Oral bruising, or ecchymosis of the oral mucosa, refers to discolorations that appear on the delicate tissues inside the mouth. These marks, which can range in color from purple or blue to reddish-brown, occur when tiny blood vessels beneath the surface are damaged, allowing blood to leak into the surrounding tissues. Oral bruising can affect various parts of the mouth, including the gums, tongue, inner cheeks, and the palate, and is a common occurrence.
Common Causes of Oral Bruising
Many instances of oral bruising stem from everyday mechanical trauma. Accidental biting of the cheek or tongue during eating or speaking is a frequent cause, leading to localized discoloration. Consuming hard or sharp foods, such as crunchy snacks, hard candies, or crusty bread, can also irritate or scratch the delicate oral tissues, particularly the palate, resulting in small, sensitive bruises. Vigorous brushing or direct impact from objects, including sports injuries, can similarly damage blood vessels within the mouth.
Oral procedures performed by a dentist are another common source of bruising. Dental extractions, fillings, deep cleanings, or the adjustments of orthodontic appliances can cause trauma to the surrounding tissues. Injections of local anesthetic, a routine part of many dental treatments, can also lead to localized bruising around the injection site. Additionally, ill-fitting dentures or other oral appliances may rub against the soft tissues, causing chronic irritation and subsequent bruising. Forceful actions like intense vomiting or severe coughing can sometimes cause tiny, pinpoint red or purple spots known as petechiae to appear on the palate.
While less frequent, certain medications, such as blood thinners (anticoagulants), can increase a person’s susceptibility to bruising, making even minor trauma result in noticeable marks. Underlying medical conditions affecting blood clotting or systemic diseases can also manifest as oral bruising. These conditions often present with other associated symptoms and require further medical investigation.
When Oral Bruising is a Concern
Most minor oral bruises will resolve on their own within a few days to one or two weeks, similar to bruises elsewhere on the body. However, certain characteristics of oral bruising warrant prompt medical or dental attention. Bruises that are unusually large, expand rapidly in size, or do not show signs of healing within one to two weeks should be evaluated by a healthcare professional.
Concerns that require immediate medical consultation include:
- Severe pain, significant swelling, difficulty swallowing, or problems breathing.
- Frequent oral bruises without obvious cause, or bruising accompanied by other bleeding (e.g., nosebleeds, gum bleeding, or easy bruising elsewhere on the body).
- Bruises in infants or young children without a clear explanation.
- Any oral bruise associated with fever, general illness, or signs of infection (e.g., pus drainage, streaks).
Caring for Oral Bruises
For minor oral bruises resulting from common trauma, several home care strategies can help manage discomfort and promote healing:
- Opt for a soft diet to prevent further irritation.
- Avoid hot, spicy, or acidic foods and beverages.
- Gently rinse the mouth with a warm salt water solution several times daily.
- Take over-the-counter pain relievers, such as acetaminophen or ibuprofen, as directed.
- Apply a cold compress or ice pack (wrapped in cloth) to the outside of the cheek for 15-20 minute intervals to reduce initial swelling.
- After 24-48 hours, a warm compress may help increase blood flow and aid healing.