Finding blood mixed with saliva can be unsettling, often triggering immediate concern about its origin. The blood may look pinkish, crimson, or like streaks in mucus, and it frequently imparts a metallic taste. Determining the source is the first step, as the cause can range from a minor issue in the mouth to a serious internal condition. The blood might originate from the oral cavity, the upper respiratory tract, or deeper within the lungs or digestive system.
Causes Originating in the Mouth and Gums
The most frequent source of blood in saliva is the oral cavity, often stemming from common dental conditions. Gingivitis, the initial stage of gum disease, causes inflammation and redness of the gums around the base of the teeth. This bacterial plaque buildup makes the gum tissue fragile, leading to bleeding when brushing or flossing.
Bleeding can also result from mechanical irritation or minor tissue damage within the mouth. Aggressive brushing, vigorous flossing, or accidentally biting the cheek or tongue can easily rupture small blood vessels. Small, painful lesions known as canker sores or mouth ulcers develop on the gums, lips, or cheeks and may bleed if irritated. These ulcers are sometimes triggered by dietary factors.
A compromised dental cavity, such as from a recent tooth extraction, is another temporary source of bloody spit. Medications, especially anticoagulants, can also increase the ease and frequency of bleeding from minor cuts or gum irritation. Persistent or unexplained bleeding should always be evaluated by a dental professional.
Bleeding from the Upper Airways and Throat
When blood is mixed with mucus or phlegm, the source may be located higher in the respiratory system. A common cause is epistaxis, or a nosebleed, where blood drains down the back of the throat and mixes with saliva. This blood often appears in the spit after waking up, as it may have been swallowed overnight.
Acute respiratory infections, such as viral bronchitis, are frequent causes of blood-streaked sputum. These illnesses involve inflammation of the bronchial tubes, which can lead to minor irritation and bleeding. Even without an infection, severe or violent coughing can irritate the lining of the throat and airways, causing small blood vessels to rupture. The resulting blood volume is usually small, presenting as mere streaks.
Serious Bleeding from the Lungs or Digestive Tract
Blood originating from deep within the body, either the lungs or the digestive tract, warrants immediate attention. Bleeding from the respiratory tract is termed hemoptysis, involving coughing up blood from the lungs or airways. This blood is often bright red or pink and appears frothy because it is mixed with air and mucus. Causes include severe infections like pneumonia or tuberculosis, chronic conditions such as bronchiectasis, or serious issues like lung cancer or a pulmonary embolism.
Bleeding from the upper digestive tract is known as hematemesis and involves vomiting blood. This blood tends to be dark red, non-frothy, and may resemble coffee grounds. The darker color results from stomach acid reacting with the blood. Hematemesis is usually associated with nausea and abdominal discomfort and can be caused by peptic ulcers, gastritis, or tears in the esophageal lining.
When to Seek Medical Care
While minor blood in the spit is often attributable to a simple oral cause, certain signs necessitate prompt medical evaluation. Contact a healthcare provider if you experience minor, unexplained bleeding that persists for more than a week. A visit is also appropriate if the bleeding is sporadic and accompanied by mild symptoms like a persistent cough, fever, or unexplained weight loss.
Immediate emergency care is required if the volume of blood is substantial (more than a few teaspoons). Life-threatening symptoms that accompany bloody spit include severe shortness of breath, chest pain, or lightheadedness. If the blood is black or resembles coffee grounds, or if the bleeding is accompanied by severe abdominal pain, seek emergency attention immediately. These symptoms suggest acute internal bleeding and require urgent diagnosis and treatment.