The presence of blood in the mouth can be the telltale sign of various mild or severe pathologies. Is this the symptom of gingivitis? Of a cancer ? Can we bleed for no reason? What are the treatments? Answers from Dr Blandine Ruhin, Maxillofacial surgeon and stomatologist.
What are the symptoms ?
The presence of blood in the mouth is a symptom that can be observed in many pathologies. Bleeding can be characterized in several ways:
- compared to the circumstance of occurrence (brutal cataclysmic or permanent, positional, trauma, morning, night, ..)
- compared to the amount of blood lost (sputum, the equivalent of a glass, a bowl, hemorrhagic bleeding ..)
- compared to l’aspect (Red Black, ..)
- compared associated signs (fatigue, fever, chills, sore throat, voice change or dysphonia, hoarseness, cough, vomiting, chest pain, abdominal pain,, ..)
- following an anticoagulant medication
What are the causes of blood in the mouth?
“The bleeding found in the mouth may be of oral origin, from one of the anatomical elements of oral cavity : teeth, gum, tongue, mucous membrane, jawbone. The blood found in the mouth can also be exteriorized by the mouth but come from elsewhere. It may thus come nasal cavity : profuse nosebleeds coming to flow into the mouth. He can also come respiratory system (larynx, vocal cords, trachea, lungs) or the digestive system (esophagus, stomach) “, develops Dr Blandine Ruhin. Thus, we will speak more precisely:
- of a gingivorragie for bleeding gums,
- of a epistaxis when blood comes from the nasal cavity (vascular spot of the nose)
- of a hemoptysis when it comes from the respiratory system (lung cancer)
- of a hematemesis when the bleeding is of digestive origin (esophageal varicose vein, gastric ulcer, stomach cancer)
When and who to consult?
“It depends above all on the volume of blood involved. If the bleeding is severe, immediately go to the hospital or call for help. because it is a serious situation which requires urgent care. The lung has no reason to bleed. Regardless of the amount of blood, if the bleeding is from the lungs, it is an emergency.“, insists our interlocutor. For a smaller volume of blood (pink saliva, stain on a handkerchief),”we can procrastinate, but However, it will be necessary to go for a consultation and quickly find the origin of the bleeding‘‘she adds. A stomatologist will be able to distinguish bleeding from the mouth from bleeding from another source after careful oral examination. If the blood does not come from the mouth, then it will refer the patient to a specialist (pulmonologist, ENT specialist, gastroenterologist…).
The sign of cancer?
Squamous cell carcinoma is the most common cancer of the mouth. “If the bleeding is from a suspicious lesion in the mouth – on the lining, tongue, gums – it may indeed be a sign of oral mucosa damage or oral cancer. However, this remains rare. Smoking and alcohol consumption are risk factors “, continues the stomatologist. The presence of blood from the lungs may be a sign of lung cancer and requires prompt treatment.
The sign of gingivitis?
“Bleeding gums often occur with their aging (loose teeth, receding gums, repeated trauma from tobacco, alcohol, hot drinks (coffee, tea, etc.). All this can cause inflammation of the gums or gingivitis, gingivopathy causing bleeding when brushing or gingivorrhagia“, explains the stomatologist.
What are the treatments ?
If the bleeding is sudden and profuse, it is an absolute emergency.
“Bleeding through the mouth is always of great concern to the patient. If the bleeding is sudden and profuse, it is an absolute emergency that requires treatment as soon as possible. S” it is moderate and repetitive, the patient must notify his doctor treating person who will know how to specify the origin, perceive the degree of seriousness, prescribe the appropriate additional examinations and refer the patient to the practitioner capable of ensuring the diagnosis and treatment“, concludes Dr Blandine Ruhin. Obviously, the cause of the bleeding will have to be treated. Several treatments are possible:
- caries treatment, avulsion of a tooth
- scaling and advice for gentle and effective brushing of teeth
- suturing a wound
- reduction in osteosynthesis of a jaw fracture
- ligature of a vessel
- biopsy of a lesion in the oral mucosa for examination under a microscope
- nasal tamponade, cauterization of a vascular spot of the nose
- embolization of a bleeding vessel
- adapted lung or digestive surgery
- specific treatment of cancer in an approved service
Thanks to Dr Blandine Ruhin, Maxillofacial Surgeon and Stomatologist (Paris).
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