Spontaneous gingival hemorrhage is not uncommon. A history of recent dental therapy such as periodontal scaling or curettage is important because resulting hemorrhage after scaling is easily controlled with peroxide mouth rinses or direct gingival pressure A careful medical history must be obtained because systemic diseases such as clotting factor deficiencies, leukemia, and end-stage liver disease that result in a hypocoagulable state may first manifest as spontaneous gingival hemorrhage. Overanticoagulation with oral agents may present as spontaneous gingival bleeding. The need for laboratory evaluation depends on a careful history and physical examination. Treatment depends on the specific cause of bleeding in the event that local measures are unsuccessful.
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