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Mouth Diseases

Unexplained bleeding from the tongue

06/15/2006

Question:

For about 8 weeks now I have noticed blood in small traces (sometimes fresh, sometimes brown) in my mouth on waking, whereby my mouth is full of mucus containing these traces. I visited my doctor and he made me have a chest X-ray (clear), an endoscopy (clear) and blood clotting tests (normal). I also suffer a general sense of dryness in the mouth, although I do seem to produce a lot of mucus, particularly overnight.

More recently I have noticed that, when fresh blood is present, it appears to be coming from tiny bleeding patches on my tongue, and the bleeding stops really quickly.

There are no other symptoms except a general glossiness and whitish colour to the tomgue - no lumps or undue swelling.

I am male, 61 years of age, British and suffered from Hodgkins Disease (nodular sclerosing) diagnosed in 1982 and successfully treated with radiotherapy (and splenectomy) only, no recurrence. The only other serious illness has been two mild heart attacks within the last five years. Treatment is daily Aspirin (75mg), Diltiazem Hydrochloride (200 mg), Losartan Potassium (100mg), Doxazosin Mesilate (4mg), Atorvastatin (20mg). I also take Esomeprazole (20mg) daily for reflux and, for asthsma, Salbutamol (when breathless) and Seretide (two puffs twice daily).

Could any of these medications be causing this?

Answer:

Although this is a question you should also ask your physician, the daily adult dose of aspirin can increase your bleeding tendency slightly.  The tongue contains many, superficial blood vessels and as we get older, it is a common place for varicose veins to develop.  If these are bitten or injured by the teeth, they could easily account for your mild bleeding problem.

I would recommend a close examination of your tongue by a dentist or dental specialist.  I would schedule your appointment early in the day and try to minimize food/drink so as to not dislodge the evidence of bleeding.  This should permit the source of the bleeding to be more precisely identified.  Treatment, if any, should be determined with input from your physician.

Good luck!

 

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Response by:

John R Kalmar, DMD, PhD John R Kalmar, DMD, PhD
Clinical Professor of Pathology
Associate Dean of Dentistry Administration
College of Dentistry
The Ohio State University