• swelling is severe, persistent, or is accompanied by other unexplained symptoms.
• discomfort is associated with swelling

The medical history will be obtained and a physical examination performed.

Medical history questions documenting bleeding gums in detail may include the following:

• Quality
  • How swollen are the gums?
  • Can you see the teeth?
  • Are the gums bleeding?
• Time pattern
  • Did the swelling begin recently?
  • Are they always swollen?
  • Does the amount of swelling change?
  • Does it only occur occasionally?
  • Have you had gum problems before?
• Oral hygiene habits
  • How often do you brush?
  • How often do you floss?
  • How hard of a toothbrush is used?
  • How vigorously do you brush?
  • What are other habits (use of toothpicks or other)?
  • When was the last time you had the teeth professionally cleaned (at the dentists)?
• Eating habits
  • Have you changed your diet?
  • Do you eat adequate amounts of fruits and vegetables?
  • Do you take supplemental vitamins?
• Other
  • What medications are being taken?
  • Do you take anticonvulsants such as Dilantin or phenobarbital?
  • Are you pregnant?
  • Have you changed mouthwash or tooth paste recently?
  • What other symptoms are present? Is there:
    • breath odor
    • redness of the gums
    • abnormal color of the teeth
    • sore throat
    • pain

The physical examination will include a detailed examination of the mouth, teeth, and gums.

Diagnostic tests that may be performed include blood studies such as a CBC or blood differential.

The patient will be taught proper mouth and gum care. Emotional support and reassurance that the swelling typically resolves with treatment should be offered.