### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I have been having blood clots in my mouth,, along with a fungal infection (treated with Nystatin). I DO and have had clotting problems in my lungs for years and am on Coumadin with INR levels checked regularly. The mouth clotting is new, however, and I have been to an Endodontost and a periodontist, no one even had a clue what it was. I figured it out. The only thing that helps is bursting them with q-tips while using Lidocaine (prescribed). Any thoughts?

### output:

Hello, This sounds like a change has occurred in your system. First, has the fungal condition been cured and time given for tissue to heal? Seeing dental specialists to rule out gum conditions and infections is an excellent and recommended step. Proper hygiene and nutrition is important. I would expect an exaggerated response and increased bleeding from your history when any oral disease is present. From your description, you seem to have evaluated your dental health which does not make me think common dental conditions that cause bleeding will apply to your complaint. My thought is a blood disorder. Second, what is the source and diagnosis of your high amount of clotting? Have you looked into blood disorders? An increase in the amount of red blood cells produced could require an additional medication to control red blood cell production and even removal of excess blood. This would be in addition to taking Coumadin. I would recommend consulting a specialist with a complete medical history review. There may be additional testing recommended. Consider the possibility of a rare disorder or a later onset change to your body that needs to be diagnosed and treated.  Bleeding elsewhere in your body, medicines, genetics, infections, all need to be looked into. Platelet insufficiency can cause leakage and blood clots form as you describe. Pinpoint blood spots to larger blisters are a common symptom in the mouth. There are many causes and this would be a common deficiency to evaluate, if you have not considered blood disorders. Bone marrow function maybe compromised. An autoimmune disorder may be diagnosed. Thrombocytopenia, a platelet disorder, commonly causes clotting in the cheeks. Consider the source of the clotted blood in your mouth may not be from your mouth.  Is it coming from the throat or gastrointestinal tract? Sinus? Ulcers can cause bleeding. Tumors may be possible. Any acid reflux? You refer to popping the clots which would make me think more blood disorder or vessel wall being compromised. I do not generally like to ask so many questions, but I am trying to be helpful in giving you some direction and suggestions. There is a wide range of possibilities. I am glad to discuss your concerns further and am available for additional questions. Thank you for your inquiry.