“I Don't Want To Brush My Teeth!” The Case of an 8-Year-Old With Gingival Bleeding

Gingival bleeding is a relatively uncommon chief complaint in the pediatric population. The differential diagnosis is broad, and both the patient's clinical presentation and medical history must be taken into account when formulating a differential diagnosis. The following is a case of a child with trisomy 21 who presented to the emergency department with oral bleeding in the setting of a normal complete blood count and coagulation studies. The patient underwent a workup for coagulopathies, malignancy, and nutritional deficiencies and was found to have vitamin C deficiency, also known as scurvy. This case illustrates a rare cause of gingival bleeding that occurs primarily in developing countries but may also occur in developed countries in children with underlying medical conditions such trisomy 21 or developmental delay.