Blood in the Mouth – Causes of Bleeding from the Mouth

The presence of blood in the mouth can be extremely worrying, especially if it is a spontaneous bleed with no clear etiology. Bleeding when coughing (hemoptysis), vomiting (hematemesis) or from the nose (epistaxis) indicates the most likely source of the bleed – the respiratory passages, gastrointestinal tract or nasal cavities respectively. Many of the causes of bleeding in these cases may also be responsible for bleeding from the mouth (stomatorrhagia).

In order to identify the most likely cause, it is important to take preceding events into consideration. Finding blood in the mouth is expected but nevertheless worrying and possibly serious after these conditions :

  • after dental work
  • postoperatively after surgery to the head or neckĀ  (mouth, nose, nasal sinuses, pharynx, tonsils, larynx)
  • after trauma to the head and neck

However, the sign of bleeding from the mouth in a situation where none of these events have previously occurred needs to be investigated further in order to quickly and accurately identify the site of the bleed. It is also important to identify whether the blood in the mouth was related to coughing, vomiting or a nosebleed.

Causes of Blood in the Mouth

Recurrent bleeding from the mouth, extending over weeks or longer, should always raise the concern about oral cavity cancer. Malignant tumors within the nasal cavity, esophagus or larynx may also result in bleeding from the mouth.

Bleeding may not often be clearly evident as it may be swallowed along with saliva, or drain down into the esophagus. It may only be obvious upon brushing or spitting and due to the action of gravity, it may be more pronounced upon waking after sleeping or lying flat.

Blood that pools in the mouth is a serious sign, most often indicative of a rupture of an artery. It needs immediate medical attention.

Mouth

  • Injury to the head or neck
  • Stomatitis – inflammation of the mouth due to mechanical or chemical trauma.
  • Bleeding dental caries (tooth cavity), gingivitis, periodontitis
  • Bleeding aphthous ulcers (mouth sores)
  • Infections – candida, herpes, cytomegalovirus (CMV), viral hemorrhagic fevers
  • Scurvy (vitamin C deficiency)
  • Heavy metals like lead, mercury or arsenic poisoning
  • Cancer – mouth, nasal cavity, pharynx
  • Bleeding disorders like hemophilia
  • Rare syndromes like Sackey-Sakati-Aur syndrome and Gardner-Morrisson-Abbot syndrome

Nose

This is discussed further under the causes of epistaxis (nosebleeds).

  • Allergic rhinitis, post nasal drip
  • Injury like nose picking, drug use (cocaine snorting), use of nasal spray (inhalants)
  • Head trauma
  • Dry air
  • Infections – sinusitis, rhinitis, vestibulitis
  • Some of the less common causes include hypertension, Wegener’s granulomatosis

Throat

Pharyngitis (inflamed throat) may be due to :

  • Infections – tonsillitis (tonsillopharyngitis) or pharyngitis
  • Chemical trauma – consuming corrosive substances, severe GERD (gastroesophageal reflux)
  • Allergies
  • Abscess (peritonsillar, parapharyngeal, retropharyngeal)
  • Tumors

Esophagus

This is discussed further under the causes of blood in the vomit. Bleeding from lower down in the gut (stomach or duodenum) is more likely to appear dark brown to black, similar to coffee grounds. It will only be passed out upon vomiting.

  • Lacerations (Mallory-Weiss tear)
  • Perforation
  • Tumors – adenocarcinoma, squamous cell carcinoma
  • Varices
  • Esophagitis – reflux, infectious, erosive, eosinophilic
  • Strictures
  • Ulcers
  • Barrett esophagus

Larynx, Trachea, Bronchi and Lungs

This is discussed further under coughing up blood.

  • Trauma
  • Foreign body
  • Infections – laryngitis, epiglottitis, bronchitis, pneumonia, tuberculosis
  • Bronchiectasis
  • Broncholithiasis
  • Cancer
  • Lung abscess
  • Pulmonary artery rupture
  • Pulmonary embolism
  • Sarcoidosis
  • Aortic aneurysm leaking into the pulmonary cavity

References

  1. Bleeding from the Mouth. Wrong Diagnosis

Please note that any information or feedback on this website is not intended to replace a consultation with a health care professional and will not constitute a medical diagnosis. By using this website and the comment service you agree to abide by the comment terms and conditions as outlined on this page

  • b.shalini

    my father is suffering from mouth bleeding last 2 months .mouth bleeding is raerly, is it serious problem?

  • Dr. Chris

    Hi B.Shalini

    Yes, it could be a serious problem depending on the cause. Some of the very serious causes include cancer of the oral cavity or throat. Your father needs to be assessed by a doctor to identify the cause of the bleed.

  • b.shalini

    sir, my father mouth bleeding quantity is very less , if it cause is oral cavity or throat cancer is there any problem for life or he can survive with treatment?

  • Dr. Chris

    Hi B.Shalini

    There is no way we can answer that conclusively without knowing his case details. Only your doctor can advise you further. Don’t be misled by the small quantity of blood. If it is cancer, then treatment can either totally resolve the problem or may increase survival rate but this is dependent on a number of factors. Without treatment, chances of survival are very low. Speak to a doctor immediately.

  • Sarah

    I was sitting in my living room and I randomly tasted blood. I got up and went to the bathroom and mouth was full of blood, It was bright red and it was like clots of blood. I checked my entire mouth and I cant figure out what is causing it. It happened 3 times in 15 mins.

  • Hi Sarah. While it could be conditions like gum disease or bleeding from the nasal passaged and so on, the bigger concern is a bleeding from a growth within the mouth or throat. Do not get worried just yet. Often this is a gum or tooth problem or even a nasal problem which are not as serious. But the possibility that it is something much more serious needs to be kept in mind. You need to see a doctor as soon as possible to have this investigated further.

  • Umar

    Sir,

    blood in mouth after sleeping every morning and taste as well, please advise

  • Patricia .

    I’m 19. I started a diet like 2 days ago. Today I woke up with blood on my pillow. When I looked to see from where I found brown blood with clots on my tounge. I was worried. Lately I did notice that my mouth and lipa have become dry but I dont know if that has anytging to do.

  • Bikash Dalai

    Today i forgot drink water after had lunch..then i slept for 1.5 hour..when i woke up and go to to the wash room at that time when i spit .i saw blood bleeding in my mouth but i donot understand what is the cause and try to find the bleeding area but i fail to find out..

  • helen

    I am helen my friend is 20 yrs fr past one yr when eva he coughs offenly blood comes from his mouth like around 6 drops of clot blood .he use to take drugs but not he is left taking is it a serious matter

  • Hi Bikash. Once off bleeding may not necessarily be a problem but if it is occurring repeatedly then you definitely need to consult with a doctor. There is no way of saying for sure. It could be from the mouth, or even dripped down from the nose or have come from the esophagus (food pipe). If you find it occurring again then definitely speak to your doctor.

  • Hi Helen. Yes, it can be very serious. It could be TB or some other very serious mouth, throat or respiratory disease. He needs to immediately see a doctor. Do not waste time. HIV and TB are two closely linked conditions and if he is/was an IV drug user the risk of HIV is very high.

  • andrea

    Hi!
    I have been noticing for quite some time now, that in morning when I wake up there are dark spots on my pillow it’s not blood, it’s more like pale greyish yellow. I am wondering what might be the cause?

  • Naomi

    My step daughter has been waking up to find blood in her mouth most mornings for a few weeks now but can’t work out where it’s coming from. Our suspicions so far are that it is her gums perhaps, she has said they sometimes bleed when she brushes her teeth.

  • Juan

    Have had a bad headache with pressure in eyeballs ans sinus for three days already. I took Bayer extra strenth in the last 2 days. And just now i had a bloody taste to my mouth it felt like a heart burn i went to the restroom spet on the sink and there was blood in it. Im 38 yrs. Old.

  • calvin haynes

    I have a bad toothache and wake up with blood in my mouth

  • Mabel

    I am Mabel some months whenever during night i spit out is blood. Xray show nothing but only mentioned mild cardio megally. Then i did the spitum test which says ” Gram positive cocci in chains”. Then mentioned mild neutrophilic infiltrate. Pl can anyone say what is this actually.. Thanks.

  • Mabel Jadhav

    I too having blood coming from my mouth. My xray shows mild cardiomegally. My sputum test shows gram positive cocci in chains also smear shows neutrophilis infiltrate. What does that mean can any one tell pl..

  • Mabel Jadhav

    I too having blood coming from my mouth. My xray shows mild cardiomegally. My sputum test shows gram positive cocci in chains also smear shows neutrophilis infiltrate. What does that mean can any one tell pl..

  • Bobby Ryant

    I wake up every morning with a blood taste in my mouth and when i go to the bathroom i see blood on my teeth what is the cause of this i hope its nothing life threating

  • Hi Mabel. You should be consulting with an otorhinolargyngologist (ENT specialist) and/or a pulmonologist at this point. It is important that you follow through with one doctor/specialist until the exact cause can be identified. As you can see from the article above, there are a number of different causes of bleeding in the mouth. While this could be a condition like strep pneumonia, you should have other symptoms at this point. Your doctor will be able to advise you accordingly.

  • shanu

    Often I taste blood in saliva and sometimes even I can see some traces of very light blood while splitting……ystrdy eve too had the same feeling but while I touched ma mouth I got blood which was more darker than before
    Till now I haven’t felt any pain in any part of my body …not even felt tired but daily I could feel the taste of blood in mouth
    Am really scared coz be4 it was very light in colour…..but yestrday I was splitting bright colour blood
    Plezzzzzzzzzz reply

  • Hi Shanu. You definitely need to have this checked up. Even though you do not have other symptoms like pain or difficulty swallowing, it could still be a very serious cause. It is difficult to say for sure just by your symptoms. You should see your doctor and possibly consult with an ENT specialist if your family doctor feels it is warranted. Further tests may be necessary because there are so many possible conditions that could present with blood in the saliva.

  • Cinthia

    I’ve been having adominal pains for the past 5 years I’ve been going to the doctors and every time they assign me medicine, the pain goes away for a little and sometimes it calms it but it never goes away, I’ve gone to the hospital as well and that didn’t work either now thorugh out the years my pains have increased to my back my sides and now my head, there are days my head hurts and I’ve had a couple times my mouth and nose are bleeding. what can it be? or what else can I do? I’m only 20 and this isn’t normal, I’ve gone so many times to the doctor and now I’m just scared if its something serious :/ ….. Please anybody answer and help me :/

  • Clement

    Hi my girlfriend was bleeding from mouth and nose without any pain what is the cause and is it serious?