Sudden Tongue Bleeding: Causes and When to Seek Help

Sudden slight bleeding under the tongue?

Hello Doctor, I just brushed my teeth and when I stuck out my tongue and moved it, I suddenly felt a burst of fluid coming from underneath.
I noticed a slight bleeding near the area of the lingual frenulum or submandibular gland, and it seemed like there was a small abrasion.
After rinsing my mouth twice, the bleeding stopped.
I'm worried about infection, so I used mouthwash for disinfection and applied an oral ointment.
However, I can barely see the wound now; I only feel a slight stinging pain when I move my tongue, and I apply the ointment to that area.

After researching online, I became quite scared and wondered if this could be classified as unexplained oral bleeding.
I read that it might be a precursor to cancer, or if it's just normal bleeding, it would be more significant and not heal.
My bleeding was minimal, just a few streaks.
However, I still feel a slight stinging pain when I move my tongue vigorously.
Should I be very concerned and seek medical attention, or if it doesn't worsen in a few days, can I just ignore it? I've been staying up late due to final reports, and I wonder if that could be related.

Do you have any suggestions for improvement besides getting more sleep? How long might it take to heal? The image I found online shows the area where I noticed a bit of blood, which is circled in blue.
Also, could you explain why it felt like water was suddenly spraying from the area near the submandibular duct? I apologize for bothering you during the pandemic, and thank you for your help.
Wishing you good health! :)

Helen, 20~29 year old female. Ask Date: 2021/05/22

Dr. Hong Yuanbin reply Internal Medicine

Hello, the spraying you mentioned is likely the salivary glands secreting saliva.
As for the bleeding part, it is true that if you stay up late, experience high stress, or have a weakened immune system, your gums can easily bleed.
Just make sure to get plenty of rest and exercise, and you will recover quickly without excessive worry.
You only need to seek medical attention if the bleeding persists.
None of these are signs of cancer.
Thank you for your question.

Reply Date: 2021/05/22

More Info

Sudden bleeding from the tongue can be alarming, especially when it occurs unexpectedly during routine activities like brushing your teeth. In your case, it seems that the bleeding originated from a small area near the sublingual glands or the frenulum (the band of tissue that connects the underside of the tongue to the floor of the mouth). This type of bleeding can be caused by several factors, and understanding these can help alleviate your concerns.

Possible Causes of Sudden Tongue Bleeding
1. Trauma or Injury: The most common cause of sudden bleeding in the mouth, including the tongue, is trauma. This can occur from biting your tongue, irritation from sharp food, or even vigorous brushing. In your case, it seems that the action of rolling your tongue while brushing may have caused a minor injury.

2. Dry Mouth: If you have been experiencing dry mouth (xerostomia), this can lead to cracks or fissures in the oral mucosa, making it more susceptible to bleeding. Dry mouth can be exacerbated by dehydration, certain medications, or breathing through your mouth, especially during sleep.

3. Infection or Inflammation: Conditions such as oral thrush or other infections can cause inflammation and lead to bleeding. If there is an underlying infection, you may notice additional symptoms like swelling, pain, or a change in taste.

4. Underlying Health Conditions: While less common, certain systemic conditions can lead to bleeding in the mouth. These include blood disorders, vitamin deficiencies (like vitamin K), or other health issues that affect blood clotting.

When to Seek Medical Attention
Given that your bleeding was minimal and stopped after rinsing, it may not be a cause for immediate concern. However, you should consider seeking medical attention if:
- The bleeding recurs or does not stop.

- You notice significant swelling or pain in the area.

- You develop other symptoms such as fever, difficulty swallowing, or persistent sores in the mouth.

- The area does not heal within a week.

Healing and Care Recommendations
1. Maintain Oral Hygiene: Continue to brush your teeth gently and avoid irritating the area. Use a soft-bristled toothbrush and be cautious around the affected area.

2. Stay Hydrated: Drink plenty of water to keep your mouth moist and help with healing. If you suspect dry mouth, consider using saliva substitutes or mouthwashes designed for dry mouth.

3. Avoid Irritants: Steer clear of spicy, acidic, or very hot foods that could further irritate the area.
4. Use Saltwater Rinses: Rinsing with a warm saltwater solution can help promote healing and reduce the risk of infection.

5. Monitor Symptoms: Keep an eye on the area for any changes. If the pain increases or if you notice any unusual changes in the color or texture of the tissue, consult a healthcare professional.

Conclusion
In summary, while sudden tongue bleeding can be concerning, it is often due to minor trauma or irritation. Your symptoms suggest a small injury that should heal with proper care. However, if you experience persistent symptoms or have any concerns about your health, it is always best to consult with a healthcare provider for a thorough evaluation. Taking care of your overall health, including managing stress and ensuring adequate sleep, can also contribute to better oral health and recovery.

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