About all

Hematoma in mouth: Soft Tissue Mouth Trauma | Dentist in Fort Collins, CO


Soft Tissue Mouth Trauma | Dentist in Fort Collins, CO

Here at Big Grins, we can offer assistance with soft tissue mouth trauma for children. If you would like more information on soft tissue mouth trauma in Fort Collins, Colorado, we invite you to call us at 970-407-1020 today and schedule an appointment for your child with our pediatric dentists, Dr. Greg Evans and Dr. Rachel Ecker.


Lip or Gum Laceration

What is this? A child can swallow and bite teeth together without pain. After wiping with a wet towel, the bleeding or bruise is localized to lip or gum.

Situation: Lip or gum laceration with blood or hematoma (bruise without blood).

What else it could be: Tooth subluxation (tooth tender to touch).

Through and through puncture wound

Is this an emergency, urgency or problem? Problem.

Unless a lip injury is a puncture wound that goes from inside the mouth all the way to the outside, the child should recover without aid. The lip will swell quickly over 48 hours and then recede.

For a puncture wound or a wound where fat tissue or glandular tissue is protruding, antibiotics and referral for sutures or emergency department is necessary.

Telling the parent: Explain the history of the injury and that lips are very vascular and swelling will occur. Suggest ibuprofen or acetaminophen (Tylenol), given as directed on the bottle. Limit any activity that may re-injure the area. Suggest a trip to the dentist if concerned. The diet is usually self-limiting but advise soft foods for two days.

First aid: If bleeding, compress with a wet towel or ice. Provide over the counter analgesia.

Follow up: None necessary if minor. Refer as directed above.

Frenum Tear

What do you see? Child has a cut on tissue connecting gums to the lip. May be bleeding freely.

This is a frenum tear.

What else it could be: Lip laceration due to fall.

Foreign body puncture wound.

Is this an emergency, urgency, or problem? Problem.

This is a frequent injury of childhood, decreasing in frequency as the child ages. The frenum on children has a low attachment and is very vascularized. With a fall that catches the lip or a sports collision, the lip will lift up and the frenum will tear with a great deal of blood. For healthy children, the clotting stops the bleeding within 10 minutes if the child can calm and not move the lip or injury. No therapy is necessary and the frenum will heal in time.

What to tell the parent: Explain the history of the injury and that this injury happens to almost half of all children. The area will heal in seven days but be sore if hit or brushed with a toothbrush. Careful brushing is a must. Sometimes a small bleb of tissue is left when the frenum heals, forming a small bump; that, too, will remodel over time and will not interfere with speech or bite.

First Aid: Find the source of the bleeding and apply pressure with a wet towel or gauze. Some advocate a wet tea bag for clotting, but the bleeding will stop in 10 minutes.

Follow up: None necessary.

Lip Bite

What do you see? Child has a cut and white plaque on lip. May be oozing blood and broken open.

This is a lip bite with a fibrin clot or a scab that has lost its pigment.

What else it could be: Lip laceration due to fall.

Foreign body puncture wound.

Is this an emergency, urgency or problem? Problem.

This is a frequent injury of childhood, decreasing in frequency as the child ages. Following dental treatment, the lip remains numb for two to three hours. During this time, young children can bite quite hard upon that rubbery thing on their face, not realizing it is their lip. For healthy children, the white clotting stops the bleeding within 10 minutes if the child can calm and not move the lip. No therapy is necessary, but the lip can also swell rapidly for 24 hours, and reinjury is a concern. Time will heal this injury, but it is upsetting to child and parent.

What to tell the parent: Explain the history of the injury and that this injury happens to many children. The area will heal in seven days but be sore if hit or bitten again. Careful brushing is a must. Swelling will go down quickly, so ice will not help. Ibuprofen is recommended for pain.

First aid: If the child is still numb, place a rolled gauze between teeth and tell the child to hold in place to prevent chewing. For young children who cannot understand this, give them a snack. They will chew the snack and not their lip.

Follow up: None necessary.

Tongue Laceration

What do you see? Obvious cut or trauma to tongue. This cut may be deep but does not flap open. It slows then restarts bleeding with activity of child. Very painful with the occurrence, then betters quickly over next 30 minutes.

This is a: Tongue laceration from biting or foreign object.

What else it could be: Irritation to tongue from orthodontic appliance.

Infectious disease.

Is this an emergency, urgency or problem? Problem.

Unless a tongue cut is more than a centimeter wide or is so deep that muscle tissue is protruding, it will heals on its own without stitches. OTC pain reliever and calm behavior will allow the cut to eventually clot and heal. Oozing of blood is not a concern. A popsicle may help alleviate pain and keep the tongue in place. If a tooth is chipped (rough or sharp incisor or inside cusp tip of molar), it is not a bad idea to feel the tongue with a gloved finger to look for the chip inside the wound. This is not a huge issue if it cannot be accomplished due to behavior. No referral is necessary unless it is deep or has any protruding tissue.

Check health history for bleeding disorders that would slow clotting to more than 10 minutes (really long minutes if you are timing it).

What to tell the parent: Explain the history of injury and that the tongue is very vascular and muscular so oozing of blood is okay. Tell them if it bleeds like a nosebleed, seek emergency care. Suggest ibuprofen or Tylenol as directed on the bottle. Limit any activity that may reinjure area. Offer trip to dentist if concerned. Diet is usually self-limiting but advise softer foods for two days.

First aid: Wet towel if bleeding. Popsicle works better. OTC analgesia.

Follow up: None necessary if minor. Refer as directed above.

Floor of the mouth hemorrhage subsequent to dental implant placement i

Bleeding during dental implant surgery can be a serious complication especially when it occurs in the floor of the mouth and this has been previously reported. 1–9 The vascular supply to this area is rich and variable.1 The lingual artery emanates from the external carotid artery along with the facial artery. At times these are conjoined in a single trunk. The lingual artery courses anteriorly giving off the deep lingual artery, to supply the tongue, and the sublingual artery, to supply the floor of the mouth. Ultimately, the sublingual artery enters the anterior mandible through the lingual cortex (Figures 1 and 2). There may be a single-entry foramen or multiple entry foramina. During a dental implant osteotomy in the anterior mandible an intra-osseous or extra-osseous perforation of the sublingual artery can occur.6,10,11 The resulting hematoma can be a serious complication.6

Figure 1 Schematic drawing of potential locations of the lingual foramina marked in green. The red lines depict the course of the sublingual artery. The lingual foramina can be single or multiple. A large single foramen may contain an artery of significant diameter to cause a significant hemorrhage if severed.

Figure 2 This cone beam computerized tomogram of an anterior mandible shows a slice of the radiographic anatomy of the anterior mandible. Note the lingual canal (A) and the genial tubercle (B).

A literature search was done for this report and found that the reporting of this complication is not replete, suggesting that it may be uncommon (Table 1). Nonetheless, floor of the mouth bleeding is potentially a life-threatening event and hemorrhage control may require hospitalization and intubation or tracheostomy.2–9 If there is deemed a risk for airway compromise, the first priority is to maintain the airway with a tube to avoid a later forced intervention that may create mucosal bleeding that would impair visualization and bleeding down the trachea.

Table 1 Articles published on severe bleeding complications after dental implant placement in the anterior mandible.

Case series

Case 1

A 56-year-old male with an insignificant medical history was referred to the Oral Surgery Division (Valencia University Medical and Dental School, Valencia, Spain), for oral rehabilitation with dental implants. Due to his age, his ASA status was deemed 2.

The patient presented with an ill-fitting and a mandibular complete denture. A comprehensive oral exam, including panoramic radiographs and blood clotting capability were performed. This patient had moderate osseous atrophy of the mandible, so a regenerative procedure was deemed unnecessary for a successful implant retained denture outcome. Treatment options were presented to the patient and a conventional tissue supported mandibular denture with a two implant-retained mandibular overdenture were planned.

Subsequently, the patient was administered 3.6cc infiltration local anesthesia with articaine 4% with noradrenalin 1:100,000 (Artinibsa, Laboratorios Inibsa, Granollers, Barcelona, Spain) infiltration, facially and lingually at the anterior mandible.

A mucoperiosteal flap was raised inter-foraminally and the residual ridge was found to be of adequate bone volume to accept Phibo TSA® implants (Phibo Dental Solutions, Sentmenat, Barcelona, Spain) (3.7 mm diameter X 11.5mm length) at sites #22 and #28 (Figure 3).

Figure 3 Panoramic radiographic view of the implants placed in Case 1. Note the apparent “safe” positions. There was an apparent severance of a branch of the sublingual artery that caused a significant hematoma.

The flap was slightly apically repositioned and sutured to provide increased attached tissue. At this time, a swelling of the floor of the mouth was noted. In less than 20 mins an expanding hematoma forced the tongue against the palate that hindered but did not block normal breathing (Figure 4). 3 platelets/microliter, coagulation INR (international normalizing ratio) 1 (<3), and prothrombin time 12 (5–13 sec). These values were found to be within normal limits. After careful monitoring for three hours the hematoma did not expand but did not diminish. A tracheostomy was placed between the first and second tracheal rings, the implants were removed as a precaution, and compression was applied. No post-operative CBCT (cone beam computerized tomogram) was able to be taken in this hospital and emerging conditions precluded a CBCT. The hematoma did finally decrease in size the following day, and the patient was discharged after 2 days in good condition. Subsequently the implants were replaced, and a successful overdenture was fabricated.

Case 2

An 80-year-old male with an unremarkable medical history was referred to our Oral Surgery Division for oral rehabilitation with dental implants. His ASA status was deemed 2.

The patient presented with a complete denture in the maxilla and several remaining root fragments in the mandible. The maxillary denture was in satisfactory condition and did not require re-fabrication. In the mandible, the treatment plan was to extract the remaining roots and placement a full arch 6 implant supported implant fixed prosthesis. The mandible had moderate to severe atrophy in the posterior region, but only slight osseous deterioration in the anterior where the implants were to be planned.

3.6cc articaine 4% with noradrenalin 1:100,000 (Artinibsa, Laboratorios Inibsa, Granollers, Barcelona, Spain) infiltration was administered facially and lingually at the anterior mandible.

Adequate attached tissue and bone volume enabled a flapless procedure. Five 3.8mm diameter X 13mm length implants were placed (Sweden & Martina, Padua, Italy) in positions #21, 22, 23, 26 and 29 (Figure 5). One less implant was placed due to a spacing issue during placement. The next day, the patient returned complaining of a floor of the mouth swelling. There was a small non-expanding stable hematoma under the tongue that did not compromise breathing swallowing or speech (Figure 6). On CBCT, the implants did not encroach on the inferior alveolar canal and the lingual cortical plates were found intact (Figure 7). The patient was admitted to a local hospital for compression and observation. The sublingual hematoma resolved spontaneously after 48 hrs. The implants were not removed. The patient was subsequently rehabilitated with a full-arch implant-supported fixed prosthesis.

Figure 5 Panoramic radiographic view of the multiple implants placed in the anterior mandible. A subsequent floor of the mouth hematoma formed in this case.

Figure 6 A hematoma of the floor of the mouth formed after dental implant placement that was reported the following day. Compression was applied, and the swelling resolved after 48 hrs.

Figure 7 Cone-beam computed tomography of Case 2 shows that the dental implant in position 22 is close to a mandibular lateral lingual canal. A small branch was probably severed to produce the hematoma.


Generally, the anterior mandible is considered a relatively complication free zone for dental implant surgery. Nonetheless, since every patient is not “normal”, they may present with non-uniform anatomical features. The prudent implant surgeon should prevent operative issues by thoroughly understanding the anatomy of the operative site.1–8 Cone beam computerized tomograms (CBCT) can reveal intra-bony vascular canals that may contain a significant artery.1–8 While a pre-operative CBCT is not an absolute necessity, the surgeon should be aware of the patient’s anatomy and be prepared to control any incidental arterial hemorrhage.

These cases demonstrate that severe bleeding is possible from implant surgery in the anterior mandible.2–9 Although an exploratory dissection was not done, the sublingual artery is the most likely vessel to cause such a serious hemorrhage. The sublingual artery is a terminal branch of the lingual artery which in-turn emanates from the external carotid artery.1 The sublingual artery generally penetrates superiorly through the genioglossus muscle (Figure 2). It then courses on to penetrate the lingual surface of the anterior mandible. There may be a single entry or multiple foramina that emanate.1–9 A single entry may have a larger diameter artery and thus more dangerous for a floor of the mouth hemorrhage. While multiple entries may indicate multiple small diameter vessels that may not have significant exsanguination if violated (Figure 1). Vessels as large as 3mm in diameter have been measured which if severed could produce a significant hemorrhage.9

It is possible for the sublingual artery to be severed intra-osseously, as seen in patient #2.10,11Figure 7 shows that the implant need not penetrate the lingual cortical plate in order to have a floor of the mouth hemorrhage (Figure 1). The terminus of the sublingual artery is held fast by connective tissue in the foramen (nutrient canal) and thus enables an osteotomy drill to cut it through.9,10 The severed proximal artery has a vasospasm and retracts into the floor of the mouth and exsanguinates, creating a hematoma.11 This hematoma can be expansive due to anastomosing with contralateral mates and the submental and incisive arteries.2–9 The expanding hematoma may impede breathing by forcing the tongue against the soft palate and into the pharynx.

A hematoma emanating from the sublingual artery does not usually connect with the submandibular space as does the submental artery.2–9 A truly life-threatening hemorrhage can occur if a hematoma occurs in the submandibular space and expands against the pharynx. This can occlude the airway. The sublingual space is separated from the submental space by the genioglossus and mylohyoid muscles.1

In order for the hemorrhage to involve the submental space the nutrient canal would be located inferior to the genioglossus and mylohyoid muscles. The submental space can communicate with the submandibular space posteriorly.1 Thus, the patient should be monitored as to the size and expansion rate of any hematoma and for the need of an airway intervention. It may be necessary to maintain the airway with an airway tube to avoid a later forced intervention that may create mucosal bleeding that would impair visualization and bleeding down the trachea. The first patient Case 1 underwent a tracheostomy to secure the airway as a precaution, though the second patient was monitored in hospital until the sublingual hematoma resolved.

In our literature review, most patients were hospitalized and underwent intubation or tracheostomy (Table 1).4 An assessment of the hematoma and its rate of expansion should be evaluated before committing to a hospitalization. Nonetheless, a patient’s life should not be endangered by underestimating the hematoma. Hospitalization may be required to preclude a fatality.

The submental artery is a branch of the facial artery and travels close to the medial aspect of the mandible. With age and edentulism it may occur directly against the mandibular fossa. Here a lingual perforation may damage the artery and create a life-threatening hemorrhage in the submandibular space.

Previous reports of floor of the mouth bleeding involved implant lengths of 12 and 15 mm.2–9 In the cases presented herein were 11.5 and 13 mm. Nonetheless, relatively long dental implants are not generally needed for adequate support or retention of overdentures or fixed prostheses.17 The anterior mandible generally is composed of dense bone that is very supportive for clinical loading of dental implants. However, narrow diameter implants, less than 3mm, may require much longer length for load resistance. Longer implants may increase the risk for an arterial encounter.

In a literature review of twenty-five reports by Law and coworkers of floor of the mouth hemorrhages, 17 of 21 (84%) of cases were the result of lingual cortex perforations.18 Management of these were variable and included removal of the implant or aborting of the procedure but most were left in place. Leaving the implant in place prevents blood escaping into the mouth and provides back pressure on the hematoma to induce cessation of the hemorrhage.18 Nonetheless, removal of the implant may be done if there is no bleeding through the osteotomy. This may occur if the soft tissue accepts the expanding hematoma volume. Only one case in this review was done with the benefit of preoperative CBCT. This demonstrates the importance of preoperative CBCT examination of the surgical site to help prevent complications.18 A post-operative, intra-catastrophe, CBCT may be difficult or impossible to accomplish due to the need for attention to bleeding control. Ascertaining the apical location of the implant may be an academic exercise since the bleeding control is paramount and the artery involved would most likely be the sublingual. Although information may be ascertained, a CBCT at this point may be a distraction.

The intra-osseous incisive artery, the terminus of the inferior alveolar artery, is usually small but anastomoses can contribute for a significant exsanguination.19 A severance of this artery may be best managed by simply placing an implant into the osteotomy. The mandible is a closed space and thus would contain the bleed.

Dental implant surgeons should have a thorough knowledge of the anatomical features of a surgical site to avoid operative risks. A CBCT can reveal anatomical structures to be avoided. Vascular nutrient canals may contain significant arteries that can be damaged during an osteotomy. These need to be identified pre-operatively.20 Pre-operative planning for an appropriate implant diameter and length can be accomplished on a CBCT.21

No attempt was made in these cases to ascertain the exact hemorrhagic culprit. Nonetheless, it may be stated with some confidence, based on CBCT evidence, that these bleeds were indeed originating from the termini of the sublingual arteries.

Bleeding was immediate in the first case and in the second case reported the following day. Other reports show that bleeding can be immediate or not be evident for up to 7 hrs post-operatively.22 An arterial transection will cause a vasospasm that slows bleeding and retraction of the artery.4–6,21 Coupled with the vasoconstrictors used in local anesthetics, this phenomenon may delay bleeding for several hours.4,22

Management of a sublingual hematoma may be to compress it and wait for resolution.5,6 Compression would prevent the hematoma from expanding and blocking the airway. Careful monitoring of the airway is important to preclude asphyxiation. The pressure exerted by the enclosing tissues will contain the hematoma and stop further bleeding into the created hematoma space. Compression with ice would help prevent expansion of the hematoma. Any attempt to ligate a severed sublingual artery may result in a severe exacerbation.5,6 A dissection for access of this area may invite further exsanguination due to the multiple anastomoses of the nearby arteries. The arterial bleeding would then not be contained.5,6 A ligation of the severed floor of the mouth artery is possible but would be extremely difficult due to the exsanguination blocking visualization and complexity of the arterial anastomosing in this area.6

In the anterior mandible, it may be best to use narrow diameter implants to minimize the risk for an arterial encounter. The implants may be placed a few millimeters away from the midline to potentially avoid a single large sublingual artery.23–25 The bone in the anterior mandible is generally very dense and would be supportive of narrow diameter implants to resist occlusal loading.6 The loads in the anterior jaws are generally about a third of those in the posterior.6

The sublingual artery typically enters the lingual of the mandible superior to the genial tubercle.1 A ridge with substantial height may allow longer implants that would not encounter the artery. With atrophy, the height of the edentulous ridge decreases and the crest approaches the sublingual foramen thus putting the artery in peril of being cut by an implant drill. However, as the osseous atrophy continues the need for vascular supply diminishes and the sublingual artery may atrophy as well. In the anterior mandible, the major vascular osseous supply comes from the facial artery via the periosteal capillaries.6

A floor of the mouth hemorrhage that is not controlled can result in fatality.5,6,25,26 The implant surgeon should be prepared to perform a tracheotomy if the patient does indeed begin to asphyxiate. Generally, the best site to access the trachea is the first tracheal ring. This is superior to the thyroid gland and inferior to the vocal chords.26

Law and coworkers published a literature review that found only one case in 25 where there was a preoperative CBCT.18 They emphasized the importance of anatomical assessment to prevent surgical complications.18

Lee et al, reported a “brisk, pulsatile bleeding from … the incisive canal” in the mandible which was successfully controlled with a “hemostatic matrix”. When there is direct access, use of a directly applied tamponade of a choice of various compositions can be used to control hemorrhage.6,35

Flapless implant placement requires knowledge of the osseous morphology and location of anatomic landmarks.6,11

Flapless placement may have fewer complications than open flap procedures due to the pervasive preoperative work-up required.


The present report describes two cases of bleeding complications after implant osteotomy surgery. These cases highlight the anterior region of the mandible for this kind of complication. Management may entail compression of the hematoma with intra-oral ice packs and monitoring for resolution of the sublingual hematoma according to the severity of the situation. Hospitalization may be indicated. The encasing tissues would contain the hematoma and stop further bleeding. Nonetheless, any expanding hematoma must be contained to prevent blockage of the airway by the tongue being pushed against the palate. The priority is to maintain the airway to prevent a subsequent forced entry, which may itself cause bleeding into the airway, further complicating the problem. Any attempt at a dissection to ligate the cut artery may create more severe bleeding from the local anastomosing arteries.

Ethical approval

The report of these cases was approved by the University of Valencia, Valencia, Spain.

Informed consent

Both patients signed written informed consents for treatment and publication of case details.

Author contributions

All authors contributed to data analysis, drafting and revising the article, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.


The authors report no conflicts of interest in this work.


1. Standring S. Ed Gray’s Anatomy the Anatomical Basis for Clinical Practice. 39th ed. In chief. Edinburgh: Elsevier Churchill Livingstone Chapter 33 Oral Cavity; 2005:583–587.

2. Dubois L, de Lange J, Baas E, Van Ingen J. Excessive bleeding in the floor of the mouth after endosseous implant placement: a report of two cases. Int J Oral Maxillofac Surg. 2010;39:412–415. doi:10.1016/j.ijom.2009.07.062

3. ten Bruggenkate CM, Krekeler G, Kraaijenhagen HA, et al. Hemorrhage of the floor of the mouth resulting from lingual perforation during implant placement: a clinical report. Int J Oral Maxillofac Implants. 1993;8:329–334.

4. Tomljenovic B, Herrmann S, Filippi A, Kühl S. Life-threatening hemorrhage associated with dental implant surgery: a review of the literature. Clin Oral Implants Res. 2015;27(9):1079–1084. doi:10.1111/clr.12685

5. Kalpidis CDR, Setayesh RM. Hemorrhaging associated with endosseous implant placement in the anterior mandible: a review of the literature. J Periodontol. 2004;75:631–645. doi:10.1902/jop.2004.75.5.631

6. Flanagan D. Important arterial supply of the mandible, control of an arterial hemorrhage, and report of a hemorrhagic incident. J Oral Implantol. 2003;29:165–173. doi:10.1563/1548-1336(2003)029<0165:IASOTM>2.3.CO;2

7. Lamas J, Peñarrocha M, Martí E, Peñarrocha M. Intraoperative complications during oral implantology. Med Oral Patol Oral Cir Bucal. 2008;13:239–243.

8. Balaguer-Marti JC, Peñarrocha-Oltra D, Balaguer-Martinez J, Peñarrocha-Diago M. Immediate bleeding complications in dental implants: A systematic review. Med Oral Patol Oral Cir Bucal. 2015;20(2):e231–e238. doi:10.4317/medoral.20203

9. Mardinger O, Manor Y, Mijiritsky E, Hirshberg A. Lingual perimandibular vessels associated with life-threatening bleeding: an anatomic study. Int J Oral Maxillofac Implants. 2007;22:127–131.

10. Isaacson TJ. Sublingual hematoma formation during immediate placement of mandibular endosseous implants. J Am Dent Assoc. 2004;135(2):168–172.

11. Flanagan D. Implants and arteries. J Am Dent Assoc. 2004;135:558. (one page). doi:10.14219/jada.archive.2004.0232

12. Krenkel C, Holzner K. Lingual bone perforation as causal factor in a threatening hemorrhage of the mouth floor due to a single tooth implant in the canine region. Quintessenz. 1986;37:1003–1008.

13. Mason ME, Triplett RG, Alfonso WF. Life-threatening hemorrhage from placement of a dental implant. J Oral Maxillofac Surg. 1990;48:201–204. doi:10.1016/S0278-2391(10)80211-3

14. Mordenfeld A, Andersson L, Bergström B. Hemorrhage in the floor of the mouth during implant placement in the edentulous mandible: a case report. Int J Oral Maxillofac Implants. 1997;12:558–561.

15. Darriba M, Mendonça-Caridad JJ. Profuse bleeding and life-threatening airway obstruction after placement of mandibular dental implants. J Oral Maxillofac Surg. 1997;55:1328–3130. doi:10.1016/S0278-2391(97)90195-6

16. Panula K, Oikarinen K, Worthington P. Severe hemorrhage after implant surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999;88:1–3. doi:10.1016/S1079-2104(99)70204-0

17. ELsyad MA, Shaheen NH, Ashmawy TM. Long-term clinical and prosthetic outcomes of soft liner and clip attachments for bar/implant overdentures: a randomized controlled clinical trial. J Oral Rehabil. 2017;44(6):472–480. doi:10.1111/joor.12500

18. Law C, Alam P, Borumandi F. Floor-of-mouth hematoma following dental implant placement: literature review and case presentation. J Oral Maxillofac Surg. 2017;75(11):2340–2346. doi:10.1016/j.joms.2017.07.152

19. Mardinger O, Chaushu G, Arensburg B, Taicher S, Kaffe I. Anatomic and radiologic course of the mandibular incisive canal. Surg Radiol Anat. 2000;22(3–4):157–161.

20. Kilic E, Doganay S, Ulu M, Çelebi N, Yikilmaz A, Alkan A. Determination of lingual vascular canals in the interforaminal region before implant surgery to prevent life-threatening bleeding complications. Clin Oral Implants Res. 2014;25:90–93. doi:10.1111/clr.2014.25.issue-2

21. Katakami K, Mishima A, Kuribayashi A, Shimoda S, Hamada Y, Kobayashi K. Anatomical characteristics of the mandibular lingual foramina observed on limited cone-beam CT images. Clin Oral Implants Res. 2009;20:386–390. doi:10.1111/clr.2009.20.issue-4

22. Sakka S, Krenkel C. Hemorrhage secondary to interforaminal implant surgery: anatomical considerations and report of a case. J Oral Implantol. 2013;39:603–607. doi:10.1563/AAID-JOI-D-10-00173

23. Tagaya A, Matsuda Y, Nakajima K, Seki K, Okano T. Assessment of the blood supply to the lingual surface of the mandible for reduction of bleeding during implant surgery. Clin Oral Implants Res. 2009;20:351–355. doi:10.1111/clr.2009.20.issue-4

24. Loukas M, Kinsella CR, Kapos T, Tubbs RS, Ramachandra S. Anatomical variation in arterial supply of the mandible with special regard to implant placement. Int J Oral Maxillofac Surg. 2008;37:367–371. doi:10.1016/j.ijom.2007.11.007

25. Lustig JP, London D, Dor BL, Yanko R. Ultrasound identification and quantitative measurement of blood supply to the anterior part of the mandible. Oral Surg Oral Med Oral Pathol Oral Radiol. 2003;96:625–629. doi:10.1016/j.tripleo.2003.08.015

26. Givol N, Chaushu G, Halamish-Shani T, Taicher S. Emergency tracheostomy following life-threatening hemorrhage in the floor of the mouth during immediate implant placement in the mandibular canine region. J Periodontol. 2000;71:1893–1895. doi:10.1902/jop.2000.71.12.1893

27. Niamtu J. Near-fatal airway obstruction after routine implant placement. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001;92:597–600. doi:10.1067/moe.2001.116503

28. Boyes-Varley JG, Lownie JF. Haematoma of the floor of the mouth following implant placement. SADJ. 2002;57:64–65.

29. Budihardja AS, Pytlik C, Haarmann S, Holzle F. Hemorrhage in the floor of the mouth after second-stage surgery: case report. Implant Dent. 2006;15:148–152. doi:10.1097/01.id.0000223224.79449.30

30. Woo BM, Al-Bustani S, Ueeck B a. Floor of mouth haemorrhage and life-threatening airway obstruction during immediate implant placement in the anterior mandible. Int J Oral Maxillofac Surg. 2006;35:961–964.

31. Pigadas N, Simoes P, Tuffin JR. Massive sublingual haematoma following osseo-integrated implant placement in the anterior mandible. Br Dent J. 2009;206:67–68. doi:10.1038/sj.bdj.2009.2

32. Hong Y.-H., Mun S.-K. A case of massive maxillary sinus bleeding after dental implant. Int J Oral Maxillofac Surg. 2011;40:758–670. doi:10.1016/j.ijom.2010.11.027

33. Felisati G, Saibene a. M, Di Pasquale D, Borloni R. How the simplest dental implant procedure can trigger an extremely serious complication. Case Reports. 2012;2012:bcr2012007373–bcr2012007373. doi:10.1136/bcr-2012-007373

34. Hwang HD, Kim JW, Kim YS, Kang DH, Kwon TG. Angiographic embolization for hemorrhage control after dental implantation. J Korean Assoc Oral Maxillofac Surg. 2013;39(1):27–30

35. Lee CY, Yanagihara LC, Suzuki JB. Brisk, pulsatile bleeding from the anterior mandibular incisive canal during implant surgery: a case report and use of an active hemostatic matrix to terminate acute bleeding. Implant Dent. 2012;21(5):368–373. doi:10.1097/ID.0b013e318264d70d

Is My Patient’s Hematoma Related to a PSA injection?

One of my patients underwent replacement of occlusal amalgams on #3 and #4 with recurrent decay using a resin restorative material. The patient complained of swelling and bruising the length of her mandible that lasted about 2 weeks, along with irritation inside her cheeks and lips.

 One of my patients underwent replacement of occlusal amalgams on #3 and #4 with recurrent decay using a resin restorative material. One carpule of articaine HCl 4% (40 mg/mL) with epinephrine 1:200,000 was administered. The patient complained of swelling and bruising the length of her mandible that lasted about 2 weeks, along with irritation inside her cheeks and lips. The patient had no history of any allergies and she underwent several dental procedures in the past. Is it possible this is related to the anesthesia injection?

Yes, it is likely the injection resulted in a hematoma. The question does not state if a posterior superior alveolar (PSA) injection was administered to anesthetize tooth #3, but a hematoma most frequently occurs with PSA injections and may also happen with the inferior alveolar and mental/incisive injections.

A hematoma develops when a blood vessel (artery or vein) is inadvertently injured by the needle. If the injury is minor or the tissue is dense, a hematoma is unlikely to be noticeable extraorally. If an artery or vessel is injured in a vascular area, such as the pterygopalatine or infratemporal fossa, a more dramatic response of swelling and bruising may occur. It is not unusual for swelling and bruising to manifest in the mandibular area following a PSA injection. Bruising can last up to 14 days depending on the amount of bleeding that occurs. The swelling may have led to the irritation intraorally.

Treating a hematoma involves discontinuing the procedure and applying pressure and ice at the first indication of swelling and bruising. A quick response can limit swelling and bleeding. Ice can be applied intermittently for up to 6 hours, and patients should be advised to avoid any anticoagulant pain relievers such as aspirin. The patient is likely to experience soreness and limited ability to open his or her mouth. Heat or a moist warm towel can be applied the following day to minimize the discomfort of muscle trismus. A patient should not be dismissed until the bleeding is stopped. Practitioners should inform the patient of the occurrence and assure him or her that the bruising will heal in 7 days to 14 days with no additional treatment required.

The patient must be advised to notify you immediately if signs of infection appear. Follow-up with the patient to ensure healing occurs is considered best practice.

The Ask the Expert column features answers to your most pressing clinical questions provided by Dimensions of Dental Hygiene’s online panel of key opinion leaders, including: Jacqueline J. Freudenthal, RDH, MHE, on anesthesia; Nancy K. Mann, RDH, MSEd, on cultural competency; Claudia Turcotte, CDA, RDH, MSDH, MSOSH, on ergonomics; Van B. Haywood, DMD, and Erin S. Boyleston, RDH, MS, on esthetic dentistry; Michele Carr, RDH, MA, on ethics and risk management; Erin Relich, RDH, BSDH, MSA ,on fluoride use; Kandis V. Garland, RDH, MS, on infection control; Mary Kaye Scaramucci, RDH, MS, on instrument sharpen­ing; Kathleen O. Hodges, RDH, MS, on instrumentation; Karen Davis, RDH, BSDH, on insurance coding; Cynthia Stegeman, EdD, RDH, RD, LD, CDE, on nutrition; Olga A.C. Ibsen, RDH, MS, on oral pathology; Michael W. Roberts, DDS, MScD, on pediatric dentistry; Timothy J. Hempton, DDS, on periodontal therapy; Ann Eshenaur Spolarich, RDH, PhD, on pharmacology; and Caren M. Barnes, RDH, MS, on polishing. Log on to dimensionsofdentalhygiene.com/​​asktheexpert to submit your question.

From Dimensions of Dental Hygiene. March 2020;18(3):46.

Jacqueline J. Freudenthal, RDH, MHE, is a professor emerita and past chair of the Department of Dental Hygiene at ISU. She has almost 40 years of experience in dental hygiene education, administration, and providing patient care. Freudenthal continues to be active in research, community outreach, and professional service. Her professional areas of interest include prevention, risk assessment, local anesthesia administration, and expanded function procedures for dental hygienists. Freudenthal serves as the anesthesia expert for Dimensions of Dental Hygiene’s “Ask the Expert” forum.

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Toddler’s unusual oral trauma is troubling

The case

A 17-month-old African American girl, with no significant past medical history, is brought to the Pediatric Emergency Department (PED) with acute onset of swelling in the floor of her mouth. The mother is a reliable historian who denies any recent illness, fever, travel, change in food/new food intake, drugs, or significant injury/trauma.

The girl was in her usual state of health when the mother dropped her at the daycare in the morning. However, after returning home from daycare in the evening, the mother noticed her daughter to be more irritable, drooling, and refusing to eat. The mother also noted a bright red-colored swelling underneath the child’s tongue (Figure 1), which prompted this PED visit. The mother denies any visible rashes, new skin lesions, bleeding, bloody stools, diarrhea, or dark-colored urine.

Exam and testing

On oral exam, bright erythematous, nontender, firm masses were seen underneath the patient’s tongue on both sides of the frenulum area (Figure 1). Mild bleeding was noted from the swelling. Each swelling was 2- to 3-cm in size and located underneath the tongue, appearing firm, noncompressible, and symmetrical in size on either side of the frenulum. Some blood-stained saliva was noted over the swelling. Elevation and bright red-colored swelling under the oral mucosa were consistent with the hematoma noted.

Sublingual caruncles looked swollen and elevated. There was no evidence of any wheezing, stridor, or difficulty with respiration. On examination of the neck, clinicians noted a small swelling in the midline that was soft, fluctuant, and tender to touch, located just behind the chin (Figure 2).

Blood workup showed: white blood cell (WBC) count, 12.5; hemoglobin, 12.4 g; aspartate transaminase (AST)/alanine transaminase (ALT), 33/15; erythrocyte sedimentation rate (ESR), 19 mm/h; uric acid, 1.5 mg/dL; lactate dehydrogenase (LDH), 304 IU/L; C-reactive protein (CRP), 1.04 mg/dL; prothrombin time (PT), 12.8 sec; activated partial thromboplastin (aPTT), 34 sec; international normalized ratio (INR), 1; fibrinogen, 407 mg/dL.

Differential diagnosis

Based on the above results, the possible differential diagnoses of oral cavity swellings in the floor of the mouth are numerous (Table):


Ludwig angina is a bilateral infection of the submandibular space including sublingual and submylohyoid (submaxillary) space. It is characterized by brawny induration of the floor of the mouth with an elevation of the tongue, potentially obstructing the airway. Ludwig angina is up to 90% odontogenic in origin. Other causes are peritonsillar/parapharyngeal abscess, oral lacerations, and mandibular fractures. Fever, neck swelling, bilateral submandibular swelling, and elevation of the tongue are the common mode of presentation. The most common etiologies are aerobes, anaerobes, alpha-hemolytic streptococci, Staphylococcus aureus, and Bacteroides. High-dose intravenous (IV) penicillin, clindamycin, and metronidazole are the best agents for infection. Complications are sepsis, pneumonia, asphyxia, and respiratory obstruction.1


Ranula is a mucous retention pseudocyst in the floor of the mouth. It can originate from trauma or obstruction of the sublingual salivary glands, less commonly submandibular/minor salivary glands may be involved. Oral ranulas originate superior to mylohyoid muscle. The intraoral component usually has a bluish color and is typically unilateral, although bilateral swelling can occur. Complete excision of the pseudocyst with the affected salivary gland is associated with the least likelihood of recurrence.2 Cervical/plunging ranulas that penetrate through the belly of the mylohyoid muscle often produce an externally visible neck mass. Posttraumatic ranula will contain mucin in the aspirate. Other modalities of treatment are marsupialization, cryosurgery, and carbon dioxide laser excision.


The oral cavity/neck is a potential target for many injuries. Penetrating injuries secondary to metal bodies/dentures/foreign bodies/metal hooks can be a serious cause of lingual/sublingual hematoma. Few case reports of coat hanger-,3 lobster tails-,4 fishhook-induced oral trauma leading to soft tissue swellings are reported. Infected sublingual hematoma secondary to tongue-tie surgery is reported in the literature as sublingual swelling.


Approximately 50% to 60% of patients with severe hemophilia (factor level <1% of the factor activity) usually present after oral trauma. It is secondary to dental surgeries, penetrating trauma, and lobsters. Food-induced oral injury can lead to acute bleeds and cause rapid worsening of sore throat, breathing difficulties, and stridor. Prompt treatment with factor 8 concentrates repeated for every 12 hours and close monitoring of vitals and respiratory status are strongly warranted. Early diagnosis and prompt treatment with factor-8 concentrates can protect airways and prevent intubations/surgical management.5


Sublingual hematoma is a rare complication of excessive anticoagulation. It can mimic Ludwig angina, often called pseudo-Ludwig phenomenon. Acute onset of sore throat, swelling in the floor of the mouth, drooling, stridor at rest, and difficulty with speaking in a patient on oral warfarin strongly suggests sublingual/submandibular hematoma. Lack of signs of cellulitis and normal inflammatory markers with elevated PT/INR are suggestive of a warfarin-induced hematoma. Sublingual hematomas typically develop quickly and extend posteriorly to involve the supraglottic larynx. Coagulation abnormality can be effectively corrected with fresh frozen plasma, IV vitamin K, and prothrombin complex concentrates.6 Acute lingual/sublingual hematoma secondary to antipsychotic haloperidol drug use has been reported. Acute dystonic reaction involving the head and neck can lead to oral trauma and acute sublingual hematoma.


Dermoid cysts of the floor of the mouth are rare lesions caused by entrapment of germinal epithelium during the closure of the mandibular and hyoid branchial arches. The histological varieties are: epidermoid, if the epidermis is lining the cyst; dermoid, if skin annexes exist; and teratoid, derivatives of 3 germinal layers. A dermoid cyst usually presents as a smooth, doughy, lobular, compressible cystic mass on the floor of the mouth. The cyst lumen is filled with a mixture of desquamated keratin and sebum.7 Complete surgical excision of the lesion using either intraoral or extraoral approach is the best treatment of choice. Magnetic resonance imaging (MRI) of the neck in this patient shows a high-intensity mass on the T2-weighted images of dermoid cyst.


Teratomas are exceptionally rare tumors in the head and neck region. Neonatal teratomas occur in about 1:20,000 to 1:40,000 live births. Most congenital teratomas are mature or immature ones but they can recur as malignant teratoma after initial surgery.8 Teratomas are tumors containing components of all 3 embryologic germ layers originating from multipotent germ cells. The incidence of malignancy of sacrococcygeal teratoma in neonates is approximately 10% and reaches 100% by age 3 years. Malignant transformation of a teratoma is documented by rapid growth after excision with markedly elevated alpha-fetoprotein (AFP) levels. It can be curable with multi-agent chemotherapy along with complete resection. The residual malignant component can be monitored by serial AFP measurements and complete resection is assured by the decline of AFP to normal after cessation of the chemotherapy.8


Foreign bodies are an unusual cause of a slow-growing mass at the floor of the mouth. Fishbones, metal hooks, broken teeth fragments, parts of dentures, pen caps,9 and air rifle pellets are rarely diagnosed and can present with a slow-growing mass in the oral cavity. After the initial injury, the open wound of the floor of the mouth can act as a check valve mechanism that leads to pneumatocele leading to slow growth.


Physical abuse in infants and children is a rare cause of sublingual hematoma. Most common injuries are tears of the lingual frenulum and open wounds of the floor of the mouth, gingiva, and palate.10 Metaphyseal bone fractures, rib fractures, various skin bruises, and retinal hemorrhages are other clinical findings of child abuse. Bleeding diathesis, osteogenesis imperfect, cutis laxa, and Ehlers-Danlos syndrome should be ruled out before the diagnosis of child abuse.

Hospital course

Based on the patient’s clinical history, physical examination, and the acuity of presentation, the clinicians suspected traumatic swelling on the floor of the mouth, probably an acute swelling of sublingual/submandibular salivary glands, as the most common possible etiology. The girl was admitted on the Pediatric floor for close follow-up of the swelling, work of breathing, and oral intake, and close monitoring for any acute worsening of stridor and desaturations. Oral Surgery and Otolaryngology were consulted for further recommendations and management.

On repeat exam after a few hours, clinicians noticed that the color of the swelling changed to dark purplish color (Figure 3). Based on the acuity of presentation, color change of the hematoma, mild bleeding from the swelling, and midline acute tender fluctuant swelling, they strongly suspected oral trauma in this case. As the mother denied any significant trauma, they communicated with the daycare center staff for further clarification and inquired about any possible oral trauma/fall/significant injury during the child’s daycare stay. The staff confirmed that the girl had fallen with a toy (Figure 4) in her mouth/neck while she was running in the daycare.

The Oral Surgery team confirmed final diagnosis as bilateral sublingual hematoma secondary to oral trauma. Oral cavity swellings usually represent engorged sublingual salivary glands with blood/hematoma.

The patient was closely monitored for any worsening of swelling size and development of stridor and drooling. Care continued with warm compressions and a soft, liquid diet as tolerated. She remained stable at room air with stable vitals.

Patient outcome

The patient was discharged in stable condition with instructions for warm compressions and close follow-up instructions with Oral Surgery on an outpatient basis. She was seen after 1 week and her oral swellings were completely resolved without any residual complications or adverse events reported.


1. Srirompolong S, Art-Smart T. Ludwig’s angina: a clinical review. Eur Arch Otorhinolaryngol. 2003;26097):401-403.

2. Zhao YF, Jia J, Jia Y: Complications associated with surgical management of ranulas. J Oral Maxillofac Surg. 2005;63(1):51-54.

3. Cheng J, Kleinberger A, Dunham B, Woo P. Do not hang your coat here. Int J Pediatr Otorhinolaryngol. 2012;76(5):750-751.

4. Kausar H, Gilani JM, Khan OA. No more Doritos and lobster tails: a case report of life-threatening sublingual hematoma. Del Med J. 2009;81(7):255-258.

5. Spindler T, Mc Goldrick N, McMahon J, Campbell Tait R. Spontaneous sublingual haematoma in acquired haemophilia: case report. Br J.Oral Maxillofac Surg. 2017;55(4):e17-e18.

6. Lim M, Chaudhari M, Devesa PM, Waddell A, Gupta D. Management of upper airway obstruction secondary to warfarin therapy: the conservative approach. J Laryngol Otol. 2006;120(2):e12.

7. Lima SM Jr, Chrcanovic BR, de Paula AM, Freire-Maia B, Souza LN. Dermoid cyst of the floor of the mouth. ScientificWorldJournal. 2003;3:156-162.

8. Ueno S, Hirakawa H, Matsuda H, et al. A case of neonatal mature teratoma transformed to malignancy in the neck extending to the mouth floor. Tokai J Exp Clin Med. 2009;34(4):130-134.

9. Uguz MZ, Kazikdas KC, Erdogan N, Aydogdu V. An unusual foreign body in the floor of the mouth presenting as a gradually growing mass. Eur Arch Otorhinolaryngol. 2005;262(10):875-877.

10. Kudek MR, Knox BL. Sublingual hematoma: when to suspect child abuse. Clin Pediatr (Phila). 2014;53(8):809-812.

(PDF) Asphyxial death related to sublingual hematoma after root canal intervention in a hemophilic patient

Romanian Journal of Legal Medicine Vol. XXVII, No 3(2019)


ere have been reported only two cases of death in the

medical literature aer minimally invasive dental surgery

[13, 14]. We have also identied some case reports of

severe dyspnea resulting from airway obstruction that

was caused by submandibular swelling, and hypovolemic

shock resulting from massive post extraction bleeding


e physiopathological development of the

sublingual hematomas can be explained by the formation

of hemorrhage that can easily spread in the loose tissues of

the oor of the mouth, to the sublingual area and the also

to the space between the lingual muscles. Swelling can

occur fast and can cause acute airway obstruction, which

may require intubation or an emergency tracheostomy

[15-17]. e mandible region from the lingual side is a very

important vascular area. It is supplied by the sublingual

branch of the lingual artery which anastomoses with the

submental artery, a branch of the facial artery, and the

incisive arteries, branches of the inferior alveolar artery

[15-17]. is rich anastomosing blood supply plexus lies

very close to the interforaminal lingual cortical plate of

the mandible and severe hemorrhage from this region has

been reported as a complication of surgical procedures

[15, 16].

Even though the medical literature is plentiful in

presentations of cases entitling spontaneous sublingual

hematoma in acquired hemophilia or hypertension [18-

24], in our case the iatrogenic action of the traumatic

factor over the vessel wall cannot be excluded.

Hsieh [25], in a recent study, shows that the type

and severity of the bleeding disorder, bone removal,

and use of a local hemostatic agent did not have any

signicant eect on postoperative bleeding. Despite

the use of perioperative factors and desmopressin, the

postoperative bleeding rates remain high for patients

with inherited bleeding disorders [25].

Inadequately-controlled hemorrhage, particularly in the

setting of coagulopathy, may quickly escalate to acute

airway obstruction [26].

e guidelines for dental treatment of patients

with inherited bleeding disorders provide the followings

principles [27]:

– Dental treatments do not require administration

of factor VIII, but the lesion of the oral mucosa must be

prevented during these treatments;

– On patients with blood clotting disorders there

could be performed mobile prosthesis, and in case of

partial prosthesis it is important to maintain the health

of the remaining teeth;

– Orthodontic treatments should be performed

without periodontal lesions;

– Dental extractions should be performed only by

including hospitalization and aer proper preoperative

training; it should be avoided to perform peripheral

troncular anesthesia that can produce hematomas; a

post-operative check should be performed at 24-48-72

hours aer the extraction with rigorous checks from 5 to

7 days aer the extraction.


To our knowledge the present case is the rst

documented fatal case of sublingual compressive

hematoma aer a non-surgical dental procedure.

Regarding the hemorrhage, we consider that in

our case, the bleeding was likely to have continued for

a long time, until the debut of the rst signs of dyspnea.

is aspect is explained by the minimal vascular lesions,

counterbalanced by the severity of the preexisting

serious pathology that led to bleeding tendency, due to

hemophilia, liver cirrhosis and arterial hypertension,

which had contributed to the continuous bleeding.

e present case is similar to the two fatal cases

reported previously [13, 14] in terms of formation of a

cervical subcutaneous hematoma and the existence of

liver cirrhosis. e dierences consist in the patients’ age,

the non-surgical method of intervention, the minimal

damage to the blood vessels, longer time between the

intervention and start of dyspnea (approximately 28-

30 h) and the presence of a hemostatic disease, such as

hemophilia. In one of the cases reported previously [13],

the lingual side of the alveolar bone at the extraction

socket had been fractured and the fracture was considered

to be the most important cause of cervical subcutaneous


Airway management remains the primary

consideration in sublingual hemorrhage. Law, Alam, and

Borumandi reported in their 2017 literature review that

there were 25 reported cases of oor of mouth hematoma:

84% of these cases were from lingual cortex perforation

and 68% required emergency intubation or tracheostomy

due to acute airway obstruction [28, 29].

Such cases, because of the circumstances of death, might

get under the jurisdiction of the forensic autopsy. e

forensic necropsy is performed only at the request of the

investigators, as in case of violent deaths, sudden deaths

or suspicious, and they are based on a forensic doctor

relationship with the deceased who will be treated with

respect and human dignity [30-32]. e main purpose

of the forensic autopsy is the establish the type of death.

In our case, from a medico-legal point of view, we

considered the death to be a violent one.

is is an exception from the regular medico-

legal classication of death which refers to the non-

violent death as to be the one determined by internal

factors (diseases) and to the violent death as the one

determined by external factors (mechanical, physical,

chemical biological and psychological). is kind of

exception usually appears in medical misconduct cases,

but not only. e principle of this exception in classifying

the medico-legal type of death is as follows: there is a

legal obligation for every physician to disrupt the relation

Floor-of-Mouth Hematoma Following Dental Implant Placement: Literature Review and Case Presentation


The authors provide a structured review of reported cases of floor-of-mouth hematoma during or after dental implantation and frequent causes and management and present a related case.

Materials and Methods

An online search of the medical literature was conducted from 1990 through 2016. The following search terms were used: floor of mouth hematoma, sublingual hematoma, dental implant hematoma, implant in mandible, and complication of dental implant. Abstracts were screened for relevance to the aims of the review. Relevant reports in the English language were included and referenced. The articles were reviewed for patient demographics, implant location, coagulopathy, pre- or postoperative imaging, airway management, treatment of the hematoma, and management of the offending implant.


The literature search identified 25 reported cases. Hemorrhage was caused by perforation of the lingual cortex in 84% of cases (n = 21). Airway obstruction resulted in emergency intubation or tracheostomy in 68% of patients (n = 17). Most cases (n = 18; 72%) required surgical management in the hospital setting. Management of the offending implant was reported inconsistently. Of 17 reported cases, 5 implants had to be removed, 9 remained in situ, and in 3 cases implant placement was abandoned. Only 1 case involved preoperative 3-dimensional (3D) imaging before implant insertion. The authors report on an additional case with a serious floor-of-mouth hematoma that required immediate surgical evacuation and hemostasis.


Serious complications, such as floor-of-mouth hematoma after dental implant insertion, can occur, which could be life-threatening. Preoperative 3D imaging helps to visualize the individual mandibular shape, which could decrease the incidence of serious complications. If injury to vessels of the floor of the mouth cannot be confidently excluded, then further assessment and treatment are recommended before the patient is discharged.

Recommended articlesCiting articles (0)

View full text

© 2017 American Association of Oral and Maxillofacial Surgeons

Recommended articles

Citing articles

Denture Induced Submandibular Hematoma in a Patient on Warfarin

A 79-year-old lady, who was taking warfarin, presented to the Emergency Department with a painless anterior neck swelling, which was associated with hoarseness of voice, odynophagia, and shortness of breath. She first noticed the swelling after she removed her dentures in the evening. On examination, she had an increased respiratory rate. There was a large submandibular swelling at the anterior side of her neck. Upon mouth opening, there was a hematoma at the base of her tongue, which extended to both sides of the tonsillar pillars. The patient was intubated with a video laryngoscope due to her worsening respiratory distress. Intravenous vitamin K and fresh frozen plasma were given immediately. The patient was admitted to the ICU for ventilation and observation. The hematoma subsided after 2 days and she was discharged well.

1. Introduction

There are few reports of upper airway hematomas after anticoagulation following minor intraoral trauma. Although some cases can be treated conservatively, others may progress to life-threatening situations. This is an interesting case of a patient with warfarin, who presented with upper airway hematoma after the use of her dentures. The management is also discussed.

2. Case Report

A 79-year-old lady presented to the Emergency Department with a painless anterior neck swelling. The swelling appeared one day before and was gradually increasing in size. She first noticed the swelling after she removed her dentures in the evening. Several hours later, she developed hoarseness of voice, odynophagia, and mild shortness of breath. There was no hematemesis, melena, or any neurological deficits. On further questioning, she had a history of hypertension and atrial fibrillation. She has been taking amlodipine and warfarin but was not compliant to her medication and follow-ups. She was supposed to be on warfarin of 3mg per day. However, she did not present herself to the clinic for warfarin optimization, and no INR was done.

On examination, she was fully conscious. However, an audible stridor was heard. Her blood pressure was 130/90mmHg, heart rate 92/min, respiratory rate 24/min, and oxygen saturation 95% on room air. There was a large submandibular swelling at the anterior side of her neck. The mass extended to the left side of neck and was 8cm by 6cm in size. The skin overlying the swelling was bluish-red, and there was tenderness on palpation. Upon mouth opening, there was a hematoma at the base of her tongue which extended to both sides of the tonsillar pillars. The uvula appeared edematous and engorged. There was limitation in mouth opening due to the pain. Bleeding was seen from the base of the tongue when her tongue was protruded.

Blood investigations revealed hemoglobin of 12.4g/dl, platelet 274 x 109/liter, with normal electrolytes. The Prothrombin Time (PT) and Partial Thromboplastin Time (PTT) were prolonged for more than 2 minutes and INR was 8.0. A flexible nasoendoscopy done by the otorhinolaryngologist found a huge swelling at the laryngeal area. The vocal cords were not visible. There were blood clots covering both the arytenoids and epiglottis.

The patient was planned for tracheal intubation due to her worsening respiratory distress. Intravenous vitamin K and fresh frozen plasma (FFP) were given immediately.

Anaesthetic management at that time was gas induction with Sevoflurane in incremental concentration until loss of consciousness with preservation of spontaneous breathing. Muscle relaxants were not used. A D-blade video laryngoscope CMAC was used. During intubation, it was noted that the laryngeal apertures were grossly engorged and swollen. The oral structures were beyond recognition. Blood clots were seen covering the pharyngeal walls, epiglottis, and arytenoids. The vocal cords were not prominently visualized. As the patient was spontaneously ventilated, air bubbles were seen from the posterior side of the engorged epiglottis. This served as a guide for tracheal tube insertion (Video 1). A size 6 endotracheal tube was used to secure the airway. It was a successful intubation only at the second attempt. Hemodynamics were stable throughout the procedure.

The patient was sent to the ICU for ventilation and observation. The hematoma at the neck and base of tongue subsided after 2 days. Her INR was 2.0, and she was discharged from the ICU soon after that.

3. Discussion

Anticoagulants are used for prophylaxis and treatment of thromboembolic diseases, acute ischemic strokes, deep venous thrombosis, pulmonary emboli, heart valve diseases, acute myocardium infarction, and atrial fibrillation. Warfarin (brand names Coumadin) is a first generation oral anticoagulant agent. It works by inhibiting the production of vitamin-dependent coagulation factors by the liver [1]. Warfarin needs to be used cautiously due to its narrow therapeutic window and dosing is affected by genetic variation, drug interaction, and nutrition [2].

During the use of warfarin, a significant life-threatening complication is haemorrhage. Although rare, spontaneous upper airway hematoma haemorrhage in patients on anticoagulant therapy of varying severity has been reported [3–9]. Most upper airway hematomas were sublingual hematomas (66.57%) followed by retropharyngeal hematomas (27.03%). Of the cases, 48.65% were reported to be managed conservatively while the rest underwent either cricothyrotomy or tracheal intubation [10]. The complications of upper airway hematomas included respiratory compromise, which was seen in almost half of the cases, followed by pulmonary oedema [11], aspiration pneumonia [8], and mild pneumonitis [12]. There was also a reported case of a patient who died due to anoxic brain injury secondary to upper airway hematoma [13].

When using warfarin, the risk of major bleeding within one year of use ranges between 0.5 to 7.0%, and this risk is directly proportional to the warfarin dosage. This haemorrhagic risk increases in patients whose INR was 6 or more [14] and also in elderly patients who were concurrently on nonsteroid anti-inflammatory and methyl-salicylate.

The commonest presentation of sublingual hematoma is hoarseness of voice and painless swelling in the oral cavity or neck. Physical examination may confirm a sublingual swelling. In our patient, a small laceration at her lower jaw was seen, most probably due to trauma during removal of her dentures. This event initially developed a painless anterior neck swelling, which was ignored by the patient. The traumatic injury in the sublingual area however became worst, causing a retropharyngeal and epiglottic hematoma.

Haemorrhage and hematoma of the oral cavity can be fatal. Bleeding and hematoma into the sublingual and submaxillary spaces may also create a pseudo-Ludwig’s phenomenon [5]. With an acute expanding hematoma, the tongue and floor of the mouth may become elevated. This will lead to an airway obstruction.

If diagnosed early and managed promptly, the prognosis will be good, and the haematomas may resolve completely. Once diagnosed, these patients will require prompt airway management, reversal of anticoagulation, as well as close monitoring. Airway management should be performed ideally with awake intubation, while maintaining a spontaneous respiration. However, in a situation where tracheal intubation is not successful, emergency cricothyroidotomy or surgical tracheostomy should be performed for definitive airway stabilization.

In severe sublingual hematoma, anticoagulation should be reversed immediately with Prothrombin Complex Concentrate (PCC) or Fresh Frozen Plasma (FFP), followed by vitamin K. Both oral and intravenous routes for vitamin K sufficiently reverse anticoagulation and result in similar reductions in INR at 24 hours [15]. Although both PCC and FFP can be used, PCC has several advantages over FFP. PCCs have smaller infusion volumes and have an enhanced safety because of viral inactivation [16]. In the treatment of our case, oral warfarin was discontinued and FFP 15ml/kg was given. PCC was not available at our centre.

4. Conclusion

Warfarin-induced submandibular hematoma can cause airway obstruction. In these patients, early definitive airway management is crucial. A rapid medical management is also crucial to reverse the effects of warfarin.

Data Availability

No data were used to support this study.

Conflicts of Interest

The authors declare that there are no conflicts of interest regarding the publication of this paper.

Supplementary Materials

Video 1: air bubbles seen from the posterior side of the engorged epiglottis, which served as a guide for tracheal tube insertion. (Supplementary Materials)

90,000 Hematoma in the oral cavity: causes of appearance, preventive measures


Reasons for the formation of hematomas on the oral mucosa

The general scheme of the formation of a hematoma is as follows: a rupture of a vessel causes the outflow of a certain amount of blood, followed by compaction and the appearance of a thrombus. A bubble is formed, visible on the flat surface of the mucous membrane due to the dark coloration and relief. Often a similar pattern can be observed with teething, when the gums bleed and become inflamed.The formation of multiple small hematomas that cover the entire surface of the mucous membrane in the mouth with unattractive dark spots looks very unpleasant for the patient. But do not panic, suspecting you have a serious illness. As practice shows, most of these phenomena occur with mechanical injury to the mucous membrane. But there are exceptions when the symptom indicates:

  • allergic reaction;
  • chronic trauma;
  • consequences of stressful situations;
  • burns or cuts on the mucous membrane.

There are also cases when multiple hematomas in the oral cavity are signs of:

  • diabetes mellitus;
  • hypertension;
  • renal failure;
  • complex types of stomatitis;
  • blood diseases;
  • vitamin deficiency, due to which the fragility of blood vessels develops.

It is possible to determine the exact cause and stage of the pathology formation only after a thorough examination and diagnosis.For this reason, one should not self-medicate, so as not to additionally injure the damaged tissue.

Symptoms of hematomas in the oral cavity

The most noticeable sign is the spread of bloody vesicles along the mucous membrane. Often, other symptoms of pathology are absent. Sometimes patients complain of itching and tingling in the area of ​​damaged tissue. Doctors say that this is a reaction to additional chemical and mechanical irritation of the inflamed mucous membrane under the influence of saliva, contact with teeth, etc.e. With the formation of hematomas on the oral mucosa during the eruption of a tooth, there are sensations of bursting and pressure from the inside of the gingival tissue. If inflammation has become a complication of the burn, pain syndrome is a logical consequence of mechanical irritation of the mucous membrane.

Signs of the appearance of blood globules on the cheeks in the mouth, requiring immediate examination and diagnosis, are highlighted in a separate group. Among them:

  • relatively frequent appearance of a large number of points of inflammation;
  • duration of wound healing, despite the measures taken to treat them;
  • too large bruises that interfere with food intake and full communication;
  • formation of bloody balls on the lips.

Each of these signs can be a symptom of serious disorders in the body. Therefore, the best solution would be to refuse self-medication and make an appointment for a consultation with a qualified dentist.

Methods for the treatment of hematomas on the palate and on the cheeks in the mouth

The tactics of treating a patient with hematomas on the oral mucosa depends on the cause of their appearance. The most effective are:

  • exposure to cold.A cube of ice or ice cream applied to the affected tissues reduces swelling and pain;
  • chamomile, known for its antiseptic properties. It is recommended to rinse your mouth with chamomile tea or decoction to quickly eliminate blood balls in the mouth and signs of inflammation.

Additional measures for the prevention of hematomas

To reduce the risk of bloating on the oral mucosa, patients are advised to follow a few simple rules:

  • give up salty and spicy foods that irritate the mucous membranes;
  • to correct the design of prostheses and orthopedic systems for the jaw apparatus;
  • to increase the number of liquid and semi-liquid dishes of average temperature in the diet

You should also not forget about the need to regularly visit the dentist for the timely detection and elimination of diseases of the teeth and gums.Such a solution will help maintain oral health and avoid a number of serious pathologies with unpleasant symptoms.

Hematoma in Dentistry – Dental Alphabetical Index French Dental Clinic

Hematoma (hematoma in dentistry) (from other Greek blood ōma) – accumulation of blood in soft tissues. It appears when blood vessels are ruptured or damaged due to trauma, falls, aggressive dental interventions, bruises, and is not always a sign of an inflammatory process.

What does a hematoma look like

Hematoma is a bloody mass under the skin, similar to a simple bruise, the color of the lesion can vary from reddish to bluish and yellow. Small hematomas can resolve on their own without medical intervention.

With large bruises, an inflammatory process is possible, accompanied by swelling of the damaged area, soreness. General malaise may also develop, up to a rise in body temperature.

Types of hematomas

Hematoma in dentistry is classified depending on the location (subcutaneous hematoma, extensive hematoma), the relationship to the lumen of the blood vessel (pulsating, non-pulsating), the state of blood flow (clotted, infected, festering).

Subcutaneous hematoma is formed as a result of local hemorrhages in the subcutaneous tissue. The intensity of the shade of the hematoma depends on the depth of localization of the bruise and the volume of the poured blood.As hemoglobin dissolves and breaks down, the hematoma changes color to greenish, yellow-green, yellow. The formation of a subcutaneous hematoma is accompanied by pain, possibly an increase in temperature, tissue swelling.

Extensive hematoma occurs as a result of rupture of large vessels; hematoma with signs of suppuration.

Causes and predisposing factors of hematoma formation

  • Violation of vascular permeability
  • Increased fragility of the vascular wall
  • Deterioration of blood clotting
  • Decrease in the body’s defenses due to exhaustion, chronic disease, old age
  • Immune system disorders
  • Damage caused by dental instruments
  • Pathology of bite
  • Sharp edges of teeth
  • Bridges and removable dentures
  • Surgical operation
  • Extraction of teeth
  • Damage to the vessel during the introduction of anesthesia
  • Hypertension
  • Displacement of the neurovascular bundle of the lower jaw
  • Household injuries
  • Abrupt injection of a large amount of anesthetic


The occurrence of hematoma in dentistry, as a rule, is caused by mechanical trauma to the oral cavity – unsuccessful operation, tooth extraction, injection of anesthesia.Household injuries are possible, people with poor blood clotting, the elderly are especially susceptible to this disease.

Stages of development of hematoma

  • Red hematoma – hemorrhage in the surrounding tissues of erythrocytes. Vascular rupture, thrombosis.
  • Blue hematoma (2-3 days) – venous stasis, changes in corpuscles.
  • Green hematoma (4-5 days) – formation and release of hemasiderin.
  • Yellow hematoma (6-7 days) – resorption therapy recommended.
  • If the process lasts more than a month, ulcers and erosion may develop.


  • Increasing body temperature
  • Pain on palpation
  • Spontaneous pulsating pain sensations
  • Compaction of fabrics
  • Tissue swelling
  • Discoloration of damaged skin
  • Edema of the mucous membrane

Hematoma treatment

In case of hematoma of dental origin, self-medication is not allowed.It is forbidden to heat, rinse and other folk remedies. This can lead to serious complications that require surgery to correct. With treatment prescribed by a doctor using prescribed medications, the hematoma disappears after 3-4 days.

Hematoma of traumatic origin (subcutaneous hematoma) . Treatment of conservative – cooling of the damaged area, applying a compress to narrow the lumen of blood vessels, the use of analgesics and physiotherapeutic procedures.

Extensive hematoma. Treatment is performed with a puncture, applying a pressure bandage. If repeated bleeding occurs, the hematoma is opened, the bleeding vessel is ligated, or a vascular suture is applied. When hematoma suppurates, it is immediately opened and drained.

what is it and what to do with it

This unpleasant phenomenon worries both children and adults, causes discomfort and causes pain while eating.

The defeat of the mucous membrane of the mouth and the appearance of a scattering of small vesicles contributes to the appearance of itching and burning, small children are especially painful for these symptoms.

It is not for nothing that doctors believe that the state of the oral cavity is a mirror reflecting the state of the patient’s health. You can provide first aid to a person suffering from this ailment with the help of folk remedies at home.

After treatment, preventive measures must be followed so that blisters in the mouth no longer occur.What does an ordinary and bloody blister look like in the mouth, what is it in general, and how to act to cure the problem?

Blisters in the mouth: photos and symptoms

Blisters in the mouth represent small white or transparent vesicles located on the mucous membrane
of the oral cavity. Usually appear in small groups. The affected areas are covered with a bloom of yellow or white.

The first symptoms of blistering in the mouth:

  • itching, burning and tingling in the mouth;
  • the appearance of pain in the mouth;
  • discomfort when chewing food;
  • slight tissue swelling;
  • dry mouth.

This is what a blood blister looks like in the mouth:

Blisters in the mouth on the cheek look like this:

And this is a photo of a watery blister in the mouth:

Blisters in the mouth: causes

If you are worried about blisters in the mouth, from what they appeared, you need to find out first. The appearance of bubbles on the mucous membranes of the oral cavity may indicate the presence of diseases and the penetration of infections and viruses into the human body.

The appearance of clear and red blisters in the mouth is most often caused by problems such as:

First aid

It is undoubtedly necessary to fight this ailment with the help of a doctor who will diagnose and establish the true cause of the appearance of such formations as blisters in the mouth. Regardless of the size and number of bubbles, contact a specialist immediately

A similar effect can be achieved with the help of folk remedies.

Treatment step by step

  1. Diagnostics, determination of the nature of blisters in the mouth.
  2. Antiseptic treatment of the oral cavity.
  3. Prescribing a course of treatment for the disease that provoked the appearance of blisters in the mouth.
  4. The use of antiviral agents.
  5. Consolidation of the result, implementation of preventive measures.


Folk remedies

  • Rinses with St. John’s wort infusion
    .It is necessary to carry out the procedure 4-5 times a day. For 1 liter of water, you need to pour 1 tablespoon of dry St. John’s wort into the kettle. The broth should be dark brown;
  • aloe
    . Grind the leaves of the plant to a state of gruel. Apply to affected areas for 1-2 minutes a couple of times a day;
  • apple and garlic
    . Mix in equal proportions freshly squeezed juice and chopped garlic. Boil for 5-7 minutes. Drink ½ cup 3-4 times a day;
  • chamomile compress. Apply to blistering sites (throat, tongue) 4-5 times a day;
  • ointment
    . Combine aloe juice, chopped cabbage leaf and egg white. Lubricate the affected areas for 2-3 minutes. Rinse the mouth with clean warm water with ½ teaspoon of baking soda.

Peculiarities of the treatment of blisters on the inner side of the cheeks

Special care should be taken when treating small blisters on the inner side of the cheek.

Vesicles can be filled with blood from the inside.

Do not pierce the blood blister
in the mouth and injure.

Damage to mucosal blisters can cause infections with fever and allergic reactions.

In addition, such formations can be easily damaged by the teeth.


First of all, it is necessary to follow the rules of oral hygiene. Buy a new toothbrush every 3-4 months
, use dental floss and mouthwash.Taking vitamin and mineral complexes and fresh fermented milk products is an excellent preventive measure against blistering in the mouth.

Any disease is better prevented than cured. Therefore, it is necessary to monitor the cleanliness of the oral cavity, thoroughly wash vegetables and fruits before eating and carefully monitor children who often like to put foreign objects in their mouths.

A blood ball in the mouth: what is it and what to do with it

The mucous membrane of the oral cavity is an important component of the human body, which consists of different tissues that perform a protective, absorptive and excretory function.She participates in thermoregulation, is responsible for the perception of the taste of food. Therefore, it is necessary to carefully monitor the state of the oral mucosa and, if there are changes in the integrity of the epithelium, consult a doctor.

Characteristics of the blood bladder on the oral mucosa

The mucous membrane protects the entire body from the negative influence of the environment, from harmful microorganisms, various kinds of pollution, and also has a fairly high level of regeneration. If blood blisters regularly appear on the mucous membrane of the oral cavity, then this signal should be taken seriously and action should be taken.

A bloody ball in the mouth – a hematoma (bruise), which is characterized by the accumulation of blood in a certain place in the oral cavity. The appearance of bloody bubbles is a kind of hemorrhage that occurs as a result of trauma to the capillaries and thin vessels of the mucous membrane.

A bladder on the mucous membrane can be with a clear serous fluid without the presence of blood. This means that the vessels were not damaged, and the resulting wound is superficial. Such blisters on the mucous membrane heal much faster.The presence of blood in the bladder indicates a deep injury and a longer period of its healing, blood resorption.

Read also

The main causes of the appearance of a blood blister

The general condition and integrity of the oral mucosa usually indicates the level of health of the body. Often, by examining the appearance of the oral mucosa and blisters, the doctor makes a definitive diagnosis. After all, the symptoms of most infectious, bacterial, chronic, as well as acute processes that occur in the body are associated with a change in the integrity and color of the oral mucosa.Therefore, it is important to understand the main reasons for the appearance of blisters with blood in the mouth.

Bloody blisters are distinguished by their place of origin – on the tongue, under the tongue, on the cheek. They can occur as a result of injury or be a signal of the presence of a serious illness in the body. Multiple blood blisters on the oral mucosa occur with stomatitis, diseases of the gastrointestinal tract, and disturbances in the functioning of the endocrine system.
The cause of the sudden onset of a blood bladder in the mouth is damage to the mucous membrane.

There are the following types of damage to the oral cavity:

  • mechanical injury.
    The cause may be various objects, solid food, cheek biting;
  • chemical injury.
    It occurs due to the use of spicy, salty food, contact with the mucous membrane of chemicals. This irritates the delicate mucous cavity of the mouth and injures it;
  • thermal injuries.
    Their appearance is provoked by too cold or hot food and drinks.

Mechanism of formation of a blood bladder on the oral mucosa

Bloody blisters in the mouth in most cases are not life-threatening. They are formed as a result of mechanical damage to the mucous membrane. When a microtrauma occurs, harmful microorganisms attack the damaged area.

After that, a number of responses are triggered in the human body:

  • The immune system is activated. Monocytes and leukocytes, as well as macrophages, instantly enter the damaged area, which attack the harmful pathogen and quickly destroy it.
  • Immune cells die. This is a signal for other cells and substances are released in the affected area that are mediators of inflammation of the mucous membrane – serotonin, histamine and bradykinin.
  • These substances cause severe spasm of the circulatory system and the outflow of blood is impeded. After the spasm is removed, all the accumulated blood instantly flows to the site of inflammation. It moves with great speed and pressure. In the mouth, detachment of the mucous membrane occurs, and a blister with a bloody filling appears.

Treatment of bloody blisters in the mouth

The blood bladder in the mouth is only a part of the body’s defense reaction and disappears on its own within a week. If this does not happen, then it is necessary to seek the advice of a doctor in order to exclude serious diseases of the body and neoplasms. He will be able to make an accurate diagnosis by making a thorough examination, studying the data of clinical tests and histology. After that, the doctor will prescribe the correct treatment.

The process of treating a blood bladder in the oral cavity is closely related to the cause of its appearance and therefore the treatment depends on several important factors:

  • amount of surface damage;
  • the degree of filling with serous fluid;
  • the nature of the contents of the blood bladder;
  • location.

The volume and nature of the damaged surface is important when prescribing treatment for a bloody bladder in the oral cavity. After all, the larger the volume of the blood bladder, the worse it heals and dissolves. Treatment of a large bladder with blood can develop from conservative to surgery. Small blood bubbles dissolve quickly and do not require any special treatment.

The blood bladder on the oral mucosa must be carefully examined to exclude hemangioma and vascular tumor.The doctor can do this when examining the oral cavity. A hemangioma is sometimes left untreated if it does not grow. With intensive growth, it should be removed surgically.

Many bloody blisters in the mouth can be associated with a disease of syphilis, sometimes pemphigus. Small red bubbles on the tongue, under it or on the side may indicate the presence of glossitis – inflammation of the surface of the tongue, which is caused by harmful microorganisms. Treatment will consist of treating and rinsing the mouth with antiseptic solutions and eliminating the disease, which has become the main cause of the appearance of blood blisters.

It is not necessary to treat a bloody bladder in the mouth if it is single and does not bother a person. If it interferes, then the doctor conducts a puncture after a thorough examination and determination of the diagnosis.

Vitamins E, A, C, K, B vitamins, multivitamin complexes are prescribed to strengthen the walls of blood vessels and the immune system.

The appearance of bloody blisters in the mouth indicates an injury to the oral cavity or is a symptom of a disease of the body. Only a doctor can establish the true cause of this education and prescribe an effective treatment.If you seek qualified help in time, then this ailment will not bring discomfort and will not lead to serious consequences.

Causes and treatment of blood blisters in the mouth on the cheek

The lining of the oral cavity is the most resistant human mucosa to irritants and pathogenic microorganisms. Therefore, it is rarely exposed to external influences. The bladder most often forms as a result of trauma. Less commonly, dental diseases or systemic pathologies are the cause.

Mechanism of blistering in the mouth

A blister on the inside of the cheek is a hematoma, or bruise. It is a small, from a few millimeters to a couple of centimeters, rounded formation. Internal exudate is serous or bloody, depending on the degree of injury. In the first case, the blister is gray-white, in the second – red, a bluish tint is possible.

Blood blisters appear due to mucosal trauma. Their formation is a natural reaction of the immune system to an irritant.It consists in:

  1. Activation of the body’s defense mechanisms in response to a stimulus.
    Agranulocytes enter the lesion site: leukocytes and monocytes. The latter, when leaving the blood into the tissues, are converted into macrophages. These cells capture the pathogen, neutralize it, and then die.
  2. The death of agranulocytes leads to their release to the site of injury.
    This process is a signal of trauma to the body. After which he begins to secrete histamine, bradykinin and serotonin into the affected area.They dramatically increase the permeability of the blood vessels.
  3. Spasm occurs at the site of injury.
    Blood flow is hampered, after which the vessels relax and the blood accumulated during narrowing enters the injured area. She moves quickly and under pressure. As a result, the upper layer of the epithelium peels off and a bubble is formed, filled with bloody contents.

Blood blisters appear due to mucosal trauma.

Red or white build-up is not dangerous.It is practically painless and heals within a week. The only discomfort is associated with the inconvenience of chewing and speaking.

The most common cause of blood blisters in the mouth is accidental injury to the mucous membrane. There are three possible defeat options:


A bladder is formed by accidental biting while talking or eating. Also, the mucous membrane can be injured:

  • hard food: lollipops, breadcrumbs, bones;
  • broken, chipped teeth or improperly made dental structures: braces, bridges, crowns, prostheses;
  • during hygiene procedures – tissues are damaged due to careless movements while brushing teeth with a brush or toothpick.

In addition, you can bite your cheek during an epileptic seizure, during sleep, or with strong arousal. In these cases, the patient may not remember the moment of the injury.

A blister may appear after biting with teeth.

Less commonly, a bloody bladder can form due to dental intervention. It is associated with the careless actions of the doctor during the sanitation of the oral cavity.


A bubble on the cheek can form when the mucous membrane is burned with hot drinks, dishes, inhalation of steam or accidental touching of heated cutlery.In this case, the appearance of the bladder is accompanied by burning, swelling, redness and slight soreness.


The cause is tissue damage by aggressive chemical elements: if accidentally swallowed, inhaled vapors in the home or at work, bubbles may appear. As with thermal injury, mucosal hyperemia and painful sensations are observed.

The provoking factors for the appearance of bubbles in the oral cavity include smoking, abuse of strong alcohol, hypovitaminosis.It is believed that under the influence of harmful elements and with a lack of vitamins, the walls of the vessels become thinner. This provokes hemorrhage and the formation of bruises.

Traumatic causes are characteristic of single bloody or serous formations. If bubbles appear regularly, there are a lot of them, they are localized not only on the cheek, but also on the tongue, gums, lips, accompanied by other symptoms (plaque, itching, unpleasant odor) – this indicates diseases of the oral cavity or systemic pathologies.Among these factors are:

  • stomatitis;
  • syphilis in the mouth;
  • tuberculosis;
  • disturbance in the work of the gastrointestinal tract;
  • diseases of the endocrine system;
  • hemangioma;
  • vascular tumor;
  • pemphigus.

The provoking factors for the appearance of bubbles in the oral cavity include smoking, abuse of strong alcohol, hypovitaminosis.

Usually a bloody bladder does not require specific treatment.Since it is a natural response of the immune system to external stimuli, the formation goes away on its own within a few days.

If the formed vesicle did not appear due to trauma, often recurs, or multiple growths are noted, it is necessary to consult a doctor to exclude possible pathologies.

In some cases, hematoma therapy is indicated. It is required for large bladder size, soreness and discomfort. When treating, the dentist-therapist takes into account the following factors:

  • education size;
  • time and factor of appearance;
  • location of the bladder: on the cheek, tongue, lip, gums;
  • Whether there are other blisters or ulcers.

If bubble persists, see your dentist.

Treatment of a bloody ball consists in a puncture, ensuring the outflow of accumulated fluid and antiseptic treatment. Rarely, surgical excision of tissue is required to remove the mass.

When blisters appear due to chipped teeth or incorrect dental constructions, the defects must be corrected. Otherwise, the cheek will be constantly injured.

If the doctor suspects that the bubbles were formed not due to injuries, but as a result of systemic pathologies, the patient will be prescribed a comprehensive examination.Further therapy will be based on test results.

According to indications, multivitamin complexes with an increased content of vitamins C, K, E, A, group B can be prescribed. This will strengthen the walls of blood vessels and prevent hemorrhages.

After surgery, the patient is recommended:

  • temporarily stop smoking and drinking alcohol;
  • do not eat irritating mucous food: salted, smoked, spicy, pickled, coarse;
  • to treat the oral cavity with medicinal solutions and herbal infusions with antiseptic and wound-healing effects: chlorhexidine, miraministin, soda-salt solution, chamomile decoctions, oak bark, sage.

To be safe from complications, rinse your mouth for several days with an antiseptic solution.

What can and cannot be done if a bubble appears on your cheek?

The formation of a bloody ball always causes excitement. However, don’t panic. First of all, it is necessary to establish the reason why it could appear: whether there were injuries, whether hot or irritating food was consumed. Further actions are aimed at relieving inflammation and disinfection:

  1. The mouth is treated with antiseptic preparations.
  2. Rinsing with a solution of soda and salt will help relieve inflammation.
  3. The provoking factors are excluded: smoking, alcohol, the use of salty, sour, spicy, pickled foods.

If after a few days the ball does not decrease and no signs of healing are visible, you should consult a doctor: dentist or therapist.

Bloody blisters in the mouth most often appear as a result of injuries: biting, burns, chemical lesions. Less commonly, the factors are diseases of the oral cavity and systemic pathologies.As a rule, no special treatment is required. If the formation interferes, the dentist pierces it and prescribes an antiseptic treatment.

Blood bladder on the tongue – causes and treatment methods

The presence of blood blisters on the oral mucosa can be a signal of the development of dental, endocrine and gastrointestinal diseases.

To know how to react in such situations, it is necessary to familiarize yourself in more detail with the causes of their occurrence and methods of elimination.

What is a blood bladder on the tongue?

What does it look like?

A blood bladder is also called a hematoma, a blood blister, a lump.

It is an accumulation of coagulated blood in an organic cavity under the mucous membrane.

On the tongue, the hematoma looks like a swelling, the color of the tongue changes and acquires a bluish color, puffiness appears.

The patient feels pain and discomfort while eating while talking.

In addition, the occurrence of punctate hemorrhages is often observed on the mucous membrane.

The appearance of bloody bumps is a kind of hemorrhage resulting from injury to the capillaries and thin vessels of the oral mucosa.

Inside the bladder, there may be a clear serous fluid without blood impurities, which indicates that the vessels are not intact, they were not damaged. Such hematomas are superficial and the healing process occurs very quickly.

If the hematoma on the tongue contains blood inside, then the trauma is deep and the period of its healing will be much longer until the blood dissolves.

How does a bloody blister form?

Bloody blisters in the mouth often do not pose a serious threat to human health.

They arise as a result of mechanical damage to the mucous membrane.

At the moment of receiving a microtrauma, harmful microorganisms begin to attack the damaged area.

To destroy them in the body, the immune forces begin to activate.

Leukocytes and monocytes, macrophages, which suppress the vital activity of microbes and eliminate them, are immediately sent to the injured area.

The level of health of the body is assessed according to the general condition and integrity of the oral mucosa, then only upon examination can a final diagnosis be made.

Since the clinical manifestations of many pathological conditions, including infectious, chronic, bacterial, proceed along with a change in the color and integrity of the oral mucosa (tongue, gums). Here it is important to identify the true cause of the blood ball.


Distinguish bloody bubbles by their location.They can be on the surface of the tongue, under it and on the cheeks.

Hematomas that have appeared indicate a microtrauma that has occurred or the presence of a serious pathological condition.

A large number of blisters on the oral mucosa, filled with blood, can form in diseases of the gastrointestinal canal, dental problems, in case of disorders in the endocrine system.

So, with stomatitis, vesicles, ulcers appear on the mucous membrane of the cheeks, and on the gums, and on the palate, as well as on the tongue.

In syphilis, blood bumps are located on the tip, back of the tongue or on its lateral surfaces. With tuberculosis, hematomas are localized on the tongue, lips, cheeks, gums, palate.

Causes of occurrence

Among the factors provoking various external injuries of the oral mucosa are:


Injury to the surface of the tongue is caused by all piercing and cutting objects that cause direct and immediately tangible harm.

For example, dishes with bones cause damage to the oral mucosa during their consumption.It is not the amount of food eaten that matters here, but the receipt of microtraumas that violate the integrity of the surface of the tongue.

Blood bladders formed during mechanical action do not pose any threat to human health. To speed up the process of resorption of the seals on the tongue, under it, it is recommended to rinse the mouth more often after eating.


During the ingestion of salty or sour food in the mouth, small lesions in the form of ulcers appear on the mucous membrane of the tongue almost instantly.

This reaction is observed in most fans of oriental cuisine, where hot spices are used.


Such injuries include microtraumas resulting from drinking too hot tea or coffee.

The duration of wound healing from thermal effects directly depends on the depth of the lesion, they heal for a rather long time.

Depending on the degree of damage, sensations change:

  • At the first degree
    the burn occurs only on the outer layer of the tongue.A person experiences pain, the color of the tongue changes to red and after a while begins to swell. Rinsing the mouth with antiseptic solutions will help speed up the healing process.
  • Second degree
    sensations become more painful, since not only the outer, but also the inner layer of the tongue is affected. Blood blistering, swelling and redness of the tongue are also observed. In this case, it is recommended to seek medical help as soon as possible so that the doctor removes the lump, rinses the affected area and treats it with an antiseptic.
  • Third degree
    the burn penetrates deep into the tongue, the burned surface turns black. The patient complains of a feeling of numbness in the tongue and severe pain. The doctor’s help is required here, otherwise there is a high probability of death.

Diseases accompanied by a blood bladder in the tongue

With various types of this pathological condition of the oral cavity, blood sacs can also form on the inside of the cheeks, on the gums, palate, tongue.Stomatitis is caused by pathogenic microorganisms (bacteria, viruses, fungi), a weakened immune system and injuries.

This disease is often herpetic in nature. Concomitant symptoms are swelling of the tongue, the presence of a yellow-white coating on it, wounds that cause severe pain and discomfort while eating and talking.

If the disease is caused by the herpes virus, then it is accompanied by the presence of a large number of bubbles on the surface of the tongue, which after a while merge into one blister.

When it bursts, erosion forms in its place. In addition to these manifestations, body temperature may rise, weakness, malaise, and loss of appetite may appear.

In this pathological condition, a characteristic feature is the presence of syphilitic chancre on the surface of the tongue, they represent an ulcer or erosion that has a rounded shape.

The edges of the chancre are uniform, smooth, and the bottom is solid, from which liquid flows out when pressed.

Their sizes can vary from 1 mm to 2 cm.

There are ulcers on the tip, back of the tongue or on its lateral surfaces. The person does not feel pain or discomfort.

In 2-3 weeks after the appearance of such ulcers, an increase in regional lymph nodes occurs.

This disease, which has an ulcerative form, proceeds with the formation of wounds on the tongue with a black bottom, which have indistinct edges and blood oozes from them. The place of localization is the edges of the tongue and its tip.

Obvious signs of this disease are pain, discomfort in the oral cavity, a putrid foul smell, swelling of the face, neck, difficulty in swallowing, talking, chewing.


After mycobacterium tuberculosis enters the human body through the mucous membrane, ulcers appear at the site of the lesion. They can form on the tongue, lips, gums, cheeks, palate. Outwardly, the ulcer looks like a pink crack, covered with a white-yellow coating, its edges are soft, scalloped.

If you try to remove plaque, then its granular bottom begins to bleed. In most cases, yellow-red bumps are formed around the affected area.

In case of tuberculous ulcers, pain, discomfort in the mouth, difficulty in eating and speaking are noted.

The process of wound healing is rather slow. During palpation, the regional lymph nodes cause severe pain, they are enlarged.

Necrotic periadenitis

In a recurrent condition, ulcers are localized on the side, they affect not only the tongue, but the lips and cheeks.

Before they are formed, the mucous membrane thickens, the edges at the site of the lesion rise.

Inside the ulcers there is an inflammatory infiltrate, which includes blood, lymph, and cell clusters.

With this disease, there is increased salivation, bleeding, and a bad smell from the oral cavity.

In neglected forms, ulcers deepen, fill with purulent contents, which provokes an increased body temperature, a feeling of weakness and feeling unwell.

They stand out with very strong soreness, it is very difficult to cure them. This period can last for several months. Treatment here must have an integrated approach.

Afty Bednara

This pathological condition most often affects young patients under 1 year old who are artificially or naturally fed.Aphthae can form due to excessive pressure on the nipple or when using an uncomfortable bottle.

After a while, they transform into ulcers covered with a gray-yellow coating, which is quite problematic to remove. The inflammatory process proceeds with a color change, the aphthae has a red color and edema appears around it.

Given the strong pain that is characteristic of such ulcers, the child refuses food, begins to be capricious, which is easy to notice.Aphthae on the tongue, cheeks, gums can also appear in older children, as a result of constant sucking of pens, fingers, toys.

Endocrine pathologies

In diabetes mellitus, due to trophic changes in the tongue, decubital wounds appear, filled with a dense infiltrate in the center.

They heal very slowly and give a person a lot of unpleasant sensations. The tongue turns red, it swells.

Gastrointestinal diseases

Blood blisters on the tongue, under it, are formed in case of disorders in the gastrointestinal tract.So, ulcerative glossitis can develop with enterocolitis, hypoacid gastritis.

Helminthic invasion

Hypovitaminosis / vitamin deficiency

With a lack of vitamin A, a person complains of a feeling of dryness in the oral cavity, which leads to the formation of cracks, ulcers on the surface of the tongue.

If there is an acute shortage of nicotinic acid, then there is an increase in the size of the tongue, a dense plaque on it, the presence of furrows.

When removing plaque, irritation of the mucous membrane occurs, which causes discomfort and soreness in the affected area.In the case of a deficiency of vitamin C, the vessels become fragile, and when ruptured, blisters form.

The papillae may atrophy, the tongue acquires a folded structure, and ulcers appear on its surface. Such manifestations in the tongue are characteristic of a lack of vitamin B6.

How to treat a blood bladder?

General Medicine

Depending on the type of pathological condition that caused the appearance of a blood bladder in the mouth, treatment can be carried out with the following medications:

With candidal stomatitis, antifungal drugs such as Levorin, Nistanin show effectiveness.

  • For diseases with viral etiology, Viferon, Amoxicillin, Tsiprolet, Azithromycin are included in the treatment regimen.
  • To combat gingivostomatitis, where it is supposed to remove the areas affected by necrosis, antiallergic medicines, antibacterial agents, and vitamin complexes are used.
  • In case of traumatic formations that pass on their own over time, the oral cavity is treated with antiseptic agents. If there is pain, the doctor may prescribe Cholisal, Ketoprofen, Voltaren, Lornoxicam, Kamistad.
  • To eliminate tuberculosis, prescribe appropriate chemotherapy, which includes Rifampicin, Ioniazid, Pyrazinamide.
  • Local therapy

    To speed up the healing process, regularly rinse with antiseptic agents. Good results are shown by Furacilin, Chlorhexidine, Stomatidin, Betadine, Miramistin, hydrogen peroxide solution, Iodoform, Chlorophyllipt.

    Treatment of the affected tongue with disinfecting solutions should be performed twice a day, at least, but before that it is imperative to brush your teeth and remove food debris.

    It is advisable to take food after the procedures in 30-60 minutes, which will significantly increase their effectiveness.

    Traditional methods

    To alleviate the condition, it is good to use medicinal decoctions based on chamomile, sage, yarrow, St. John’s wort, viburnum fruits.

    They are prepared at the rate of 1 tbsp. phyto-raw materials for 1 glass of water.

    Bring the mixture to a boil and leave for 2-3 hours to infuse. Strain before use.

    Aloe or Kalanchoe juice has a wound healing effect.

    Sea buckthorn and rosehip oil has the same property. They are applied directly to the affected area.

    These funds accelerate the regeneration process, prevent the growth of pathogenic microorganisms and anesthetize the lesion.

    A solution made from salt (1 tsp), 3 drops of iodine and soda (1 tsp), is a universal remedy in the fight against inflammatory processes in the oral cavity.

    These components are mixed in one glass of warm boiled water and used for lotions, rinses.Also treat the affected area well with hydrogen peroxide.

    What not to do?

    In the presence of blood bubbles, you must not:

    • Pierce and burst them yourself.
      Such a technique will only aggravate the situation, as a result of additional trauma, a fungal infection will join the existing problem, which will prolong the disease.
    • Ignore the emerging hematoma, lump, clot in the oral cavity.
      If there are any changes in the mucous membrane of the tongue, gums, palate, cheeks, it is recommended to contact a qualified specialist who will identify the true cause of the disease and prescribe an appropriate treatment regimen.

    According to specially conducted studies of a famous infectious disease specialist
    N.I. Morozkin, on the 1-2 nd day of illness, on the sharply hyperemic and somewhat cyanotic mucous membrane of the soft palate, and sometimes on the back wall of the pharynx with influenza, millet eruptions (inflamed follicles) appear in the form of small (up to 1-2 mm) and larger (up to 4-5 mm) grains. By the 3-4th day, hyperemia of the soft palate is replaced by a pronounced injection of blood vessels that form a mesh, punctate hemorrhages are possible.

    By the 7-8th day these phenomena subside
    . Fine granularity is characteristic of influenza caused by type A virus, larger – for type B influenza. Typical lesions of the mucous membrane of the oropharynx with influenza are not traced in all cases, but if they are present, these changes are important to take into account in the differential diagnosis of influenza from other acute respiratory diseases , in which hyperemia and edema of the mucous membrane of the oropharynx are diffuse in nature and are usually combined with hyperemia and edema of the mucous membrane of the nasopharynx.

    This picture is observed with parainfluenza
    , rhinovirus infection and other acute respiratory viral infections. It should be emphasized that there are no manifestations of acute gastroenteritis with influenza. There is no “intestinal flu” as you can still hear from some medical practitioners. Sometimes vomiting and loose stools (diarrhea) in patients with influenza are the result of neurotoxicosis and exacerbation of concomitant diseases of the gastrointestinal tract (colitis, cholecystitis, pancreatitis, etc.)).

    Changes in the mucous membrane of the oropharynx
    with adenovirus infection are especially pronounced with its pharyngeal and pharyngoconjunctival forms. They appear as a thin whitish coating on the tonsils and an abundant exudate that extends beyond the arches to the soft palate and posterior pharyngeal wall. In addition to pharyngitis and conjunctivitis (catarrhal, follicular, membranous), keratoconjunctivitis, rhinitis, rhinopharyngotonsillitis, rhinopharyngobronchitis are observed.

    Regional lymph nodes
    increased.In some patients (1/3), the liver and spleen are enlarged, there may be diarrhea. In the case of diseases caused by the respiratory syncytial virus, there is a moderate hyperemia of the mucous membrane of the oropharynx.

    Significantly different from described lesions
    the mucous membrane of the oropharynx in case of enterovirus and herpetic infections (SG Cheshik). In the majority of patients with enterovirus infections proceeding according to the type of acute respiratory diseases, hyperemia of the oropharynx is observed, sometimes combined with moderate scleritis and conjunctivitis, rhinitis.Special forms of Coxsackie enterovirus infection can manifest as vesicular stomatitis and skin rashes.

    In the oral cavity
    , on the tongue, soft palate, gums, mucous membrane of the cheeks, vesicular pale gray rashes 2-8 mm in size and indiscriminate painful ulcerations with a diameter of up to 20 mm, formed from vesicles, are formed. At the same time, elements of a blistering rash are present on the hands, feet; they are surrounded by a red rim up to 1 cm. Along with a blistering rash, there may be a maculopapular rash on the skin of the extremities and trunk.An independent form of enterovirus infection is possible – herpangina (vesicular and aphthous pharyngitis).

    Oropharyngeal mucosa
    is hyperemic, on the anterior palatine arches, uvula, soft palate, tonsils, small vesicles are found, which soon turn into superficial erosion. Herpangina, in contrast to classic tonsillitis, is recorded mainly in the summer and autumn months. Children are sick more often than adults. With herpes infections caused by simple and zosteriform viruses, the lesions of the mucous membranes are more extensive and painful, last much longer than with herpangin.

    With zosteriform herpes
    they are more often one-sided. Rashes on the oral mucosa appear on the side of cutaneous herpetic lesions, most often associated with lesions of the II and III branches of the trigeminal nerve.

    Sometimes the child begins to complain of a sore throat, and the parents, examining the baby closely, notice red dots on the mucous membrane of the palate, resembling pimples. Red rashes on the tissues of the throat are called enanthema in medical practice.What is it, is it worth fearing rashes, and in what cases is the help of a specialist needed?

    Treatment of enanthema differs depending on the cause of the rash.

    Signs of enanthema – rashes on the oral mucosa

    Malaise in some cases may be accompanied by rashes, the nature of which depends on the disease. Most often, enanthema is triggered by bacteria or viruses. The baby’s condition is characterized by the following symptoms:

    • he complains of sore throat and itching;
    • he has difficulty breathing;
    • it hurts the crumb to swallow;
    • pain and aches are felt in the body;
    • in the morning and in the evening the baby is worried about a dry cough;
    • there is an increase in temperature and signs of intoxication.

    Reasons for the appearance of red dots on the throat and palate

    This article tells about typical ways of solving your questions, but each case is unique! If you want to know from me how to solve your particular problem – ask your question. It’s fast and free


    There are many reasons for the enanthema. The most common rashes provoke:

    1. fungal infection;
    2. viral diseases;
    3. allergic reactions.

    Red dotted throat often seen in chickenpox, measles, lichen or dermatitis. Below is a detailed description of the most common causes of enanthema.

    Diseases of a viral nature

    Enanthema can occur as one of the symptoms of measles

    Allergic reaction

    Allergies in a baby are caused by many factors. The rash can be caused by various allergens, such as animal hair, certain foods, items of clothing or household chemicals.With allergic enanthema, the child does not have discomfort, high fever and malaise. Allergic rashes are characterized by the following features:

    • no itching and burning;
    • spots can merge together;
    • there are light areas around the spots;
    • a rash is possible both on the palate and on the whole body of the crumbs (see also:).

    For diagnosis, you must visit an allergist. After the allergen is identified, it must be eliminated – sometimes the child gets rid of unpleasant symptoms without treatment.

    Fungal infection

    Candidiasis in infants

    Fungal infection (thrush) in babies is provoked by fungi of the genus Candida (we recommend reading :). The rash with this ailment looks like small red pimples, covered with a white bloom. Common in both breastfed and formula-fed infants.

    When should I see a specialist?

    Regardless of the nature of the rash in the child (it is present only on the mucous membrane of the throat or is distributed throughout the body), you should immediately seek help and explanations from a doctor.Such symptoms may indicate the presence of dangerous viruses or infection in the baby’s body.

    Without treatment, enanthema of a viral or infectious nature can cause serious complications and spread to internal organs. To determine the exact cause of small rashes, the ENT doctor conducts a thorough examination of the throat mucosa. If necessary, additional studies can be prescribed: a general blood and urine test, identification of an allergen, etc.

    Preventive measures

    To reduce the likelihood of a rash, certain preventive measures must be followed.The basic rules for caring for a child include:

    1. strengthening the baby’s immunity – daily walks in the fresh air, hardening, eating a large amount of vegetables and fruits, taking vitamin and mineral complexes;
    2. thorough oral hygiene;
    3. timely treatment of caries;
    4. implementation of preventive vaccinations, timely vaccination of the baby;
    5. during outbreaks of infectious diseases, visiting public places should be limited, and antiviral drugs should be given to the child for prophylactic purposes.

    ( 5
    rated at 4.60
    90,200 of 90,199 5

    What is Changes in the oral mucosa in diseases of the hematopoietic system –

    Diseases of the blood and hematopoietic organs
    are often accompanied by changes in the oral mucosa, which in some cases appear earlier than the clinical signs of the underlying disease. This forces patients to seek help from the dentist first. The dentist is often the first to encounter such patients, so he must be well versed in the manifestations of the pathology of the hematopoietic system in the oral cavity.This will make it possible to diagnose in a timely manner and prescribe the correct treatment. In addition, the inability to recognize the disease can significantly worsen the patient’s condition.

    must know the scope of necessary and acceptable interventions for diseases of the hematopoietic system. Unjustified dental intervention can contribute to profuse bleeding from the socket of the extracted tooth or during curettage, as well as the progression of necrotic processes in the oral cavity and even death.

    Psychological and deontological aspects of the first contact of a dentist with a hematological patient are very important. It is necessary to be able to carefully and convincingly explain to the patient the need for some special examination methods or consultation with a hematologist in connection with the revealed features of the lesion of the oral mucosa. When communicating with a patient, it is very important not to frighten him and not cause psychological trauma, since fear of a malignant neoplasm (acute and chronic leukemia) is a natural state of most people.

    Pathogenesis (what happens?) During Changes in the oral mucosa in diseases of the hematopoietic system:

    Acute leukemia
    is characterized by an increase in the number of blast, “young” cells in the bone marrow, spleen, lymph nodes and other organs and tissues. Depending on the morphological and cytochemical characteristics of blast cells, several forms of acute leukemia are distinguished: myeloblastic, lymphoblastic, plasmablastic, etc. The lesion of the oral mucosa is observed in 90.9% of patients with acute leukemia.It is diagnosed mainly at a young age (up to 30 years).

    Hemorrhagic syndrome
    are detected in 50-60% of patients and it is based on pronounced thrombocytopenia, which develops as a result of inhibition of normal hematopoiesis due to leukemic hyperplasia and bone marrow infiltration.

    Clinical manifestations of hemorrhagic syndrome can be different: from small-point hemorrhages on the oral mucosa and skin to extensive hematomas and profuse bleeding.

    Bleeding gums
    is very often the first clinical sign of acute leukemia. At the same time, the gums become loose, bleed, ulcerate. Bleeding occurs at the slightest touch, and sometimes spontaneously. Bleeding is possible not only from the gums, but also from the tongue, cheeks along the line of closing the teeth and other areas of the oral mucosa. Sometimes they find extensive hemorrhages and hematomas of the oral mucosa.

    Differentiation of hemorrhagic syndrome in acute leukemia follows from hypovitaminosis C, traumatic injuries (especially on the mucous membrane of the cheeks along the line of closing the teeth).The final diagnosis is established on the basis of the clinical picture of the disease, a general blood test and a study of bone marrow punctate.

    Gingival hyperplasia
    is a common symptom of acute leukemia, especially in its severe course, and hematologists assess it as an unfavorable prognostic sign. Hyperplasia and infiltration of the gums by leukemic cells are so significant that the crowns of the teeth are almost completely covered by a loose, bleeding, ulcerated shaft in places that prevents the patient from eating and talking.It is characteristic that in most cases, already at the very beginning of the disease, hyperplasia is more pronounced on the inner (palatal or lingual) surface than on the buccal. This clinical symptom sometimes helps to differentiate gingival hyperplasia in leukemia from the banal hypertrophic gingivitis.

    According to histological data, gingival hyperplasia is caused by infiltration of the connective tissue layer of the mucous membrane by myeloid cells, which leads to disruption of trophism, followed by tissue necrosis and ulceration.

    Ulcerative necrotic lesions of the mucous membrane of the mouth
    and often develop in acute leukemia. It is characteristic that the apex of the gingival papilla undergoes necrosis. Around the focus of necrosis, the gums have a bluish color, while the entire mucous membrane is pale, anemic. Necrosis spreads quickly and soon an ulcer with a dirty gray fetid plaque forms around the tooth.

    Often, necrosis is detected on the tonsils, in the retromolar region and other parts of the oral cavity. A feature of the necrotic process in acute leukemia is its tendency to spread to adjacent areas of the mucous membrane.As a result, there may be extensive ulcers with irregular contours, covered with a gray necrotic plaque. Reactive changes around the ulcer are absent or weak. With necrotic changes in the oral cavity, patients complain of severe pain when eating, difficulty swallowing, putrid fetid breath, general weakness, dizziness, headache. At the beginning of the development of ulcerative necrotic changes, hypersalivation is possible, and then the amount of saliva decreases, which is associated with dystrophic processes in the salivary glands.

    The reasons for the appearance of necrotic processes on the oral mucosa in acute leukemia have not been completely clarified. It is believed that necrosis can occur as a result of the disintegration of leukemic infiltrates, as well as as a result of neurotrophic disorders in tissues and disturbances in the body’s defenses.

    An important factor determining the development of necrosis is the action of external factors, especially microorganisms.

    Lymph nodes
    in acute leukemia increase slightly – up to 0.5-1 cm, they are soft, painless.In some cases, acute leukemia can occur with the formation of pronounced specific leukemic infiltrates on the skin and oral mucosa. As a result of the formation of infiltrates in the gums, a sharp deformation of the gingival margin occurs. This condition is often diagnosed as hypertrophic gingivitis. Leukemic infiltrates can ulcerate, which often leads to bleeding.

    – clinical and hematological syndrome, characterized by a decrease in the number or disappearance of granulocytes (granular leukocytes) from the peripheral blood.By the mechanism of occurrence, myelotoxic and immune agranulocytosis are distinguished. The cause of myelotoxic agranulocytosis is a violation of the formation of granulocytes in the bone marrow as a result of exposure to the body of ionizing radiation, cytotoxic drugs, benzene vapor, etc. Immune agranulocytosis is observed when granulocytes in the blood are destroyed by immune complexes formed in people with hypersensitivity to certain drugs (amidopyrine , butadione, analgin, phenacetin, sulfonamides, some antibiotics, etc.).

    Agranulocytosis often begins with changes in the oral cavity, which forces patients to go to the dentist first. Against the background of a deterioration in the general condition of patients (fever, lethargy, headache, pallor of the skin), pain occurs when swallowing, bad breath. At first, there is abundant salivation in the oral cavity, the tongue becomes covered with a dirty gray coating. The mucous membrane of the soft palate, anterior palatine arches, the pharynx is hyperemic and edematous. Subsequently, on a hyperemic background, a small-dotted, loose white, difficult-to-remove plaque appears, resembling thrush.After a day, it acquires a gray-green color, characteristic of necrotic tissue. Gums become cyanotic, putrid odor from the mouth, ulcerative necrotic processes appear, which tend to spread rapidly. Sometimes necrosis of the root of the tongue is possible. The destruction of the oral mucosa proceeds without a pronounced leukocyte reaction of the surrounding tissues and is characterized by slight pain. Easily bleeding, offensive ulcers develop. Sometimes the jaw bone tissue is also involved in the ulcerative necrotic process.The gums, lips, tongue, cheeks, tonsils are more often affected. When the tonsils are affected, pain occurs when swallowing. Some patients develop ulcers along the digestive tract. The lymph nodes are enlarged. The number of lymphocytes in the blood is significantly reduced. In the leukocyte formula, the number of granulocytes is sharply reduced or they are absent, only lymphocytes and monocytes are found.

    Polycythemia (erythremia, or Vakez’s disease) is a chronic disease of the hematopoietic system, characterized by a persistent increase in the number of red blood cells and hemoglobin per unit volume of blood.Along with an increase in the volume of circulating blood, an increase in its viscosity and a slowdown in blood flow, an increase in the number of platelets and an increase in blood coagulation are noted. The disease associated with increased production of erythrocytes, leukocytes and platelets in the bone marrow develops gradually and has a long chronic course. It occurs more often in men aged 40-60 years. The color of the skin and mucous membrane of the mouth changes. They acquire a dark cherry color with a cyanotic hue, which is due to the increased content of reduced hemoglobin in the capillaries.The gums bleed frequently. Possible severe bleeding for minor trauma in the oral cavity, as well as spontaneous nose, gastrointestinal, uterine bleeding.

    Characterized by a dark cherry color with a cyanotic shade of lips and cheeks. In the oral cavity, Kuperman’s symptom is typical – pronounced cyanosis of the mucous membrane of the soft palate and pale coloration of the hard palate. Many patients experience pruritus, paresthesias of the oral mucosa, associated, in the opinion of many authors, with increased blood vessels and neurovascular disorders.The picture of peripheral blood is characterized by an increase in the content of erythrocytes (up to 6.8-10.2 / l), hemoglobin (180-200 g / l), a decrease in ESR to 1 – 3 mm / h.

    Symptoms of Changes in the oral mucosa in diseases of the hematopoietic system:

    Chronic leukemia

    Depending on the nature of the lesion of the hematopoietic organs, there are myeloproliferative (myeloid leukemia) and lymphoproliferative (lymphoproliferative leukemia) forms of chronic leukemia. Chronic myeloid leukemia goes through two stages: benign, lasting several years, and malignant (terminal), which lasts 3-6 months.The first stage often begins without pronounced clinical symptoms, then neutrophilic leukocytosis appears with a shift to promyelocytes and single blast cells. In the second stage, as in the first during blast crises, there are many blast forms in the blood (myeloblasts, hemocytoblasts), a rapid increase in the number of leukocytes in the blood. As leukemia progresses, anemia, thrombocytopenia, accompanied by hemorrhages develop.

    Chronic myeloid leukemia
    is asymptomatic for a long time and can be accidentally diagnosed by a clinical blood test.The blood picture is characterized by high leukocytosis (50-60109 / l). In a blood smear, various intermediate forms of the myeloid series are found: myeloblasts, promyelocytes, myelocytes.

    Hemorrhagic manifestations are characteristic of chronic myeloid leukemia, although their intensity is much less than in acute leukemia. Bleeding of the gums does not occur spontaneously, but when injured. The mucous membrane of the mouth is pale. The gums are swollen, bluish, bleed at the slightest touch, there is no inflammation.Absence of inflammation and severe bleeding are characteristic symptoms of leukemia.

    Erosive and ulcerative lesions of the oral mucosa
    , according to V.M. Uvarova (1975), observe in / 3 patients with myeloid leukemia. The appearance of severe necrotic lesions is considered as an unfavorable sign indicating an exacerbation of the process. In the severe stage of the disease, candidiasis often develops.

    Chronic lymphocytic leukemia usually occurs in middle-aged and elderly people, is characterized by a long-term benign course and a significant increase in the number of leukocytes in the blood (lymphocytes prevail among them).The number of leukocytes can reach 500109 / l.

    The initial period of chronic lymphocytic leukemia often goes unnoticed by the patient. The only complaint may be an increase in lymph nodes (on palpation, they are not very dense, mobile, painless). Leukemic lymphocytic infiltrates or tumor nodes are formed in the oral cavity in chronic lymphocytic leukemia. They are most often located on the mucous membrane of the gums, cheeks, tongue, palatine arches, tonsils. The resulting infiltrates (knots or nodules) of a soft (pasty) consistency, bluish color, mobile, rise above the level of the mucous membrane.Ulceration is rare. Bleeding occurs with minor injury. Leukemic lymphocytic infiltrates are also localized in the bone marrow, lymph nodes, spleen, and liver.

    Thrombocytopenic purpura
    – a syndrome characterized by increased bleeding due to a decrease in the number of platelets in the blood. Thrombocytopenic purpura – Werlhof’s disease – can be an independent disease (idiopathic form) or be the result of malignant neoplasms, radiation sickness, hepatitis, infectious diseases, drug intoxication (symptomatic form.)

    Idiopathic thrombocytopenic purpura, or Werlhof’s disease
    , characterized by a prolonged recurrent course with chronic bleeding. The disease is most often hereditary.

    The main clinical symptoms of the disease are hemorrhages in the skin, mucous membranes, as well as bleeding from the nose, gums, arising spontaneously or under the influence of minor trauma. Bleeding often occurs at injection sites. Dangerous bleeding can be associated with surgical interventions in the oral cavity (tooth extraction, curettage).In the oral cavity, dryness of the oral mucosa, atrophy of the filiform papillae of the tongue. In areas of atrophy of petechiae. Hemorrhages are observed in the serous membranes, retina and other parts of the eye. Hemorrhages in the heart and brain are life-threatening. Patients have a slightly increased body temperature and severe thrombocytopenia (up to 20109 / l or less), as a result of which the retraction of the blood clot is impaired and the bleeding time is lengthened up to 10 minutes or more (normally 3-4 minutes). As a result of repeated prolonged bleeding, iron deficiency anemia can develop.

    Anemia –
    is a group of various pathological conditions characterized by a decrease in the hemoglobin content and (or) the number of erythrocytes per unit of blood volume. Anemias are hereditary and acquired. According to the modern classification, anemias can develop as a result of blood loss (post-hemorrhagic), increased destruction (hemolytic) and impaired erythrocyte formation.

    For some forms of anemia, along with general manifestations, typical symptoms in the oral cavity are characteristic.First of all, anemias that develop as a result of a violation of the formation of erythrocytes are deficiency anemias associated with insufficiency of such hematopoietic factors as iron (iron deficiency anemia), as well as vitamin B | 2 and folic acid (megaloblastic anemia).

    Iron deficiency anemia, hypochromic. The causes of the disease are associated with insufficient intake of iron in the body or its increased consumption (during growth, pregnancy, lactation, with increased sweating), as well as with endogenous disorders leading to insufficient absorption of iron (with resection of the stomach, intestines, achilic gastritis, gastroenteritis , chronic colitis, endocrine disorders, etc.). Deficiency of iron reserves in tissues leads to a breakdown of oxidation-reduction processes and is accompanied by trophic disorders of the epidermis, hair, nails and mucous membranes, including the oral mucosa.

    Clinical presentation
    is characterized by pallor of the skin, weakness, dizziness, tinnitus, cold sticky sweat, a decrease in body temperature and blood pressure, and an increased tendency to faint. Along with general symptoms, changes in the oral cavity are recorded, which have a certain diagnostic value.Thus, paresthesias and disturbances in taste appear long before the decrease in the level of serum iron and the development of obvious anemia. On examination, the mucous membrane of the mouth is pale, insufficiently moisturized. Atrophy of the oral mucosa is pronounced, it becomes thinner, less elastic and easily injured. The atrophic process also captures the epithelial cover and papillae of the tongue. Patients are worried about dry mouth, difficulty swallowing food, burning and pain in the tongue, lips, aggravated by eating, taste perversion.Patients eat chalk, tooth powder, raw cereals. Cracks often appear in the corners of the mouth and on the lips (especially with anacid gastritis and after resection of the stomach). The back of the tongue is hyperemic, shiny, the papillae are atrophic. The tongue is very sensitive to all mechanical and chemical stimuli. There is soreness when taking spicy, sour, hot food. Slight swelling of the tongue, which is determined by the imprints of the teeth on its lateral surfaces. In a number of patients, a loss of the natural gloss of the enamel, increased abrasion of the teeth is observed.

    Hyperchromic anemia, malignant, or pernicious, Addison-Birmer anemia,
    is characterized by impaired erythropoiesis. Vitamin B, 2 and folic acid are essential factors for normal hematopoiesis. Deficiency of vitamin B, 2 affects the maturation of erythroblasts in the bone marrow, resulting in the formation of immature cells – megaloblasts, megalocytes, which quickly die. Deficiency of vitamin B12 in the body is due to the absence of Castle’s internal factor – a gastromucoprotein produced by the gastric mucosa, without which vitamin B, 2 (external factor) is not assimilated.The causes of vitamin B, 2 deficiency can be atrophic processes in the gastric mucosa, gastric resection, inflammatory bowel diseases or resection of certain areas of the intestine, vitamin B, 2 deficiency in food.

    Folic acid deficiency anemias
    occur with impaired absorption of folic acid (alcoholism, sprue, etc.), with insufficient intake of folic acid with food and prolonged use of antiepileptic drugs.

    Vitamin B! 2 deficiency anemia is more common in people over 40 years of age.The appearance of patients is characteristic: a pale face, skin with a yellowish tinge, thin, atrophic, hair turns gray early. Weakness and fatigue develop. The clinical picture is characterized by damage to the hematopoietic tissue, nervous and digestive systems. Complaints of patients about pain and burning of the tip or edges of the tongue. Paresthesias in most cases are the first, ahead of the further development of symptoms of anemia.

    On examination, a pale, atrophic with an icteric tinge of the mucous membrane is revealed, sometimes punctate hemorrhages on the cheeks, bleeding of the gums.

    Changes in language are characteristic of pernicious anemia. It becomes smooth, shiny, “polished” due to atrophy of the papillae, thinning of the epithelium and muscle atrophy. Painful bright red spots of a round or oblong shape appear on the back of the tongue, spreading along the edges and tip, when they merge, the entire tongue becomes bright red (Gunther’s glossitis, Hunter-Möller).

    It is in stark contrast to the pale mucous membrane in the rest of the mouth.At the same time, soreness, burning sensation appears when eating spicy and irritating food, as well as when the tongue moves during a conversation. Subsequently, the inflammatory phenomena decrease, the papillae atrophy, the tongue becomes smooth, shiny (“lacquered” tongue). Atrophy gradually spreads to the mushroom and grooved papillae, which is accompanied by a perversion of taste sensitivity. In the epithelium of the tongue, the number of taste buds decreases, and necrobiotic changes occur in the remaining ones.

    Diagnosis of Changes in the oral mucosa in diseases of the hematopoietic system:

    In the diagnosis of acute leukemia
    An important role belongs to general symptoms (weakness, malaise, fatigue, pallor of the skin). Body temperature can be high with large differences, but sometimes it is subfebrile. The patient gives the impression of being seriously ill. Due to a sharp decrease in the body’s defenses, patients with leukemia sometimes develop candidiasis, and herpes infection in the oral cavity manifests itself.Blast cells are present in the blood, and the number of platelets and red blood cells is often reduced.

    Great value in recognition of acute leukemia
    90,200 have oral symptoms that are very characteristic and easily detectable. On examination, pallor of the skin, pastiness, pallor, slight vulnerability and bleeding of the oral mucosa, hemorrhages on the gums, cheeks (especially along the line of teeth closing), palate, tongue are noted. Hematomas and hemorrhages can be observed both on the mucous membrane and on the skin.

    Differentiate the manifestations of acute leukemia on the mucous membrane follows from:

    • hypertrophic gingivitis;
    • Vincent’s ulcerative necrotizing stomatitis;
    • hypovitaminosis C;
    • intoxication with salts of heavy metals.

    The results of blood tests are decisive in the diagnosis of leukemia.

    • Agranulocytosis

    Diagnosis is based on history, clinical presentation, peripheral blood and bone marrow punctate results.

    Differential diagnostics.

    Agranulocytosis should be differentiated from ulcerative necrotizing stomatitis of Vincent and other blood diseases.

    • Thrombocytopenic purpura

    The diagnosis of thrombocytopenic purpura is established on the basis of anamnesis data (detection of contact with various chemicals, uncontrolled intake of analgesics, hypnotics, etc.), clinical picture and blood test.

    Differential diagnostics.

    Differentiate disease from:

    • hemophilia;
    • Sorrows;
    • hemorrhagic vasculitis.

    Diagnosis is based on history data, clinical manifestations, but the decisive moment is the blood picture. It is characterized by hypochromic anemia – a decrease in hemoglobin content and a low color index (0.5-0.6 and below), anisocytosis and poikilocytosis, as well as a decrease in the content of iron and ferritin in the blood serum.

    The diagnosis is made on the basis of the history data, the clinical picture of the disease and the results of a blood test.In the blood, hyperchromic anemia – a decrease in the number of red blood cells saturated with hemoglobin; the color index is 1.1 – 1.3; erythrocytes are large (megalocytes). There are erythrocytes with nuclear remnants and giant hypersegmented neutrophils. When examining bone marrow punctate, megaloblasts are detected in large numbers.

    Treatment of Changes in the oral mucosa in diseases of the hematopoietic system:

    90,200 patients with diseases of the hematopoietic system, carried out by special means and methods, as a rule, are carried out in specialized hematological institutions.The volume of medical manipulations is determined by the severity and stage of the clinical course of the underlying disease, and often the dentist conducts it in a dental or specialized hematological department.

    The task of the dentist is the correct and timely recognition of acute leukemia
    for clinical symptoms in the oral cavity and other manifestations, as well as for the analysis of peripheral blood. Treatment of acute leukemia is carried out in a specialized hematology department; local – in agreement with the hematologist.Good oral hygiene is essential. Treatment and extraction of teeth, removal of tartar is carried out under the supervision of a hematologist in a hospital. With ulcerative lesions of the oral mucosa, it is anesthetized, treated with antiseptic solutions (hydrogen peroxide, chloramine, etonium, romazulan, furacilin, etc.), proteolytic enzymes and agents that stimulate epithelization (rosehip oil, sea buckthorn, propolis preparations, oil solution of vitamins A and etc.). If fungal or herpetic lesions of the oral mucosa are detected, antifungal or antiviral therapy is indicated.

    • Chronic leukemia

    General and local treatment is carried out in the same way as in acute leukemia.

    • Agranulocytosis

    General treatment is carried out under the supervision of a therapist and hematologist, primarily involves blood transfusion, elimination of the etiological factor.

    Local treatment
    includes pain relievers, application of proteolytic enzymes to necrotic areas of the oral mucosa, antiseptic treatment and drugs that stimulate epithelialization.

    Usually, during treatment on the 6-7th day, the necrotic tissue is rejected, and after 2-3 weeks the ulcers are healed.

    • Thrombocytopenic purpura

    General treatment is carried out by a hematologist, as a rule, in a hospital setting.

    Dental interventions should be performed with extreme caution after consulting a hematologist.

    • Polycythemia (erythremia, or Vakes’s disease)

    Treatment is performed by a hematologist. Special topical therapy not indicated.

    General treatment is aimed at eliminating the causes of the anemia and the elimination of iron deficiency. Prescribe iron supplements, vitamins. They recommend a balanced diet.

    Local treatment includes, first of all, the elimination of traumatic factors, oral cavity sanitation. According to indications, symptomatic therapy is prescribed, aimed at eliminating cracks in the red border of the lips, normalizing salivation, eliminating burning sensation, paresthesia, etc.

    • Hyperchromic anemia, malignant or pernicious, Addison-Birmer anemia

    Prescribe vitamin B, 2, 100-500 mcg and folic acid, 0.005 g per day.In severe cases, the administration of vitamins is combined with blood and red blood cell transfusions. Changes in the oral cavity go away quickly after general treatment.

    No topical treatment required. Reorganization of the oral cavity is necessary, according to indications, agents are prescribed for local anesthesia of the oral mucosa (2% trimecaine solution, 1-2% pyromecaine solution, anesthesin in glycerin, etc.).

    Which doctors should you contact if you have Changes in the oral mucosa in diseases of the hematopoietic system:

    • Dentist
    • Hematologist
    • Therapist

    Are you worried about something? Do you want to know more detailed information about Changes in the oral mucosa in diseases of the hematopoietic system, its causes, symptoms, methods of treatment and prevention, the course of the disease and following a diet after it? Or do you need an inspection? You can make an appointment with the doctor
    – clinic Euro
    is always at your service! The best doctors will examine you, study the external signs and help identify the disease by symptoms, advise you and provide the necessary assistance and diagnose.You can also call a doctor at home
    . Clinic Euro
    is open for you around the clock.

    How to contact the clinic:

    The phone number of our clinic in Kiev: (+38 044) 206-20-00 (multichannel). The clinic secretary will select a convenient day and hour for you to visit the doctor. Our coordinates and directions are indicated. Look in more detail about all the services of the clinic on her.

    (+38 044) 206-20-00

    If you have previously performed any research, be sure to take their results for a consultation with a doctor.
    If the research has not been performed, we will do everything necessary in our clinic or with our colleagues in other clinics.

    Do you have? You need to be very careful about your overall health. People do not pay enough attention to disease symptoms
    90,200 and do not realize that these diseases can be life-threatening. There are many diseases that at first do not manifest themselves in our body, but in the end it turns out that, unfortunately, it is too late to treat them.Each disease has its own specific signs, characteristic external manifestations – the so-called symptoms of the disease
    . Identifying symptoms is the first step in diagnosing diseases in general. To do this, you just need to be examined by a doctor several times a year
    90,200, in order not only to prevent a terrible disease, but also to maintain a healthy mind in the body and the body as a whole.

    If you want to ask a doctor a question – use the section of the online consultation, perhaps you will find answers to your questions there and read advice on personal care
    .If you are interested in reviews of clinics and doctors, try to find the information you need in the section. Also register on the medical portal Euro
    , to be constantly updated with the latest news and information updates on the site, which will be automatically sent to your mail.

    Other diseases from the group Diseases of the teeth and oral cavity:

    Abrasive pre-cancerous cheilitis Manganotti
    Abscess in the face
    Partial or complete adentia
    Actinic and meteorological cheilitis
    Actinomycosis of the maxillofacial region
    Allergic diseases of the oral cavity
    Allergic stomatitis
    Anaphylactic shock
    Angioedema Quincke
    Developmental anomalies, teething, discoloration
    Anomalies in the size and shape of teeth (macrodentia and microdentia)
    Temporomandibular joint arthrosis
    Atopic cheilitis
    Behcet’s disease of the oral cavity
    Bowen’s disease
    Warty precancer
    HIV infection in the oral cavity
    The effect of acute respiratory viral infections on the oral cavity
    Tooth pulp inflammation
    Inflammatory infiltrate
    Dislocations of the lower jaw
    Hematogenous osteomyelitis
    Dühring’s dermatitis herpetiformis
    Herpetic sore throat
    Gynerodontics (Overcrowding.Persistent milk teeth)
    Hyperesthesia of teeth
    Hyperplastic osteomyelitis
    Oral hypovitaminosis
    Glandular cheilitis
    Deep incisal overlap, deep bite, deep traumatic bite
    Desquamative glossitis
    Defects of the upper jaw and palate
    Defects and deformities of the lips and chin
    Facial defects
    Lower jaw defects
    Distal bite (upper macrognathia, prognathia)
    Periodontal disease
    Diseases of hard tissues of teeth
    Malignant tumors of the upper jaw
    Malignant tumors of the mandible
    Malignant tumors of the mucous membrane and organs of the oral cavity
    Dental deposits
    Changes in the oral mucosa in diffuse connective tissue diseases
    Changes in the oral mucosa in diseases of the gastrointestinal tract
    Changes in the oral mucosa in diseases of the nervous system
    Changes in the oral mucosa in cardiovascular diseases
    Changes in the oral mucosa with endocrine diseases
    Calculous sialoadenitis (salivary stone disease)
    Oral candidiasis
    Tooth decay

    Red spots on the palate in the mouth are often the result of a complex pathological process in the body.There are many reasons for this. Only an experienced doctor can determine the specificity of the disease with meticulous precision and only in a clinic.

    Why do red spots appear on the palate in the mouth

    There are a lot of provoking factors for the appearance of red spots on the palate in the mouth in adults.

    However, doctors divide them into three groups:

    • pathological processes of blood and vessels;
    • allergic reactions;
    • infectious lesions.

    Red spots on the palate in the mouth may appear once in a lifetime. Often, a person encounters such problems quite often. The recurrent nature is usually the herpes virus, thrush or enterovirus infections.

    In the first stage, the rash develops deep down the back of the throat. However, gradually it begins to affect more and more mucous membranes. Often affecting the tonsils, tongue and even the skin around the mouth.

    Infectious diseases are manifested not only by the appearance of red spots in the sky.The clinical picture appears with increased body temperature, pain in the larynx, weakness, painful swallowing. The rash gradually affects not only the palate, but all the mucous membranes of the mouth.

    An allergic reaction occurs to toothpaste, mouthwash, toothbrush bristles or food. It is important to remember that allergies will be accompanied by redness and other areas of the body.

    It is characterized by the absence of itching or burning. All spots are arranged in a symmetrical order, and they seem to merge with each other, that is, they represent a red bumpy surface.

    Some rare diseases will be a solid spot on the sky.

    Atypical manifestations of palatal lesions are accompanied by specific signs:

    1. Pyogenic granuloma. It develops in areas of the sky that are very often injured.
    2. Kaposi’s sarcoma. It manifests itself in the form of neoplasms of a flat or convex type, crimson in color. The defeat occurs in the presence of HIV infection.
    3. Petechiae in the sky. The red spots are especially large.They appear in a scattered order equally on both hard and soft palates. Such lesions are most often observed with mononucleosis.

    Spots were also poured into the throat

    Redness in the throat often occurs due to neck injury from clothing. Occasionally, material allergies can cause red spots in the throat and palate. The occurrence of such a lesion in atopic dermatitis must be treated with antihistamines. Allergies in the palate and in the throat require similar therapy.

    The rapid spread of Candida fungi, leads to the formation of red spots on the palate and in the throat with a characteristic white bloom. The impetus for the development of candidal stomatitis can be dysbiosis, microflora disorders, poor nutrition, including excessive consumption of sweets. In treatment, one cannot do without a thorough diagnosis and taking a number of medications, including antibiotics.

    Red spots in the throat and on the palate may appear as symptoms of streptococcal sore throat.There is also an increase in body temperature, weakness, pain in the throat. This disease is very dangerous to health.

    Treatment is focused on antibiotics. Less commonly, but still there are red spots or rashes on the palate and throat due to tuberculosis.

    Doctors prescribe antibiotics to prevent complications only when necessary. A particularly effective therapy is one to two weeks. During this time, rashes on the palate and in the throat disappear.

    A visit to an ENT doctor or dermatologist, the therapist recommends with a thorough examination of external signs. The history of any disease depends on the results of laboratory and clinical studies. Correct treatment of red spot problems depends on these conditions.

    Masses around the mouth

    The appearance of red spots around the mouth, which can often crack and peel off, is called perioral dermatitis in medicine. Another name for this disease is cheilitis.If measures are not taken in time, in addition to red spots, a rash is formed, and sometimes turning into purulent acne.

    The main provoking factors of the doctor include:

    1. Irritating effect of the environment. Frosty air, strong wind, direct sunlight, constant humidity.
    2. Deficiency of vitamins A, B and C causes serious disruptions in the body’s defenses. The skin is especially affected.
    3. Poor quality cosmetics, affects the most delicate areas of the skin.Especially with prolonged use.
    4. Lack of water in the body, in other words, dehydration dries out the skin around the mouth, especially at high temperatures.
    5. Dry skin of the face, will periodically suffer from any effects.
    6. Allergic reactions to food, pollen, dust and other factors.
    7. The risk group consists of adolescents whose androgen levels are slightly higher than normal. The skin almost constantly dries up and causes the formation of red spots.

    Cheilitis is treated in a comprehensive manner, depending on the complexity of the pathology, methods are also selected. The use of pills and medicated ointments is often indicated, and sometimes you can just get by with a few masks.

    Here is a list of procedures that are prescribed in most cases:

    • lubrication of the area around the mouth with fatty creams, diluting them with essential oils;
    • intake of a complex of vitamins and minerals;
    • replenishment of water balance in the body;
    • shows the intake of brewer’s yeast enriched with potassium and calcium4
    • the use of natural masks based on aloe juice;
    • allergic irritations require elimination of the allergen;
    • Stir a solution of iodine and olive oil, apply to red skin around the mouth daily;
    • apply natural cosmetic creams with olive extract;
    • Sometimes the doctor prescribes special medicines and treatment procedures.

    Whole oral cavity in adults with red spots

    Lesions with spots on the tongue may result from malocclusion or injury during brushing.

    Red spots on the tongue and palate arising from complex pathologies can become hazardous to health:

    1. Monucleosis, manifested by punctate hemorrhages in the tongue and palate. Lymph nodes also increase, breathing is impaired. The patient is very painful to swallow, the body temperature rises, then rises.The disease, which has become chronic, contributes to the enlargement of the liver and spleen. The risk group is left by people during the period of hormonal changes or disruptions.
    2. Exudative erythema is a rapidly developing disease. Literally during the day, there is a significant increase in temperature, the head hurts constantly, itchy throat. A day after the described signs, the tongue becomes covered with red spots, which subsequently turn into bubbles with a grayish liquid. They also spread to the hard and soft palate, as well as to the lips.The red spots develop into ulcers, causing difficulty in swallowing and severe pain.
    3. Kawasaki syndrome appears as very bright crimson spots. With the disease, spots develop on the skin all over the body. The lips are swollen and reddened, and a high temperature rises. Simultaneously with the red spots affecting the tongue and palate, fingers on all limbs begin to peel off. The risk group is made up of children under the age of 8 years.
    4. Syphilis provokes the formation of red chancre on the tongue, they are hard to the touch.No painful sensations are observed.
    5. Kaposi’s sarcoma refers to malignant lesions. The red spots are bluish and painful when pressed. This pathology develops in people with HIV.

    All of the above lesions require immediate diagnosis in a specialized center or clinic. Self-medication is hazardous to health.

    During treatment, all appointments are carried out in strict accordance with the individual characteristics of the patient.

    In choosing synthetic drugs, doctors rely on the age of the patient, the complexity of the disease and the presence of other chronic problems.


    Ailment near the nose and mouth

    Red spots and discomfort around the nasolabial triangle develop for a variety of reasons:

    1. As a phenomenon after a cold or flu. Redness will go away on its own as soon as the underlying disease is cured.
    2. Demodecosis, develops with the spread of a skin mite.You need to treat only with medications.
    3. Allergic reaction, for treatment it is important to revise the diet. If you react to cosmetics, you should change the manufacturer.
    4. Irritation due to sudden cold snap, in other words “cold allergy”. Dermatologists recommend applying special protective creams to exposed skin areas.
    5. Rosacea, a rare disease associated with problems with small vessels in the skin. Broken capillaries form red spots that can only be removed with a laser.
    6. Disruptions of hormonal levels during pregnancy or with the onset of menopause.

    Undoubtedly, one should not exclude the fact that red spots on these areas of the face can appear during trauma or aggressive peeling. Such defects warn of the presence of any malfunctions in the work of internal organs. Consultation with a dermatologist and therapist will help clarify the situation and choose the right ways to eliminate redness.

    Redness on the soft palate

    Lesion of the soft palate with red spots may accompany the development of dermatitis, lichen or chickenpox.In adults, such pathologies are as difficult as in small children. They are often accompanied by multiple complications.

    More reasons are highlighted that lead to the appearance of red spots in the mouth:

    • lesion of the mucous membranes of the mouth with a fungus;
    • violations in the activity of blood vessels;
    • allergy;
    • flu;
    • infections of various origins;
    • smoking.

    During the development of pharyngitis, a viral disease of the ENT organs, red spots affect not only the soft palate, but also the entire oral cavity.However, they become noticeable in the sky much earlier.

    The clinical picture of the disease is manifested by fever, headaches and muscle pains, pain when swallowing. It is important to treat viral diseases quickly and in a timely manner. Rashes on the palate in such cases disappear after recovery

    A red rash and spots on the palate can develop with chickenpox. With allergies, red spots appear on the palate, due to a negative reaction to any food or toothpaste.To get rid of the problem, it is important to eliminate the allergen from food.

    The appearance of such formations in the palate provokes a streptococcal infection, which is a consequence of scarlet fever. All treatment steps must be agreed with a therapist or otolaryngologist.

    Effective drug treatment

    It is possible to treat sarcoma only in the conditions of an oncological dispensary, with the help of ionizing radiation and chemotherapy. Thrush requires the use of immunomodulatory and antifungal agents.It is important to treat the oral cavity with antiseptics in accordance with the prescriptions of the attending physician.

    Antihistamines are indicated in the treatment of allergies. Often it is required to take corticosteroids and potassium preparations; in order to relieve the symptoms of the disease, it is important to eliminate the allergen provoking a deterioration in health.

    For scarlet fever, rinsing the mouth and throat with antiseptics, taking antibiotics. Miramistin and Stomatidin are recommended.

    In almost all cases, regardless of the main reasons, Cholisal and Metrogyl Denta are prescribed.Shingles can be cured only after a course of therapy with antiviral and antibacterial drugs.

    It is necessary to adjust the diet, giving up fatty, smoked and spicy foods. Alcohol abuse inhibits the entire healing process.

    Help with folk remedies

    It is optimal to use calendula, sage, coltsfoot, flax seeds, chamomile in the treatment of oral cavity problems. These plants heal the affected areas and coat, preventing the development of almost any infection.

    In folk medicine, decoctions and infusions of chamomile are especially popular. The herbal components of chamomile are useful not only as rinses, but also as herbal tea. Even 4 cups of drink a day are able to create a healing miracle.

    Shingles in the palate and in the oral cavity in folk healing are eliminated by rinsing with wormwood, oregano and celandine. You can lubricate problem areas with sea buckthorn and camphor oil.

    A decoction of chamomile and calendula will bring a quick recovery if you rinse your mouth with it at least 5 times a day.The people often use the usual soda-salt composition for solutions.

    Birch bud lotions are used to remove red spots around the mouth and nose. You can make mini masks from fresh cabbage juice, with the addition of glycerin and any baby cream.

    Potential consequences and complications

    Red spots with streptococcal sore throat in the throat and palate indicate the complexity of the disease. If treatment is not taken, rheumatic fever or heart disease may develop.Enlargement of the tonsils with any, even a seemingly harmless cold, are life-threatening.

    The development of thrush requires an integrated approach to treatment. Pathogens spread very quickly.

    Hematoma in the mouth: symptoms, causes, treatment

    Translated from Greek “heme” means “blood”. A hematoma is an accumulation of blood that occurs due to rupture of blood vessels and capillaries when tissue is injured. Hematomas can form in the mouth under the mucous membrane, located in the cheeks, lips, palate, gums.Why there is a hematoma in the mouth and how dangerous it is, how to get rid of an unpleasant neoplasm, you will learn from our article.

    2> Features of pathology

    Hematoma is a hemorrhage in the submucosal layer, so it will look like a bloody bladder, a burgundy or bright red ball. The blood inside it can be liquid or clotted. Hematomas that appear in the submucous layer of the oral cavity are called superficial submucosal.

    In addition, the hematoma cavity can be filled with colorless serum fluid secreted by the serous membranes.Such a neoplasm is formed without damage to the vessels, as evidenced by the absence of blood in the hematoma cavity. The healing period of the hematoma in this case will be shorter.

    Hematoma in the mouth, due to the sensitivity of soft tissues, can cause significant discomfort. But as a rule, soreness disappears 1-3 days after the appearance of a bloody bladder.

    Hematomas can be localized in the palate, tongue, cheeks and gums.

    3> Why are hematomas formed?

    The formation of a blood bladder is preceded by an injury to the mucous membrane lining the oral cavity: blow, bruise, pinching or squeezing of tissues.Getting a mechanical injury is possible with accidental biting of the mucous membrane, for this reason, a hematoma is most often formed on the inner side of the cheek. In addition, the formation of a blood bladder is possible during dental treatment if the dentist handles instruments carelessly, for example, during a tooth extraction operation, forceps can come off the crown and injure the mucous membrane. In a child, a hematoma on the gum, cheek, or tongue may result from an accidental fall. Hits to the face and bruises received in accidents, falling from a height, in a fight can also cause a tumor in the mouth.

    Do you know how much dentists earn? We recommend reading our article.

    We advise you to find out why the dislocation of the jaw occurs and how to correct it.

    The blood vesicle formed on the mucous membrane is a protective reaction of the body. The mechanism of hematoma formation is as follows:

    • when tissue is injured, the immune system is activated;
    • , monocytes, leukocytes and macrophages are “pulled together” into the damage zone, whose task is to destroy the enemy agent;
    • death of immune cells provokes the release of inflammatory mediators – seratonin, histamine and bradykinin;
    • they cause vasospasm, which interferes with the outflow of blood at the site of injury;
    • as soon as the spasm passes, the accumulated blood enters the site of injury;
    • , detachment of mucosal tissues occurs, the formed bladder is filled with blood.

    Note: people with impaired vascular permeability, problems with blood clotting and fragile vessels are more likely to form hematomas.

    3> The severity of the pathology

    The intensity of pain depends on the severity of the pathology.

    There are 3 degrees of severity of the condition:

    • mild: in this case, a blood bladder forms during the first days after injury, while the victim feels moderate pain;
    • medium degree: a blood bladder forms a few hours after the injury, the site of injury swells, severe pain appears;
    • severe: a bubble forms within 2 hours after tissue damage, the victim feels severe pain, possibly a rise in body temperature.

    3> Why are hematomas dangerous?

    Small hematomas resulting from minor injuries usually do not pose a serious risk. They go away on their own, however, it will take a lot of time for the tissues to heal completely – about 2 weeks.

    Note: During the healing process, the color of the bladder changes from crimson red to blue-yellow. This is due to the breakdown of hemoglobin.

    Painful sensations associated with the presence of a neoplasm in the mouth, as a rule, disappear within 2-3 days from the moment of injury.

    However, if the hematoma in the mouth (on the palate, cheek, gum, tongue) has not disappeared within the specified period of time, you should definitely see a doctor.

    Important: numerous blood blisters in the oral cavity may indicate the development of such dangerous diseases as syphilis and pemphigus.

    It is also worth knowing that a hematoma can become infected and fester with reduced human immunity, which develops with depletion of the body, prolonged illness, and the presence of diseases of the immune system.In addition, a natural decrease in immunity occurs in the elderly, in pregnant women, and also in young children. Therefore, if the pain does not go away within 3 days after the formation of the bladder, and even more so if the discomfort intensifies, other unpleasant symptoms appear, such as swelling, fever, bad breath, do not delay a visit to the doctor. If a hematoma appears on the gum, you need to consult a dentist-therapist.

    A dentist-therapist deals with the treatment of hematomas in the mouth.

    2> Methods of diagnosis and treatment

    For a diagnosis of superficial hematomas, a visual examination of the oral cavity and palpation of the neoplasm are sufficient. The doctor must ask the victim whether tissue damage as a result of mechanical injury preceded the appearance of the hematoma.

    As we have already said, small hematomas resolve on their own and do not need treatment. The only thing that is required of the patient is thorough oral hygiene and antiseptic treatment of the injury site.

    The use of antiseptics will accelerate tissue healing and prevent infection. For antiseptic treatment, it is recommended to rinse the mouth with a solution of potassium permanganate or hydrogen peroxide. A good wound healing effect will be given by rinsing with herbal decoctions at room temperature. For their preparation, you can use the following medicinal herbs: chamomile, yarrow, sage, St. John’s wort, calendula.

    The injured area can be lubricated with sea buckthorn and rosehip oils, an oil solution of vitamin A.They will accelerate tissue regeneration.

    Learn about denture benefits for retirees.

    Read: What toothpaste to use for stomatitis to accelerate the healing of ulcers.

    We advise you to find out if it is possible to carry out dental implantation in type 2 diabetes.

    If the hematoma is large, it can interfere with the usual activities – chewing, talking, carrying out hygiene procedures. With large hematomas, there is a risk of damage to the walls of the bladder and subsequent tissue infection.Therefore, large neoplasms require the help of a doctor.

    As a rule, it consists in the surgical opening of the bladder. Under local anesthesia, the bladder is cut, its contents are washed out, and drainage is installed. In the recovery period, the patient is prescribed to take vitamin complexes that help to strengthen the immune system and increase the elasticity of the walls of blood vessels. In especially severe cases, if the wound has become infected, a course of antibiotic therapy may be prescribed.

    A hematoma formed in the mouth after a mechanical injury, for example, when falling or biting the tongue through negligence, does not pose a serious health hazard.But we are talking about small neoplasms that do not interfere with the usual actions. In all other cases, the formation of a blood bladder in the mouth should be the reason for seeking medical attention. Be healthy!

    90,000 A bruise has formed inside the child’s cheek! Causes and treatment!

    Hematomas in children are not uncommon. And bruises appear more often, the more active and mobile the baby is. But a hematoma in the mouth on a child’s cheek can cause even the most “hardened” parents to worry and a natural question: what caused this, and how dangerous is the bruise?

    Causes and accompanying symptoms

    A bruise inside the cheek in children by its location, frequency of occurrence and other features can tell about the causes of this condition:

    Features of the hematoma Possible causes Other symptoms
    A single bruise resembling an imprint of teeth. Injury by falling, impact. The bruise is located in the area that is most often in contact with the teeth (from the lateral surfaces of the cheeks, on the mucous membrane of the lips). In the place where the hematoma has formed, an abrasion may be visible, and the mucous membrane in this area is very swollen and reddened. Puffiness can spread to the outer side of the cheek, to the red border of the lips, etc.
    Bruises on both cheeks, located symmetrically along the line of the teeth. Anomaly of bite, deformation of the dentition, supernumerary teeth. Hematomas are almost constantly present, in areas with bruises, the mucous membrane looks more voluminous – it rises above the healthy area, this “elevation” is extended in one line. On the tongue, in the same projection as the hematomas on the cheeks, symmetrical wounds in the form of “waves” can be observed. The lateral surfaces of the tongue are unevenly colored, edematous.
    Multiple bruises of various sizes – from punctate hemorrhages to accumulation of spots. Blood clotting disorders caused by diseases of the blood system, taking anticoagulants.Fragility of the walls of blood vessels caused by vitamin deficiency or congenital diseases of the connective tissues. Absence of pain or swelling in the area of ​​bruising, individual hematomas may increase in size, which indicates that the injured vessels are not thrombosed and blood flow continues from them.
    The formation of hematomas is observed with varying frequency on the body of the child – their characteristic difference is that the appearance of a bruise occurs with little pressure on the skin.

    The listed reasons for the appearance of a hematoma on the inner side of the cheek in children are the most common. But what exactly became a provocateur of hemorrhage can only be decided by a doctor.

    Bruise inside the cheek in children photo

    Do I need to see a doctor?

    Minor injuries (scratches, cuts) of the mucous membrane with bruising, as a rule, do not require special treatment. Healing takes place on its own, without any intervention.
    But a completely different picture develops with malocclusion and problems with blood coagulation.

    In the first case, we are talking about chronic injuries of the same areas, as a result of which the replacement of epithelial cells with connective cells and the formation of scars can occur.
    In addition, if a child has a weakened immune system, permanent mucosal injury with a high probability can become the beginning of acute and chronic infectious processes in the oral cavity.

    If a bruise on the inside of a child’s cheek appears as a result of blood clotting disorders, this is an even more formidable symptom.Blood lines penetrate all organs and tissues of the human body, and problems with blood coagulation are not local. If hemorrhages are observed in the mouth, it means that blood vessels throughout the body are at risk. Therefore, it is important to consult with a doctor, undergo an examination and find the cause of such a violation, not only from the point of view of oral health, but also the state of health in general.

    Treatment methods

    Treatment of diseases and conditions in which hematomas form in the oral cavity can be divided into several directions:

    • Medication.Treatment with drugs is prescribed for hematomas, accompanied by damage to the integrity of the mucous membrane. Antiseptics (Cholisal, Rotokan, Chlorhexidine, hydrogen peroxide, etc.) and antimicrobial agents (benzydamine, metronidazole, etc.) prevent the addition of a secondary infection or eliminate an existing infection with bacteria, viruses or pathogenic fungi. In case of blood clotting disorders and increased fragility of blood vessels, the complex of therapy is formed individually, with the participation of a pediatrician, hematologist, endocrinologist and other specialists of the relevant profile.
    • Orthodontic. It is prescribed for bite anomalies of any nature. Treatment is carried out using special braces and plates that accelerate the growth of the jaw, braces that move the teeth to the anatomically correct position and the final stage – wearing retainers.
    • Surgical. With supernumerary teeth, one or more teeth are removed, and only after that the wearing of orthodontic devices is prescribed.

    The choice of one or another direction, or a combination of several of them, remains with the doctor.

    First aid equipment

    Regardless of the reasons for the bruise, it is important to provide first aid quickly and correctly.

    1. First of all, put a towel soaked in cold water on the outside of the child’s cheek and change it regularly (about every 3 minutes) to a fresh one.
    2. Place a couple of ice cubes in a glass of clean drinking water and ask the child to take a sip of cold water into his mouth and hold it behind the bruised cheek.
    3. If, due to injury, the mucous membrane is very swollen, there is a high risk of re-injuring it while chewing food. Therefore, for the first few hours after the injury (or before consulting a doctor), exclude from the child’s diet anything that requires chewing.
    4. Within 3-4 hours he can eat any liquid or crushed food and consume liquid in any quantity (except for hot meals and drinks).

    If a child complains of pain in the cheek, do not use any preparations containing acetylsalicylic acid or heparin, which can increase the secretion of blood .

    The best choice would be paracetamol or any analgesic that is not contraindicated for your child (analgin, baralgin, etc.). But first of all, be sure to read the information from the package insert for the preparation.

    Damage to the oral cavity and lips: what to recommend to the buyer?

    From infancy, a person is faced with damage to the oral mucosa when teething milk teeth, and if he himself does not remember this anymore, his parents, perhaps, remember this period with “trembling”, because it is then that the baby often begins to be capricious and sleep poorly , swelling appears on his gums, and touching them is associated with painful sensations.Growing up, children may experience discomfort when changing milk teeth to molars, and adults even more often face problems in the oral cavity, ranging from lesions of the mucous membrane to the removal of wisdom teeth. What should the headmaster know about lesions of the oral mucosa and which drug to advise in this situation?

    – What problems can arise on the oral mucosa and what is the risk?

    – Regardless of the cause, be it infection, trauma or surgery, lesions of the oral mucosa are inflamed and extremely painful.Eating is difficult, since food has a mechanical and chemical effect on the affected areas of the mucous membrane. Food particles are trapped in the wound, which can further exacerbate the inflammation. Because of the pain and discomfort, the patient may have sleep disturbances and, of course, all this affects his performance.

    In childhood, painful sensations in the oral cavity can occur due to the eruption of deciduous and molar teeth, injuries to the mucous membrane as a result of biting it, the development of diseases of the oral cavity, for example, stomatitis.In general, oral lesions can present with swelling, rashes, or sores in the mouth, lips, or tongue.

    – How to deal with painful oral ulcers and other mucosal damage?

    – Oral cavity lesions, inflammation of the mucous membrane and wounds on it can be painful, unpleasant in appearance and interfere with eating and talking normally. Therefore, when treating lesions of the oral cavity, it is rational to use an agent with analgesic and healing effects in combination with adhesive properties that contribute to the preservation of the drug on the oral mucosa for a long time.Solcoseryl dental adhesive paste from MEDA Pharmaceuticals Switzerland GmbH (Switzerland), created taking into account the anatomical and physiological characteristics of the oral cavity, fully meets these criteria. It is the only product in the form of a paste * in its competitive group. Gelatin and pectin in the composition of the base of the paste ensure its long-term adhesion to the mucous membrane (Grigoryan A.A. et al., 2013).

    – How does Solcoseryl dental adhesive paste work?

    – Its active ingredients are solcoseryl and polidocanol.Solcoseryl is a chemically and biologically standardized pyrogen-free derivative of calf blood without proteins and antigens. It improves the supply of oxygen to tissues, restores the mucous membrane and significantly shortens the healing time of wounds. The local anesthetic polidocanol, which is part of Solcoseryl dental adhesive paste, has a fast and long-lasting analgesic effect. Polidocanol has a good binding capacity with the mucous membrane, its effect is 400 times higher than that of procaine and 4 times higher than that of tetracaine (Strakhova S.Yu., Drobotko L.N., 2015). After applying the paste to the mucous membrane, the pain disappears after 2-5 minutes, and the anesthesia persists for up to 3-5 hours. The paste firmly adheres to the mucous membrane and forms a protective layer on it, protecting it from mechanical and chemical damage (Kolesnik V.M. et al. ., 2010), performing the function of a “gauze-free surgical dressing” for the mucous membrane of the mouth and gums.

    Thus, Solcoseryl dental adhesive paste solves 3 main problems of patients, the manifestation of which is associated with lesions and injuries of the oral mucosa, namely:

    • relieves pain;
    • protects the affected area of ​​the mucous membrane from the traumatic effects of saliva, food and other external factors;
    • shortens the time of wound healing (Kubanova A.A. et al., 1999; Kolesnik V.M. et al., 2010).

    The base of the paste remains on the oral mucosa from 3 to 5 hours (Nikolaychuk V. et al., 2009), thereby improving the absorption and bioavailability of the main components of the drug. Preservation of Solcoseryl dental adhesive paste on the wound surface for a long time leads to the fact that the anhydrous base of the paste, consisting of gelatin, pectin and cellulose, absorbs saliva and wound discharge. The components included in the base of the paste swell, forming an adhesive film, protecting it during eating and drinking.Long-term adhesion promotes the release of the active components of the drug (Strakhova S.Yu., Drobotko L.N., 2015).

    – In what cases and for whom is Solcoseryl dental adhesive paste suitable?

    – Such broad possibilities of the paste allow the use of the drug both in infants and adults with a number of problems in the oral cavity – from the eruption of milk teeth and wisdom teeth to pathology of the oral mucosa with the formation of erosions, aphthae, ulcers, periodontal diseases and red border of lips.Thus, Solcoseryl dental adhesive paste is indicated for use at:

    • stomatitis, gingivitis, periodontitis;
    • the presence of mechanical, physical, chemical injuries of the oral mucosa in patients;
    • using dentures or braces;
    • cracks in the lips, seizures in the corners of the mouth;
    • recently undergone dental procedures, for example, removal of dental calculus;
    • difficult teething of milk and molars in children, including infants from 6 months;
    • Difficulty teething wisdom teeth in adults.

    – How to use Solcoseryl Dental Adhesive Paste correctly?

    – First of all, dry the area of ​​application with a cotton or gauze swab. Then apply a small strip of paste (about 0.5 cm) on the mucous membrane with a thin layer using a dry, clean finger or a cotton swab, then slightly moisten the paste with water. This procedure must be repeated 3-5 times a day after meals and before bedtime for 3-14 days. With painful teething of milk teeth in children, the paste is applied 3 times a day after meals and before bedtime.

    NB! It is important to apply the paste to the dried surface of the mucous membrane in order to avoid deterioration of its adhesion and, as a consequence, reduce the duration of the therapeutic effect of the paste!

    – Is it possible to combine Solcoseryl dental adhesive paste with antiseptic solutions?

    – In the treatment of lesions of the oral mucosa, topical application of drugs from different pharmacotherapeutic groups, for example, antiseptics and wound healing agents, is relevant.The use of Solcoseryl dental adhesive paste in the complex therapy of erosive lesions of the oral mucosa contributes to a more rapid relief of clinical symptoms and epithelialization of the lesion (Kolesnik V.M. et al., 2010). Of interest is the combined use of antiseptic solutions and this paste for the complex treatment of children with lesions of the oral mucosa of various etiologies (Terekhova T.N. et al., 2012).

    Solcoseryl dental adhesive paste: fast pain relief, high-quality healing and protection of mucous membranes for the whole family!

    Press service of “Weekly APTEKA”

    Tsikava information for you:

    Hematoma on the gums: causes of appearance, how to remove, photo

    Most people diligently care for their teeth, completely forgetting to monitor the health of the gums.Dentists say that the beauty of a smile depends on the state of the soft tissues in the mouth, so any disease has serious consequences. The appearance of a dark bruise on the mucous membrane is always alarming and confusing. This may be a consequence of trauma or tooth extraction, but in any case requires careful consideration and full treatment.

    * {visibility: hidden}]]>

    Periodontitis Risk Test

    Periodontitis Risk Test

    Do you spit out blood when brushing your teeth?

    Do you spit out blood when brushing your teeth?

    Is the color and gum fit a concern?

    Is the color and gum fit a concern?

    Are your gums loose?

    Are your gums loose?

    Does food get stuck under the gum?

    Does food get stuck under the gum?

    Are your teeth loose?

    Are your teeth loose?

    Do you observe the exposure of the roots of the teeth?

    Do you observe the exposure of the roots of the teeth?

    Do you have tartar?

    Do you have tartar?

    Are you using an irrigator and dental floss?

    Are you using an irrigator and dental floss?

    Do you do professional oral hygiene?

    Do you do professional oral hygiene?

    Is there bad breath?

    Is there bad breath?

    You are at risk for more than three pronounced signs of periodontitis.You cannot do without the intervention of a periodontist.

    Don’t look for an answer on the Internet, sign up for a free consultation.

    You are at risk with more than three pronounced signs of periodontitis. You cannot do without the intervention of a periodontist.

    Don’t look for an answer on the Internet, sign up for a free consultation.

    You are in the border zone, there is a risk of developing periodontitis. Pay attention to hygiene and systematic professional examinations.

    Don’t look for an answer on the Internet, sign up for a free consultation.

    You are in the border zone, there is a risk of periodontitis. Pay attention to hygiene and systematic professional examinations.

    Don’t look for an answer on the Internet, sign up for a free consultation.

    There is no disaster, but it is not worth bringing to it either. Planned visits to the dentist at least once a year and proper hygiene.

    Don’t look for an answer on the Internet, sign up for a free consultation.

    There is no disaster, but it is not worth bringing to it either. Planned visits to the dentist at least once a year and proper hygiene.

    Don’t look for an answer on the Internet, sign up for a free consultation.


    Cause of hematoma on the gum in adults

    A bruise on the gum itself is not a separate disease. This is a hemorrhage in the soft tissues of the mucous membrane due to the destruction of small capillaries. Despite its small size, this problem sometimes provokes serious inflammation in the periosteum and may well cause the loss of healthy teeth. If it is accompanied by swelling and other painful symptoms (bumps, growths), treatment is required under the supervision of a dentist.

    The most probable reasons for the formation of a dark spot on the gum in an adult patient:

    • Carrying out by the doctor manipulations with soft tissues or teeth: removal, filling or cleaning of dental canals, cutting to remove drainage, installation of a prosthesis. The larger the area where such procedures are carried out, the more noticeable the bruise on the jaw.
    • Problems with blood pressure, which provokes sharp surges and drops in the circulatory system.
    • Congenital diseases associated with blood clotting disorders in the body.In such people, a hematoma on the gums is formed from a slight scratch, bite or injection.
    • Consequences of injury and impact.

    In adult patients, abnormal growth of wisdom teeth is a common cause of mucosal bruising. As a rule, they come to the surface at an already mature age, when the jaw is fully formed. They do not have enough space in the row, they move to the side and damage the periosteum. In this case, edema collects around the dark spot, swelling and severe redness occurs.The process is accompanied by aching pain, slight fever and loss of performance.

    Why does a baby have a bruise on the gum?

    Many parents are perplexed to find a characteristic bruise in the child’s oral cavity. It can be the result of an injury from active play, chewing on toys, or biting a nipple. But more often than not, a small black-and-blue spot forms at the top of the gum.

    Dentists warn that teeth are sometimes erupted this way.The milk molars and incisors do not have enough sharpness to pierce the dense tissues of the periosteum. There is damage to the smallest capillaries and a slight hemorrhage into the gums. From the outside, the picture looks unpleasant and worries the parents, but in most cases the seal dissolves on its own and does not require special treatment. The doctor may recommend light analgesic gels so that the baby is not overly restless and easier to endure the teething process.

    Symptoms of bruising in the mouth

    Depending on the reason why a hematoma appeared on the gum in an adult, it has different sizes.Dentists divide them into two groups according to the complexity and severity of the consequences:

    1. Blood pours into the dental pockets and accumulates around the tooth, encircling it with a dark bluish area. Usually, the mucous membrane increases in volume, the patient feels discomfort and cannot fully close the jaw. It is uncomfortable for him to chew and pronounce some sounds.
    2. Hemorrhage occurs inside the roots of the teeth, therefore, a rounded edema is formed, affecting the inner surface of the cheek. Outwardly, this resembles a gumboil in the acute stage: a person complains of aching pain, irritability, a slight asymmetry of the face appears.The gums swell and there is a feeling of tightness, chills, general weakness and fever.

    Gradually, with proper treatment, all unpleasant symptoms go away, and a spot with a yellowish tinge remains at the site of the hematoma. It gradually dissolves and disappears completely. This process can take several weeks.

    Methods of treatment for bruising on the gums

    Patients mistakenly believe that the bruise should go away without treatment. But a hematoma on the gum after a blow or tooth extraction requires special attention: harmful bacteria that are present in the oral cavity can easily penetrate into an open wound.This is fraught with extensive abscesses, fistulas on the mucous membrane and accumulation of suppuration in the roots of the teeth. Therefore, when the temperature rises and discomfort, it is better to seek help.

    The dentist may open the gum to allow any accumulated fluid to escape. If necessary, a small drainage remains in the wound to accelerate the outflow of the ichor. Through a miniature incision, the doctor rinses the damaged area with antiseptics, which eliminates the formation of infection. At home, the patient is advised to continue therapy:

    • Use broad-spectrum antibiotics (Lincomycin, Tetracycline or Gentamicin).As a rule, this is more of a preventive measure, which is necessary if there are teeth destroyed by caries in the oral cavity.
    • Nurofen, Paracetamol or Nise are suitable for relieving fever and pain. If a person cannot tolerate discomfort, feels pulsation and twitching at the root of the tooth, you can drink Nimesil.
    • Every day, at least 3 times, the mouth should be rinsed with special antiseptic agents: Miramistin, Chlorhexidine, Chlorophyllipt or Fukortsin diluted in water.
    • To relieve discomfort, the gums are lightly lubricated with Metragil Denta, Kamistad or Cholisal ointment. They will improve blood circulation and the swelling will go away faster.

    For the healing of the incision and the speedy resorption of the bruise, dentists recommend using compresses with Solcoseryl healing ointment. After a few days, the gums will become firmer and the dark area will be less sensitive.

    Folk ways to eliminate hematomas on the gums

    To improve the health of the mucous membrane, you can use recipes with natural ingredients.Their medicinal properties help to quickly cope with bruises and restore beauty to a smile. For the preparation of natural preparations, plants with wound healing and anti-inflammatory properties are used. Tannins and useful compounds contribute to the speedy resorption of hematoma and restore the soft tissues of the periodontium:

    • Several inflorescences of calendula (fresh or dried) insist on a glass of boiling water, rinse their teeth 4-5 times a day.