The most common causes of a bleeding tongue include:
- sudden harsh biting of the tongue
- mouth sores
- injuries from dentures or braces
- eating sharp or hard foods
- radiation treatment for cancer
This article provides a brief overview of the possible reasons for a bleeding tongue, how to diagnose and treat the condition, and when it is advisable to see a doctor.
Various conditions may cause a bleeding tongue, including oral infections.
There are many reasons why a tongue might start bleeding. Some of these will be obvious, for example biting it too hard or injuring it with a sharp piece of food.
Other causes may be less clear though. These include various infections and sores that can affect the tongue.
Some less obvious causes of tongue bleeding include:
Mouth ulcers or blisters
Ulcers or blisters that develop in the mouth, including on the tongue, are also known as canker sores. These can develop as a result of hormonal changes or genetics or can be triggered by certain health conditions, such as vitamin B-12 deficiency or inflammatory bowel disease (IBD).
They are rarely a cause for concern and tend to heal on their own. However, irritants such as sharp food or a harsh toothbrush may injure these sores and result in a tongue bleed.
A doctor or dentist is likely to make a diagnosis by examining the mouth. If they suspect an underlying infection or another medical condition, they will ask for a mouth swab or other tests.
There is no quick fix for mouth ulcers and blisters, but they usually clear up within 1 to 2 weeks.
Some treatment options that may reduce symptoms and prevent infection include:
- antimicrobial mouthwashes, gels, and sprays
- lozenges containing corticosteroids
If the problem persists for more than 3 weeks, it could be a sign of an infection and should be checked by a doctor.
Fungal or yeast infections in the mouth are fairly common, but if they are left untreated then they can progress to cause tongue bleeds.
Infections such as oral thrush (candidiasis) may result in hard mouth sores that cause pain while eating, drinking, and swallowing.
Many healthy people have yeast in their mouth, but only some go on to develop an infection. Those with a higher risk of getting these infections include:
- people who have HIV
- people undergoing radiation therapy or chemotherapy for cancer
- people taking antibiotics
As with mouth ulcers, doctors tend to diagnose oral infections by visual examination.
A doctor may recommend taking a mouth swab to work out which germ is responsible for the infection. Knowing this will help the doctor decide how best to target it with a specific treatment.
Depending on the type and extent of the infection, people can use both creams and oral medicines to treat an oral infection.
Oral herpes has no cure, but it is treatable.
Oral herpes is a contagious condition caused by the herpes simplex virus. This virus can survive in the human body for years without causing any problems. However, certain triggers, such as stress or hormonal changes, may activate the virus to cause an infection.
Oral herpes initially appears as cold sores in the mouth. If present on the tongue, these sores are prone to bleeding on sudden injury or contact with certain trigger foods.
Oral herpes is not easy to diagnose as it tends to cause either symptoms that are similar to those of other medical conditions or no symptoms at all.
Common signs include:
- blisters that burn
The best way to diagnose oral herpes is by taking a tissue sample from the affected area, which a doctor can test to check for the presence of the virus. A blood test can also be used to detect the virus.
There is no cure for a herpes infection, but medications are available to treat its symptoms. The most common treatment option for oral herpes is antiviral medication, which can be in the form of pills or an injection.
Other treatments that help manage symptoms include antiviral ointments, topical anesthetics, and over-the-counter (OTC) anti-inflammatory agents.
Blood vessel abnormalities
Sometimes a collection of excess blood vessels known as a hemangioma develops on the face, head, mouth, or neck. This will generally be present at birth or develop in early childhood.
Tongue hemangiomas, though rare, can cause bleeding, pain, and difficulty eating. They are more common in women than in men.
Doctors diagnose a tongue hemangioma through a physical examination and by studying a person's medical case history.
Various treatment options are now available to treat tongue hemangiomas. Depending on the individual's age and physical condition, a doctor may use the following methods to treat these blood vessel defects:
- radiation treatment
- cryosurgery, where extreme cold is used to destroy cells
- laser treatment
- radiofrequency, a technique that uses heat to trigger a healing response
In many cases, tongue hemangiomas go away on their own over time.
Squamous cell carcinoma (SCCA) is the most common type of tongue cancer. It gets its name from the type of cells that are affected, which make up the lining of the mouth, nose, voice box, thyroid, and throat.
Symptoms of tongue cancer include:
- unexplained bleeding of the tongue
- persistent pain when swallowing
- a sore spot or lump on the tongue
- a feeling of numbness in the mouth
Other medical conditions can cause these symptoms, but it is worth visiting a doctor if they appear.
Early detection of tongue cancer is important to prevent it from spreading to other parts of the body.
A biopsy is the best way to confirm the presence of tongue cancer. It involves examining a small sample of tissue under a microscope.
As with most cancers, the stage and extent of the tongue cancer will determine how it is treated. For example, a different approach may be needed if the cancer has spread to other parts of the body.
Surgery, radiotherapy, and chemotherapy are all used to treat this type of cancer.
Maintaining good oral hygiene may prevent a bleeding tongue.
People can help prevent a bleeding tongue by being aware of the risk factors.
While it is not possible to prevent many of the health conditions that can cause a bleeding tongue, people can change certain habits or lifestyle factors to reduce their risk.
Risk factors for tongue bleeding include:
- poor oral hygiene
- excessive alcohol consumption
- excessive smoking
- poor use of dentures, floss, and other dental apparatus
Taking care while eating will also make mouth injuries less likely.
Some easy home remedies can provide relief and may temporarily stop the bleeding. These include:
- Placing ice cubes on the affected area of the tongue, either directly or in a clean napkin or gauze. Repeat two or three times a day if this provides relief.
- Gargling several times a day with an antiseptic mouthwash or warm water.
- Stirring a teaspoon of salt or baking soda into a cup of warm water and rinsing the mouth three to five times a day.
- Avoiding foods or liquids that could trigger or worsen a mouth sore or ulcer. These include spicy foods and foods that are sharp in texture.
- Taking an OTC painkiller to reduce pain and swelling.
- Allowing the tongue to heal. Avoid chewing on the affected side of the tongue and do not poke it.
When to see a doctor
It is a good idea to make a note of any signs and symptoms ahead of the appointment in order to communicate these clearly with the doctor. This information will help them make a more accurate diagnosis.
A bleeding tongue could be the result of many conditions, and may sometimes heal on its own.
If the symptoms persist, a doctor will be able to recommend a specific course of treatment.
Written by Gillian D'Souza