Phantom Bleeding

“Dear dentist,

I come to you with a unique problem that has baffled my previous dentist, and for which I cannot seem to be able to find a remedy or cure. My mouth is free from bacteria, I have no missing teeth, and only 2 fillings altogether, and yet every time I brush there is blood in my sputum. I probably do not have periodontitis, as there is no swelling of the gingiva, and I have absolutely no cavities or other problems. Aside from a bit of morning breath I have no halitosis and no indication of a bacterial infection of any sort, and I do not smoke or drink alcohol. What do you think my problem is?

Sincerely, Calvin”

Dear Calvin,

Base don the information you gave me, it is quite tricky for me to tell what your problem is. It does seem rather baffling, and there are a couple of questions that could have cleared this case up a little bit more, to make it slightly less baffling. Like this, I can only give a very preliminary analysis, and hopefully that will suffice in bringing about a solution to this problem.

Extra capillary action, or bleeding through is something that happens quite frequently with the gingiva, it is one of the things that can be expected to occur, as there is so much gingiva with so many capillaries in it. Based on the amount of knowledge gien, I think one of three things is happening, possibly with a combination of the three.

You may indeed have gingivitis, or periodontitis. You say you have no symptoms, but bleeding gums in and of itself is a symptom of gingivitis, so you do have the symptoms. Discoloration and swelling only occur when there is a quite severe problem already, and although you are not suffering from a problem that severe, it does not mean that there s no problem there at all.

You may also have damage that is not visible or a sore that is not visible. You can have damaged your gingiva or bruised it, and it may only be visible beneath the gumline, or not at all. This can have been caused by a number of factors, such as a trauma, or a tooth root going awry, or a number of other things. This may continue to bleed.

Finally, there may be a chance that you are a victim of your own doing. You may be brushing too vigorously, or with a toothbrush where the bristles are too hard, and this may be causing damage to the gingiva, which bleeds as a response. If this is the case, you have it easy, as all you have to do is ease that grip up a little bit, and you should be fine.

Most likely, the bleeding you are seeing is a result of a combination of these three factors. There may be some damage or a bacterial infection that is very low grade, and only bleeds when you brush as vigorously as you do. If we assume this is the case, you still only need to worry about letting up on your grip and using proper brushing technique, as the infection may be so slight that it may not warrant the use of antibiotics at all.

The questions that can clear this situation up entirely are; how often do you brush? What technique do you use how hard do you brush? Also, how long has this problem persisted? Is it a recurring one? Is the bleeding more severe at some times, or is it always the same amount? Do you ever taste blood in your mouth, or notice blood on your foods after biting into,say, a sandwich or an apple?If you answered yes to any of these, you probably have ome form of periodontitis, and need to take care of it, and if you are brushing too hard, you may need to change your technique, or get an electronic toothbrush. They regulate how hard you brush automatically, and they also do not need to be changed as often.