are normal, My PT/INR are normal, MY WBC and RBC is normal, aPTT is 34, Platelet ct 392. I don’t know what this may mean? Can anyone help please??????? My doctor is currently being hush hush with me, and just doing more and more blood test, which so far are fasting and non fasting CBC with and wihtout diff and I thinkd checking my lipids and some others I just don’t know.

   • ANSWER:
     You lab values are at the upper end of the normal range, but not outstanding.
     Platelet: 150-400
     aPTT: 25.9 – 34.9 (critical high >50.0)

     Could be as simple as a case of chronic inflammation.

     Your doctor is requesting lab work and will be the most qualified to provide any necessary treatment.

3. QUESTION:
   please help me with this case?
   a 45 year aged male comes to dental clinic for bleeding from the gums . on examination oral mucosa is pale and there is gingival hypertrophy and bleeding . all the teeth are normal. Laboratory investigations
   show Hb:8 gmldl . TLC 40 000 cell /cmm and platelet count : 42000/cmm . on systemic examination there is mild enlaregement of liver an spleen and bony tenderness.

   please who help me this is an assignment and i don’t knew from where i’ll star
   what is TLC mean :
   why gingival hypertrophy are occuring?

   • ANSWER:
     Hemoglobin is low. Platelet counts are low. TLC= total lymphocyte count = WBC — its is very high.

     Suspect leukemia, lymphoma, or bone cancer (idk)??

4. QUESTION:
   Periodontal issues…what do I do???
   Hello all,

   The past couple of months regarding my gums have been frustrating. My dentist informed that he saw signs of early periodontal disease but that it could be correctable since he noticed it. I have started brushing a new way (not vigorously, but scooping to bring the gums back), and I’ve had several gingival plasties done.

   The main problem is bleeding. It’s NOT chronic, but it is recurring. The last three days it has affected the inner right gum, starting mildly, and now it seems like it’s gushing blood when I brush it, almost to the point where gentle really hurts.

   My dentist and I are frustrated, and he does not know what the problem is. Tomorrow I have an appointment with my doctor for a physical and blood work. I understand that there’s a strong link between gum disease and heart disease, and my dentist said my body chemistry could be changing-I could be diabetic, I may have a high blood cell count, etc. If the exam comes back OK, what will I do? I am frightened!

   • ANSWER:
     You need to see a periodontist, someone who specialises in this area. If your dentist seems no to be assisting you then get a second opinion. Perhaps he did not do a good enough root planing, some cases need root planings done three times. Yes there is a link to systemic problems and periodontal disease. Heart problems donot cause perio disease, it is the other way around. Diabetes can be a cause of perio disease. Go for the physical so that other things can be excluded. If you are otherwise healthy, i suggest go to a periodontist and get advice.

5. QUESTION:
   Worried about peridontal disease….?
   Hello all,

   I am very concerned about my dental health, and don’t know what to do…or where to turn.

   The past few months have been very difficult for me as my dentist tried to explain I am in the beginning stage of periodontal disease. I know that basically, this attacks the gums, and causes the bone structure to loosen. At its most severe, it can cause you to lose your teeth. I bought a Rotadent, and while this has helped somewhat, my gums (particularly the bottom) are still bleeding, and I’ve had peridontal scaling done, and two gingival plastys done too. My dentist told me at this past visit I was brushing the wrong way, that I needed to do this at a 45-degree angle, which I have been doing ever since last Friday. My bottom gums are still bleeding, which is to be expcted, but I am getting frustrated. If plaque is below my teeth where a brush can’t get to it, how can it help me?

   My questions are what’s next? How much more surgery will I need? (I get cleanings every 3 months)

   • ANSWER:
     You haven’t mentioned flossing.
     If you want to really go over the top, you could eat three meals, and brush and floss after every meal, saving sugary snacks after main meals, what really messes gums up is grazing, and snacking inbetween meals.
     You can buy a waterpick from a department store or a good chemist, it shoots jets of water out, and cleans btwn the gums, Americans say, it halts gum disease.
     You could think carefully about the idea of giving up sugar, as people in tribes don’t even have to brush their teeth, and have no gum issues.
     Really good luck, it’s reeally a western problem, we are all in the same boat..

6. QUESTION:
   Im getting Gum Grafting done and am really scared, any advice?
   Ok so this Thursday (april.21) Im told my dentist to go get a Gum Graft done. free gingival graft. Im really freaked out right now after researching it and finding the worst comments about afterwards. Heard the pain and bleeding is horrible and someone mentioned that the pain they endured during treatment after the grafting felt worse than the pain they had giving birth. This is a real scare for me. Im only fourteen. I’ll take advil for sure but does anyone know what happens once i go inside of the room? Whats the procedure like if anyones experienced it before?

   • ANSWER:
     it depends on where you are getting it done. I am guessing that you are going to have it on the bottom teeth in front? thats a common area. they numb you up so you do not feel anything. Once numb they will be scraping the gum that they do not need away from the teeth. Then take tissue from somewhere else to put onto that spot and then will stitch it up. They will probably give you some pain killers just incase you need then, and they should give you a little pack to bring home of stuff to use. If it is still bleeding after a while they usually will tell people to put a tea bag on it and it will help. You should be fine. I would recommend bring something to listen, that should make you less scared.

7. QUESTION:
   How long till I can exercise and drink coffee again after having had oral surgery?
   I had gingival grafting surgery done in my mouth. I was told not to exercise or drink caffeine (as well as other things), which I am both dying for again.

   I got the surgery on Monday (5 days ago), and it’s still swollen, naturally, but not bleeding anymore.

   How long till I can exercise and drink coffee again?
   For anyone reading this post, please DO NOT click on the link provided by the person who answered below. It’s an attack site and it will mess up your computer if you don’t have an ad-blocker.

   • ANSWER:
     1 week

8. QUESTION:
   I think I am developing periodontal disease. Can anyone help?
   Ok, I have bad gingivitis. My gums are puffy and red and they bleed when I floss them. I use listeriene. I brush. I floss. The problem is still here. Over the last 3 years I have had a sucession of cavities develop. Since 2003 I have noticed a rapid decline in my dental health. I had my wisdom teeeth removed in 2004 because they were impacted. Then for two years I wore braces because I had an underbit that was wearing down my front teeth. Most of the cavities developed because of that. I also do not produce enough protective saliva in my mouth. I think I have developed gingival pockets where bacteria is growing. ( That’s just a hunch, not a fact right now.) I see the dentist at ever 5 months. Last time he gave me a bad report and told me I have two cavities now and two areas to watch. He could not fix them at the time due to time constraint. The next time I can do anything is after this quarter at college ends for summer break and I can go home again. I don’t have dental insurance!!!

   • ANSWER:
     are you suffering from any systemic disease like diabetes, etc., You may need deep cleaning & filling up of decay teeth. Your method of flossing & brushing is not correct.