How many times have you been snacking away on a handful of chips or chewing a stick of gum and accidentally bit the inside of your cheek or tongue? Ouch. Small injuries like this, especially if you accidentally keep biting in the same place, can cause gum and tongue bleeding. But sometimes, other less obvious things can cause your tongue to bleed, too.

While the occasional bleeding tongue doesn’t usually mean a trip to the dentist, frequent bleeding may be a symptom of an underlying oral health (or overall health) issue. We spoke to dentists to learn why your tongue may bleed, how to stop it when it does, and when it might be a good idea to get it checked out.

9 reasons your tongue may bleed

Here are the top reasons why your tongue may bleed, from minor injuries to underlying health issues.

1.You scraped your tongue

“Our tongues are covered in thousands of tiny finger-like projections called papillae that take in sensory information like taste, texture, and temperature,” says Chrystle Cu, DDS, founder of Cocofloss. “Each of these little papillae have their own mini blood vessels in them, so any sort of trauma to the tongue can make them bleed.”

On top of this, “the outer layer of the tongue (a delicate mucosal layer) can easily be damaged,” says Marina Gonchar, DMD, founder of Skin to Smile. Given how sensitive the tongue is, even a minor scrape can irritate it and draw blood.

Here are just a few things that can cause tongue bleeding, according to Dr. Cu and Dr. Gonchar:

• Accidentally biting your tongue during eating or speaking
• Brushing too hard
• Contact with something sharp (think: a broken tooth, poorly fitted crown, and other dental appliances such as lingual braces, dentures, retainers, and nightguards)

Note: “If you feel like your tongue always gets caught in between your teeth, it’s a good idea to see a dentist to evaluate your occlusion (how your teeth fit together),” Dr. Cu says. Not only can a bad bite cause tongue bleeding, but it can also affect your ability to breathe well. “If your tongue lacks sufficient resting space within your dental arches, there’s a possibility that your airway may also be compromised,” she says.

2. It’s something you ate

Tongue bleeding after eating pineapple? There’s a scientific reason behind it. “Acidic foods can irritate the tongue by disrupting the pH balance of the mouth and creating damage to the protective layer of the tongue’s mucous membrane,” Dr. Gonchar says. This is also why your tongue may feel raw and sensitive after sucking on too much sour candy. The acids in the candy eat away at the top layer of your tongue.

Same goes for spicy foods, Dr. Gonchar says. “Multiple exposures or very high concentrations of these foods can damage the delicate outer barrier” of the tongue and trigger bleeding, she says.

3.You have a mouth ulcer

If you have a mouth ulcer—those small, painful red, yellow, or white sores that develop anywhere inside your mouth—your tongue might be more susceptible to bleeding. They tend to form on your tongue, gums, palate, inner cheeks, or lips due to minor injuries (like accidentally biting your cheek or tongue) eating lots of acidic foods, hormonal changes (like during your period), or stress (think: lack of sleep), according to the Cleveland Clinic.

“Mouth ulcers usually do not bleed [on their own], but their presence indicates damaged tissue on the tongue,” Dr. Gonchar says. “And anything that can aggravate the ulcer or re-traumatize the area can result in bleeding from the sore.”

Luckily, mouth ulcers are typically no big deal. In most cases, the sores subside on their own without treatment.

4. You have a fungal or yeast infection

When you hear the term yeast infection, you might immediately think about your private parts. But an overgrowth of fungus can affect your mouth, too. And when it does, it can make your tongue bleed. Known as oral thrush, this type of yeast infection happens when Candida fungus accumulates on the lining of your mouth, per the Mayo Clinic.

Normally, candida lives in your mouth (and your vagina) without causing any problems. But if something throws off the balance of good bugs in your mouth, say, a weakened immune system, these fungi can flourish. And this is bad news for your tongue. “Fungal and yeast infections can cause irritation and inflammation of the mucous membranes, which damages the underlying tissues and can result in [tongue] bleeding,” Dr. Gonchar says.

Other symptoms of oral thrush may include the following, per the Mayo Clinic:

• Creamy white lesions on your tongue, inner cheeks, and sometimes on the roof of your mouth, gums, and tonsils
• Slightly raised lesions with a cottage cheese-like appearance
• Redness, burning, or soreness that may be severe enough to cause difficulty eating or swallowing
• Cracking and redness at the corners of your mouth
• A cottony feeling in your mouth
• Loss of taste
• Redness, irritation, and pain under dentures (denture stomatitis)

If you think you’re dealing with oral thrush, see your doctor or dentist who can prescribe an antifungal medicine to treat the infection.

5.You have oral herpes

If you have a cold sore or fever blister on your mouth, it’s likely you have oral herpes. Between 50 to 80 percent of American adults have this common infection that’s caused by herpes simplex virus type 1 (HSV-1), according to Johns Hopkins Medicine. The most common symptom of oral herpes is painful, fluid-filled blisters that become sores. But when the infected tissues become inflamed, they’re super sensitive and susceptible to irritation. “These ulcers are prone to rupture and can be easily traumatized by any normal daily activities, resulting in bleeding,” Dr. Gonchar says.

To treat the blisters, you can try over-the-counter topical anesthetics or anti-inflammatories. If these remedies don’t provide relief (or you keep getting frequent outbreaks), talk to your doctor. They may prescribe a stronger antiviral ointment or an oral antiviral medication, such as acyclovir, famciclovir, or valacyclovir, per Johns Hopkins Medicine.

And remember: When you have an active outbreak or cold sore on your mouth, avoid physical contact (like kissing or sharing utensils) with others. This is how the virus spreads.

6. You have a nutrient deficiency

“Some underlying conditions can cause your tongue to be more sensitive, fragile, or prone to injury and bleeding,” Dr. Cu says. “This includes an iron or vitamin B12 deficiency,” she adds.

Some signs you’re lacking vitamin B12 include the following, per Johns Hopkins Medicine:

• Weak muscles
• Numb or tingling feeling in hands and feet
• Trouble walking
• Nausea
• Decreased appetite
• Weight loss
• Irritability
• Lack of energy or tiring easily (fatigue)
• Diarrhea
• Smooth and tender tongue
• Fast heart rate

Signs of an iron deficiency can include the following, per Johns Hopkins Medicine:

• Abnormal paleness or lack of color of the skin
• Irritability
• Lack of energy or tiring easily (fatigue)
• Increased heart rate (tachycardia)
• Sore or swollen tongue
• Enlarged spleen
• A desire to eat non-food substances like dirt or ice (a condition called pica)

If you have any of these symptoms, don’t ignore them. Without adequate vitamin B12 or iron, your body won’t be able to make enough red blood cells, which carry oxygen to your tissues and organs. This means your body won’t function as well as it should. Better to be safe and get checked out by your doctor. They can do a blood test to determine whether you’re dealing with a nutrient deficiency.

7. You have a tongue hemangioma

“A tongue hemangioma is a benign vascular lesion resulting in abnormal overgrowth of blood vessels in the tongue,” Dr. Gonchar says. Because tongue hemangiomas tend to be located very close to the surface of the tongue (and can protrude), they’re an easy target for any trauma and irritation, she says. When they rupture, it can result in profuse bleeding.

Your doctor may treat tongue hemangiomas with corticosteroids, beta blockers, or a sclerosing agent (a solution that’s injected into the blood vessels), according to the University of Iowa.

8. You have tongue cancer, in rare cases

Though rare, a bleeding tongue could be a sign of something more serious like cancer. “Tongue cancer can often result in weakened blood vessels, inflammation of the site, ulceration, and erosion of the surrounding tissues,” Dr. Gonchar says. All can lead to tongue bleeding.

Other possible symptoms of tongue cancer to look for include the following, per the Mayo Clinic:

• A sore on the tongue that doesn’t heal
• A lump or thickening on the tongue
• A red or white patch on the tongue or lining of the mouth
• A lump in the back of the mouth, throat, or neck
• A sore throat that doesn’t go away
• A feeling that something is caught in the throat
• Numbness of the mouth or tongue
• Difficulty or pain with chewing, swallowing, or moving the jaws or tongue
• Swelling of the jaw
• A change in voice
• Swollen lymph nodes in the neck
• Coughing up blood
• Weight loss
• Ear pain

See a doctor or a dentist if you have any of these symptoms. Early detection is key to stop the spread of tongue cancer to other parts of your body.

How to treat tongue bleeding

Here’s the good news: “Minor tongue bleeding usually resolves on its own,” Dr. Gonchar says. That’s because the tongue is especially equipped to heal itself. “The tongue is bathed in saliva, which has several clotting factors,” and the “vast number of small blood vessels makes clotting easier and more efficient,” she says.

That said, if you want to speed up the healing process (and decrease discomfort if you have any), try these home remedies, per Drs. Gonchar and Cu:

• Apply firm pressure with a clean cloth or gauze for at least 15 minutes. Don’t dab repeatedly with new cloth or gauze. If you wipe away the blood too often, it may take longer to clot and stop bleeding.
• Use ice. You can wrap ice in a clean cloth or gauze and apply it to your tongue. The cool temperature helps constrict the blood vessels and resolve the bleeding. Sipping on a very cold drink (think: ice water) will do the trick, too.
• Place a black tea bag on the affected area (or drink black tea). This can be helpful with clotting because black tea contains tannins, which promote platelet aggregation.
• Eat a bland diet. At least until your tongue heals. This will prevent you from further irritating the area. In other words, save the spicy or acidic food for a later date.
• Identify the underlying cause of the bleeding. For example, if tongue bleeding is due to an irritant (like sharp fillings or crowns), see your dentist to address the problem.

Can you prevent tongue bleeding?

You can’t always prevent your tongue from bleeding, but there are ways to reduce the risk. Try these expert tips from Drs. Gonchar and Cu:

• Use proper technique with a tongue scraper. Don’t push down too hard. This can damage the papillae on your tongue.
• Avoid using worn toothbrushes. Worn bristles can irritate the tongue. Instead, use a very soft bristled toothbrush with a smooth, compact head, and replace it every three months.
• Be mindful when chewing food. This can help you avoid accidentally biting your tongue while eating.
• Limit irritating foods. Eating a lot of spicy and acidic foods can cause tongue trauma.
• Avoid tobacco and limit alcohol use. Both can irritate the tongue and other dental tissues.
• Be aware of new dental devices. If they’re rubbing or scraping your tongue, have them adjusted by a dental professional.
• Don’t use or place sharp objects near or around your mouth. Dr. Cu has “seen too many mouth and teeth injuries from beer bottle caps and broken glass.”
• Attend regular dental checkups. This ensures proper care of all dental fillings, crowns, and other appliances. Plus, dentists can often detect other oral health conditions, like cavities or gum disease.

When to see a doctor

In most cases, tongue bleeding is a temporary issue (you accidentally bit your tongue or snagged it on a chipped tooth) that goes away on its own. But if bleeding continues, it can be a cause for concern. “If your tongue bleeds frequently and persistently, it is time to see a dentist for an exam,” Dr. Gonchar says.

Dr. Cu agrees: “It’s a good idea to see a dentist if you experience repeated tongue bleeding from mild injury, or if you see new lumps, bumps, or lesions on your tongue that don’t heal after a couple of weeks.” These symptoms could indicate an underlying health issue that needs to be treated.