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Abstract: A 9-year-old girl had frequently noticed gingival bleeding during brushing and eating hard foods for the last six months or so, with relatively small amounts that could stop bleeding on their own, and red and swollen gums, with symptoms occurring repeatedly and intermittently, and never fully recovered before consultation. So supragingival scaling was performed in the outpatient clinic, adjuvant medication was prescribed, and the little girl was asked to enhance oral cleaning, and her gum bleeding and redness were relieved after 1 week.
Basic information】Female, 9 years old
Disease Type】Gum bleeding
Hospital】The First Hospital of Harbin Medical University
Date of Consultation】June 2020
Treatment plan] Scaling treatment (supragingival scaling) + medication (iodine glycerin)
Treatment Period】7 days of outpatient treatment, regular follow-up
Effectiveness】The bleeding and redness of the gums were gradually eliminated and the disease was cured.
I. Initial consultation
The girl was usually healthy and had no other diseases, but she had been experiencing bleeding gums intermittently for the past six months or so, and her parents brought her to the clinic for treatment. In order to better diagnose the disease, we carefully inquired about the medical history and symptoms and learned that the gingival bleeding mainly occurred when brushing and eating hard food, the bleeding volume was small and could stop after a while without pain, and we also observed that the little girl’s gums were red and swollen, her oral hygiene was average, and there was more soft tartar and a small amount of tartar on the lingual side of the anterior teeth, i.e., on the inner side.
Subsequently, the whole jaw surface tomography film was taken, and the results showed that there was no alveolar bone resorption, which could exclude periodontitis, and the blood routine and coagulation function test results were not abnormal, which could exclude bleeding diseases, thus diagnosing gingivitis as the cause of gingival bleeding.
Second, the treatment process
Since the little girl’s gingivitis was related to unsatisfactory oral hygiene, supragingival scaling was used to improve oral hygiene and remove soft scale, which is also commonly known as scaling. The parents were worried that the little girl could not have her teeth scaled, so they talked to the parents and advised them not to worry, as many younger children have had their teeth scaled, and the treatment can be done without damaging the teeth of the child. After the parents agreed to perform supragingival scaling for the little girl, the working head of the ultrasonic scaling machine was used to move back and forth with small to medium power in the location of soft tartar and tartar buildup to gently eliminate the tartar, while the water and saliva were sucked away with a suction tube, the scaling process took about half an hour without pain and the little girl was more cooperative. Iodine glycerin was then chosen to be applied daily to the red and swollen locations of the gums to help eliminate the inflammation of the gums.
III. Treatment effect
After 7 days of scaling treatment and topical application of iodine glycerin to the gum area, the gum swelling of the little girl basically improved, and the gum bleeding did not occur again during the treatment period.
IV. Notes
We are glad that the girl’s bleeding gums were effectively treated, but we need to tell her and her parents that they should pay close attention to whether her gums are bleeding and swollen again in daily life, and that they should not ignore the bleeding gums just because they are not painful. The little girl was advised to keep the habit of brushing and rinsing her teeth. Since she is a student, it is not convenient for her to brush her teeth at school, so it is recommended that she should brush her teeth for at least 3 minutes after breakfast and dinner respectively, and all tooth surfaces should be brushed. There is no mandatory requirement for diet after the gum bleeding symptoms improve, but in order to reduce tartar production, it is recommended to eat a diet low in sugar and high in fiber, eat more fresh vegetables, and avoid eating too hard or spicy stimulating foods.
V. Personal insight
The symptom of bleeding gums is very common in life, and it is also easy to be ignored and misinterpreted. Some people think it is just a fire and does not need treatment, while others think it is a manifestation of blood disorders and stop paying attention to it when they see that the blood routine is normal, which is a wrong approach. In this case, the little girl’s gums were bleeding and swollen, which is more typical of gingivitis. The best treatment for gingivitis caused by poor oral hygiene is scaling, and fortunately the little girl was seen in time and finally cured.