The Use of Tranexamic Acid Mouthwash in the Gingival Bleeding Management in Aplastic Anemia Patient

Abstract

Objective: The aim of this study was to describe the role of tranexamic acid mouthwash in the management of gingival bleeding in aplastic anemia patients.
 Methods: Complete subjective, objective, and supporting examinations were carried out to confirm the diagnosis. Treatments were given in collaboration between the departments of internal and oral medicine. Anamnesis and history taking were done, and it was revealed that a 21-year-old male patient came with the chief complaint of active anterior mandible gum bleeding, starting two weeks ago and accompanied by fever. Extra-oral examination revealed a hematoma on the lip. Intra-oral examination found spontaneous bleeding from the anterior mandible gingiva and hematomas on the labial mucosa and lateral of the tongue. Laboratory examination results showed hemoglobin, hematocrit, erythrocytes, leukocytes, and platelets below the normal range, and the bone marrow morphology examination confirmed the diagnosis of aplastic anemia.
 Results: Treatment included a blood transfusion of 39 flasks for 14 d for the systemic condition. Tranexamic acid and chlorine dioxide mouthwash were given for intra-oral problems, and petroleum jelly to treat lip lesions. Gingival bleeding and hematomas resolved within 8 d.
 Conclusion: Tranexamic acid mouthwash, along with manual scaling of calculus, which is a predisposing factor for gingival bleeding, as well as blood transfusion, have an important role in the successful comprehensive management of gingival bleeding due to pancytopenia in patients with aplastic anemia.