The sight of blood in the saliva is usually a cause for concern among most people. It is not necessarily due to a serious medical condition. Many cases arise with everyday occurrences such as brushing the teeth too vigorously. Tiny cuts that may form in the mouth quickly heal and does not lead to any further problem. However, there are times where blood and saliva can be a sign of a much more serious medical condition, which if left untreated can even be deadly.
What is stomatorrhagia?
Stomatorrhagia is the medical term for bleeding in the mouth. Sometimes this bleeding is not evident within the mouth but may be seen in the saliva. This can range from gross bleeding to blood-tinged saliva. The sight of blood in the mouth does not necessarily mean that the bleeding is originating from the mouth cavity. Since the mouth connects with a nose, the throat and the airways, bleeding in the mouth can be from any of these areas.
Therefore it is important to try to identify the origin of the blood. For example, blood in the mouth after vomiting may very likely have originated in the digestive tract like the esophagus or stomach. Similarly blood in the mouth after coughing could be from the airways, lungs or the throat. Possible cause of the bleeding varies by the location and the presence of other symptoms has to be considered when trying to identify the possible cause.
Other signs and symptoms
The presence of blood in the mouth or more specifically in the saliva is a symptom of some underlying condition. It often presents with other symptoms, such as:
- Metallic taste in the mouth
- Bloodstained teeth
- Bloody lips
- Nasal congestion
- Foul breath
- Mouth sores
Causes of blood in the saliva
The mouth is lined with than tissue known as mucosa. It is therefore prone to injury as it does not have the same strength as skin. This delicate lining is constantly replenished to main tain the integrity within the month. However even the slightest of trauma can lead to a break in the mucosa and bleeding.
Injury to the mouth is probably the most common cause of blood in the saliva. It is usually an acute occurrence and quickly heels on its own without the need for any medical treatment. This can occur with a blow to the mouth, brushing or flossing too vigorously, dental surgery, poorly fitting dentures, biting the lip, chewing on hard and/or abrasive forwards and other substances, or consuming harsh and toxic substances, including tobacco chewing.
Infections of the mouth is another common cause of blood in the saliva. These infections are largely bacterial or viral, but in people with weak immune systems there is also the risk of fungal infections of the month like yeasts. These infections may present as sores within the month, including the tongue, gums (gingivitis) the cheek or the roof of the mouth as the palate. It may also involve the teeth as is the case with a tooth cavity or periodontitis. Bleeding in the mouth may also be seen with infections of neighboring areas, including infections of the sinuses and nose, of the throat, the stomach, for the air ways like in bronchitis, and the lungs such as in tuberculosis.
There are several cancers that may involve the mouth, throat and airways which may result in bleeding within the mouth. This is often a concern for people who consume tobacco, whether it is chewing tobacco or smoking it. Another high risk activity for mouth cancers includes chewing on areca nuts. Therefore bleeding in the mouth or blood and saliva may be a sign of mouth cancer, throat cancer, lymphoma, leukemia, and even lung cancer. Sometimes it may also occur with stomach cancer.
Toxins and Poisons
A number of different substances that may be consumed, either ingested or inhaled, may lead to bleeding in the mouth. This is more likely to be seen with poisonous substances, caustic substances and strong corrosives. Sometimes even a very harsh mouthwashes can injure the lining of the mouth and leads to bleeding. Often in these cases the poisoning is intentional. It may also occur with the use of certain narcotic substances like crystal meth. Similarly sniffing illicit substances such as cocaine may result in bleeding in the nose which can then drip into the mouth.
Blood in the saliva or specifically bleeding in the mouth may also be a characteristic symptom of certain nutritional deficiencies. This is prominent with a vitamin C deficiency, known as scurvy. Although not common these days, scurvy presenting with a host of mild symptoms including bleeding from the mouth was a major problem for seafarers in the past. Other deficiencies where they may be blood in the saliva or bleeding in the mouth includes pellagra which is a deficiency of vitamin B3 also known as niacin, or with iron deficiency anemia.
Stomatorrhagia may occur as a result of certain medical therapies. It is more likely to occur when using substances that can thinthe blood, such as warfarin and aspirin. These drugs may not cause the bleeding but it increases the risk of profuse bleeding when there is some injury to the mouth area. Even simple activities like brushing the teeth and flossing can lead to profuse bleeding due to the minor injuries sustained during these activities. It is also not uncommon to see bleeding from the mouth as a result of radiation therapy to the area and sometimes even with chemotherapy.
There are a number of different bleeding disorders which may also contribute to blood and saliva or bleeding from the mouth as well as in the surrounding areas. As with medication that thins the blood, these bleeding disorders may not necessarily be the cause of bleeding. Instead it increases the risk of profuse bleeding even with a minor injury to the month. This is a result of a disturbance in the blood clotting mechanism. Hemophilia is probably among the more well known of these conditions.