Differential diagnosis
The parameters for normal menstruation have been defined as a result of an international process designed to simplify terminologies and definitions for abnormalities of menstrual bleeding. The causes of abnormal vaginal bleeding vary by age. In children
Bleeding in children is of concern if it occurs before the expected time of menarche and in the absence of appropriate pubertal development. Bleeding before the onset of pubertal development deserves evaluation. It could result from local causes or from hormonal factors. In children, it may be challenging to determine the source of bleeding, and "vaginal" bleeding may actually arise from the bladder or urethra, or from the rectum.Vaginal bleeding in the first week of life after birth is a common observation, and pediatricians typically discuss this with new mothers at the time of hospital discharge. During childhood, other possible causes include the presence of a foreign body in the vagina, trauma (either accidental or non accidental, i.e. child sexual abuse or molestation), urethral prolapse, vaginal infection (vaginitis), vulvar ulcers, vulvar skin conditions such as lichen sclerosus, and rarely, a tumor (benign or malignant vaginal tumors, or hormone-producing ovarian tumors). Hormonal causes include central precocious puberty, or peripheral precocious puberty (McCune–Albright syndrome), or primary hypothyroidism.While the symptom is typically alarming to parents, most causes are benign, although sexual abuse or tumor are particularly important to exclude.
However, mucosal trauma is thought increase the ability of C. albicans to invade the tissues.Aside from infection and mechanical trauma, inflammatory reactions of the mucosa beneath a denture can also result from irritation or allergy (allergic contact stomatitis) caused by the materials in the denture itself (acrylic, cobalt, chromium), or in response to substances within denture adhesives. Incomplete curing of the acrylic resin (the prosthetic material) may also be an involved factor. Diagnosis
The diagnosis is usually made based upon the clinical appearance, and swabs can be taken of the surface of the denture. Investigations to rule out possibility of diabetes may be indicated. Tissue biopsy is not usually indicated, but if taken shows histologic evidence of proliferative or degenerative responses and reduced keratinization and epithelial atrophy. Classification
The Newton classification divides denture-related stomatitis into three types based on severity. Type one may represent an early stage of the condition, whilst type two is the most common and type three is uncommon. Type 1 - Localized inflammation or pinpoint hyperemia
Type 2 - More diffuse erythema (redness) involving part or all of the mucosa which is covered by the denture
Type 3 - Inflammatory nodular/papillary hyperplasia usually on the central hard palate and the alveolar ridge

Treatment
The most important aspect of treatment is improving denture hygiene, i.e. removing the denture at night, cleaning and disinfecting it, and storing it overnight in an antiseptic solution. This is important as the denture is usually infected with C. albicans which will cause re-infection if it is not removed.