Mouth bleeding with a bleeding disorder

Article Translations: (Spanish)

What causes bleeding in the mouth?

• loss of baby teeth
• injury to the mouth
• biting the inside of the cheek or tongue
• gum disease
• dental work, including Novocain®
• injections

Why is mouth bleeding a problem?

Bleeding from the mouth in a child with a bleeding disorder can be hard to control. Healing takes longer because enzymes in the saliva naturally break down blood clots. Bleeding often restarts during eating.

How should I care for my child?

Try to limit sucking (pacifiers, straws, bottles, or sippy cups). Avoid sharp foods (such as chips and crackers) hot drinks, and bumping the mouth during the healing process. Medicine may be needed:

• Amicar®, to help stop the enzymes in saliva from breaking down blood clots
• Nosebleed QR®
• Factor concentrate or DDAVP if your hematologist recommends them

When should I call the clinic?

• if bleeding continues for 30 minutes
• loose tooth or teeth due to injury
• black, bloody, or tarry bowel movements
• vomiting blood
• swelling of the tongue or throat

What else do I need to know?

Mouth bleeding is usually not life threatening, unless the child has had a very bad accident that results in severe swelling in the mouth or throat area. This could lead to breathing problems.

A small amount of blood mixed with saliva looks like more blood than it really is.

Some children might have mouth bleeding and swallow the blood. They may throw up blood or it will show up as dark or tarry looking bowel movements.

If mouth bleeding lasts for several hours, anemia (low hemoglobin) may result.

Good dental care in patients with bleeding disorders is very important. Children should brush twice daily, floss every day, and see the dentist every 6 months. If your child is having dental work, see the education sheet, "Dental care with bleeding disorders."

Questions?

This is not specific to your child, but provides general information. If you have any questions, please call your clinic. For more information about bleeding disorders the following websites are available:

• www.cdc.gov
• www.hemophilia.org

Children's Hospitals and Clinics of Minnesota
Last reviewed by Hematology 8/2015

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