The unexpected sight of your own blood can be unsettling. One of the times this can happen is when you spit and see blood in your saliva. Another time you might notice blood in your saliva is when you have a rusty, metallic taste in your mouth.

Let’s take a look at the causes of blood in saliva and how each is treated.

Gingivitis

Gingivitis is a common gum disease (periodontal disease) characterized by swelling and redness of the gums around the base of your teeth. Poor oral hygiene typically causes it.

Treatment usually includes a professional dental cleaning followed by good oral hygiene. Later stages of the condition may require surgical treatment.

Mouth ulcers

Also called canker sores, mouth ulcers are small, painful sores that develop on your gums, inside your lips, and inside your cheeks. They’re often triggered by:

Treatment for mouth ulcers isn’t typically needed, as they tend to clear on their own. If they grow large or last for more than a couple of weeks, your doctor might recommend prescription mouthwash with dexamethasone or lidocaine.

Over-the-counter (OTC) gels, pastes, or liquids may also help. Options include:

  • hydrogen peroxide
  • benzocaine (Anbesol, Orabase)
  • fluocinonide (Vanos, Lidex)

You may also consider eating foods containing higher levels of the following vitamins and minerals:

Some cancers, such as lung cancer and esophageal cancer, will cause you to cough up bloody phlegm. This may look like bloody saliva if some stays in your mouth, but it’s actually not in your saliva.

Cancers that can cause you to have blood in your saliva are:

  • Mouth cancer. This is also called oral cancer or oral cavity cancer. It occurs on the inside of the mouth on the gums, tongue, or cheeks, or roof or floor of the mouth.
  • Throat cancer. This cancer is characterized by tumors that develop in the pharynx (throat), larynx (voice box), or tonsils.
  • Leukemia. This cancer affects the blood and bone marrow.

Treatment

Your doctor will discuss treatment options tailored to the stage of the cancer, its specific location, the type of cancer, your current health, and a number of other factors. Treatment might include:

Schedule regular visits with your dentist for cleaning and exams. Consider making an immediate appointment if you notice symptoms such as:

If you see blood in your saliva and don’t have an explanation, such as aggressive brushing, a canker sore, or biting your tongue, bring it up with your dentist.

In the meantime, practice good dental hygiene:

  • Brush twice a day.
  • Floss daily.
  • Use a mouthwash with fluoride.