Mouth Bleeds

Bleeding in the mouth is usually from your gums around your teeth.  You can also bleed from your tongue, lips, or the inside of your cheek, often from accidentally biting it.  Bleeding in the tongue, the floor of the mouth, or the cheek can be dangerous if it is not stopped.  The blood can build up in your throat and make it hard for you to breathe.

How to treat a bleeding in the mouth:

• People with hemophilia usually do not need to take factor concentrate for minor bleeding from the gums.  However, they should take factor for bleeding in the tongue, the floor of the mouth, or the cheek.
• Your doctor may give you a prescription for Amicar®.  Amicar® is the medicine that helps keep blood clots in your mouth from breaking apart.  It will only work if a clot has already formed.  People with hemophilia will need to take factor first.

Remember these things, too:

• Bleeding that lasts for several days can cause a low red blood cell count (anemia).  Your doctor may want to check.
• Your saliva (spit) sometimes breaks down blood clots that form in your mouth.  The drug Amicar® helps prevent this.
• Don’t eat papaya or fresh pineapple after having a mouth bleed.  Enzymes in these foods can break down the blood clots.
• Your dentist should talk to your bleeding disorder doctor or HTC before doing dental work.  You will need to take clotting medicine before having dental work that might strike a blood vessel.  For instance, you will need treatment before having a deep shot in your mouth or before having a tooth pulled.
• It may be hard to tell how much blood you are losing during a mouth bleed.  During the day, you may swallow blood and not be aware of the amount.  At night you may see blood mixed with saliva (spit) on your pillow.
•  Blood that you swallow can make you sick to your stomach.  It can make you throw up (vomit).
• After you have a mouth bleed, it is best to eat cool, soft foods for several days until your mouth heals.  Hard or sticky food may make the bleeding start again.
• If you need to drink through a straw after bleeding in your mouth, two straws taped side by side are better than one.  You suck harder when you use one straw.  This can restart the bleeding.
• It is important to keep your teeth clean.  Since a toothbrush can tear a clot, it is safer to use a cotton swab (Q-tip) to clean the teeth near the clot.  Gently rinse your mouth with water.  Don't swish it around.  Once your mouth is healed, go back to brushing your teeth normally.

How to prevent mouth bleeds:

• Do not chew gum.  Chewing all the time can cause you to bite your tongue or cheek by mistake.
• Never put objects like pencils or paper clips in your mouth.
• Chew slowly so you will not bite your lip or cheeks.
• See your dentist every six months.
• Brush and floss your teeth every day.
• If your mouth bleeds often, talk to your bleeding disorder doctor or dentist.  They can give you further tips.

Call your doctor or treatment center if:

• The bleeding lasts for more than a day.
• You have signs of bleeding in your throat or neck:
  • swelling
  • choking
  • trouble breathing or swallowing
  • darkening of the skin over the neck or throat.
• Your baby or young child has bleeding inside the mouth.
• You have problems with your teeth.