Blood in Saliva or Spit-up

Mouth | General Practice | Blood in Saliva or Spit-up (Symptom)


The presence of blood in the saliva does not involve every time a bleeding from the mouth, known by the medical term of stomatorrhagia. The mouth communicates with the nose, esophagus and larynx via the throat. This implies that bloody saliva may also occur due to bleeding in the nasal cavity, respiratory or gastrointestinal tracts.


Tracing the cause may be easier if the blood in the saliva is only evident or more pronounced in one of these situations: after or during vomiting, regurgitating or when belching indicates bleeding from the esophagus; after or during coughing (hemoptysis) or sneezing indicates bleeding from the airways or lungs; after sneezing, blowing the nose, in post nasal drip, with nasal congestion or accompanying a bleed from the nose indicates bleeding from the nasal cavity. If there is blood in the saliva without any clear correlation with the features mentioned above, then pathology within the mouth has to first be excluded before the neighboring cavities are investigated.

Causes of bloody saliva include: trauma after dental work/surgery or oropharyngeal surgery, poorly fitting dentures and other dental prosthetics, mouth biting, chemical injury to he mouth with: ingesting caustic substances; excessive gum chewing, tobacco chewing, acidic foods; infections (bacterial, acute necrotizing ulcerative gingivitis, periodontitis, tooth cavity, syphilis, gonorrhea), viral such as HIV, Epstein Barr virus, Cytomegalovirus, Herpes Simplex virus; nutritional deficiencies; drug and toxins.