Hello, I am a dentist in Sydney, I saw a patient ( young women in mid twenties wuth no bleeding disorder history or any medication taken) with advanced periodontitis in particular around upper left molar region! I did a general clean and was all fine! She started to have bleeding issue a few hours after the clean at one site only, I had tried to ask her to keep a pressure pack mesial of the second molar and also prescribed some tranexamic acid mouthwash, so far it has been almost 2 days and it does not seem to be able to arrest the bleeding (oozing)! I am asking for possible suggestion of causes and treatment alternatives? Was there a possible blood vessel in bone that was exposed via even a general clean? Please help!
Hello, First an OPG should be taken to rule out there is any other problem in the region. If there is bone loss a flap surgery and bone grafting should be done. It could mainly be associated with the advanced periodontitis. Or it could be a sinus problem which can be detected by an ENT specialist. Ask the patient to take saline gargle 3-4 times a day.