What should I do about bleeding in my mouth?

ACS Answer

Bleeding in the mouth is generally caused by mouth sores, gum (periodontal) disease, or a decrease in the number of platelets (a blood component). This is usually a temporary problem. Platelets, which are responsible for blood clotting, may decrease as a side effect of radiation therapy, chemotherapy, or because of disease. A person with decreased platelets bleeds easily; an everyday action such as brushing teeth can result in bleeding. Side effects of chemotherapy or radiation therapy can cause dryness of the lining of the mouth or the formation of small mouth ulcers that result in bleeding.

What to look for

• Blood or bruises in mouth (on gums, tongue, etc.)
• Rash or bright red pinpoint-sized dots on tongue, under tongue, on roof of mouth, and/or on inside of cheeks
• Oozing of blood from mouth

What to do

• Rinse mouth gently with ice water every two hours.
• Have ice chips available to suck on; avoid hard candies if mouth is bleeding.
• Use Toothettes or gauze wrapped around a popsicle stick or tongue depressor to brush teeth.
• Rinse and/or brush teeth with a soft toothbrush after eating any food.
• Eat foods that are soft and smooth in consistency and high in calories and protein. Refrigerated soft foods, such as ice cream, applesauce, and yogurt, are good alternatives because the coldness also helps to control bleeding.
• Soften hard foods (apples, pears, etc.) by running them through a blender.
• Avoid hot drinks, such as coffee and tea. (Heat dilates blood vessels and increases bleeding.)
• Apply cream or salve to lips to prevent dryness.
• Keep dentures out of mouth, especially if they do not fit properly.

Do not

• Use a hard-bristle toothbrush
• Use commercial mouthwash
• Eat hard foods (such as crackers, non-blenderized apples or pears)
• Drink hot beverages
• Use dentures
• Use aspirin, which can increase the tendency to bleed (do check labels of all over-the-counter drugs because some contain aspirin)

Call the doctor about any of the following symptoms

• When you bleed from the mouth for the first time
• If bleeding continues for more than half an hour
• If you vomit blood
• If you feel light-headed

Related Resources

Find books that cover this and other cancer topics at the American Cancer Society bookstore.

Recommended Consultation

You should consider discussing this question with your doctor or health care team.

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