Tooth and gum in pregnancy: dental treatment in pregnant patients

During pregnancy, you are more likely to have problems with your teeth or gums. If you have an infection in your teeth or gums, the chance of your baby being premature (born early) or having low birth weight may be slightly higher than if your teeth and gums are healthy. Taking good care of your mouth, teeth and gums during pregnancy can help you have a healthy pregnancy and a healthy baby.

How does pregnancy affect your dental health?

Dental health (also called oral health) is the health of your mouth, teeth and gums. It’s an important part of your overall health. And if you’re pregnant, it’s an important part of your prenatal care (medical care you get during pregnancy).

Being pregnant can increase your risk for oral health problems, and these problems can affect your pregnancy. For example, some studies show a link between gum disease and premature birth. Premature birth is birth that happens too early, before 37 weeks of pregnancy. Premature babies may have more health problems at birth and later in life than babies born full term.

Changes in your body during pregnancy can affect your teeth and gums. For example:

  • You have increased levels of certain hormones, like progesterone and estrogen, in your body during pregnancy. These can increase your risk for certain oral health problems.
  • Your eating habits may change. You may eat more of certain foods during pregnancy than you did before you were pregnant. The kinds of food you eat can affect your dental health.
  • You may brush and floss your teeth less than you did before you got pregnant. This may be because your gums are tender or you’re more tired than usual. For some women, brushing and flossing may cause nausea (feeling sick to your stomach).

Dental issues in pregnancy

Dental issues in pregnancy

These changes can increase your risk for certain dental problems during pregnancy, including:

Cavities (also called tooth decay or caries)

 These are small, damaged areas in the surface of your teeth. Being pregnant makes you more likely to have cavities. You can pass the bacteria that causes cavities to your baby during pregnancy and after birth. This can cause problems for your baby’s teeth later in life.


 Gingivitis is inflammation (redness and swelling) of the gums. If untreated, it can lead to more serious gum disease. Pregnancy hormones can increase your risk for gingivitis. Sixty to 75 percent of pregnant women have gingivitis. Signs and symptoms include:

  • Redness and swelling
  • Tenderness in the gums
  • Bleeding of the gums, even when you brush your teeth gently
  • Shiny gums

Loose teeth

 High levels of the hormones progesterone and estrogen during pregnancy can temporarily loosen the tissues and bones that keep your teeth in place. This can make your teeth loose.

Periodontal disease (also called periodontitis or gum disease)

  If gingivitis is untreated, it can lead to periodontal disease. This causes serious infection in the gums and problems with the bones that support the teeth. Your teeth may get loose, and they may have to be extracted (pulled). Periodontitis can lead to bacteremia (bacteria in the bloodstream). This is a serious condition that needs immediate treatment. Smoking is a cause of severe gum disease.

Pregnancy tumors (pyogenic granuloma)

 These tumors are not cancer. They’re lumps that form on the gums, usually between teeth. Pregnancy tumors look red and raw, and they bleed easily. They can be caused by having too much plaque (a sticky film containing bacteria that forms on teeth). These tumors usually go away on their own after giving birth. In rare cases they may need to be removed by your health care provider.

Tooth erosion

 If you have vomiting from morning sickness, your teeth may be exposed to too much stomach acid. This acid can harm the enamel (the hard surface) of your teeth. Morning sickness (also called nausea and vomiting of pregnancy or NVP) is nausea and vomiting that happens during pregnancy, usually in the first few months.

signs of dental problems during pregnancy 

If you have any signs or symptoms of dental problems, call your dentist. Signs of a condition are things someone else can see or know about you, like you have a rash or you’re coughing. Symptoms are things you feel yourself that others can’t see, like having a sore throat or feeling dizzy.

Signs and symptoms of dental problems include:

  • Bad breath
  • Loose teeth
  • Mouth sores or lumps on the gums
  • New spaces between your teeth
  • Receding gums (when your gums pull away from your teeth so you can see roots of your teeth) or pus along your gumline (where your gums meet your teeth)
  • Gums that are red, swollen, tender or shiny; gums that bleed easily
  • Toothache or other pain

If you have pain or swelling, call your dentist right away. If you have an infection, you need quick treatment to help prevent problems for your baby.

Tell the Dentist As Soon As Possible

  • Make sure your dentist knows that you are pregnant. If medications for infection or for pain are needed, your dentist can prescribe ones that are safe for you and your baby. Tell your dentist about any changes you have noticed since you became pregnant and about any medications or supplements you are taking.  Routine x-rays should be avoided in pregnancy, but it may be necessary if there is a problem or an emergency.
  • Your body should be covered with a lead apron to protect you and your baby. Dental work can be done safely at any point in pregnancy. If possible, it is best to delay treatments and procedures until after the first trimester.

the best time to perform dental treatment 

the best time to perform dental treatment

Dental treatment can be done at any time during pregnancy. However, the best time to perform elective dental treatment during pregnancy is in the second trimester, weeks 14 through 20.

By this time, the development of the fetal organs is complete and the risk of side effects is lower. Research also suggests that women who receive fillings, undergo tooth extractions or have root canal treatment during the second trimester don’t experience higher rates of problems at birth. In addition, nausea and postural discomfort are often less of an issue during the second trimester.

Keep in mind that if you have oral pain or swelling, you might need immediate treatment. The consequences of not treating an infection during pregnancy outweigh the possible risks of the medications used during dental treatment. Your health care provider will carefully monitor the use of any antibiotics or pain medications.

you should Postpone Dental Care During Your First Trimester

The first trimester of your pregnancy (the first 13 weeks) is the time in which most of the baby’s major organs develop. If you go to the dentist during your first trimester, tell your dentist that you’re pregnant and have only a checkup and routine cleaning. If possible, postpone any major dental work until after the first trimester. However, if you have a dental emergency, don’t wait! Infections in the mouth can be harmful to you and your baby. See your dentist immediately, and make sure that all dental professionals who examine you are aware you’re pregnant.

Are x-rays safe?

One of the most common concerns people have about visiting the dentist while pregnant is being exposed to radiation from x-rays.

However, modern dental x-rays use very low doses of radiation and a single dose is not usually high enough to cause any adverse effects in the development of the foetus. Your dentist will also make sure your baby is shielded from the radiation by using a lead apron and thyroid guard.

Although x-rays are safe, your dentist may still recommend avoiding them during the first trimester if you’re only having a routine check-up. But if you have a dental emergency or a severe, non-specific pain, x-rays could still be needed to help your dentist plan your treatment effectively.

is dental anesthesia safe during pregnancy? 

If you need to have a dental procedure while pregnant, anaesthetic can still be used safely to help you relax and numb the pain. It’s essential that you inform your dentist about your pregnancy so they can choose suitable anaesthetics and set appropriate levels.

Anaesthetics containing felypressin should be avoided during pregnancy because this chemical constricts the blood vessels – just ask your dental practitioner if you have any questions or concerns about the type of anaesthetic they’re using.

Your dentist will use the lowest concentration of anaesthesia possible for the type of procedure being carried out but still enough to help you feel relaxed. When you feel comfortable, your body and your baby will be placed under less stress.

Can I get a tooth pulled when pregnant?

Can I get a tooth pulled when pregnant

Extractions are a last resort for dentists, who will always try to save your tooth if possible. But if your tooth is too badly damaged by decay or injury to be repaired, it could put your oral health at risk and should be removed.

Extractions can be performed any time during pregnancy, but your dentist may recommend the second trimester as the ideal time. This helps you avoid having x-rays in the first trimester when your baby is first developing, as well as the discomfort of having to lie on your back for prolonged periods during the third trimester.

Does a root canal affect pregnancy?

If tooth decay reaches the inside of your tooth where the nerve endings are, this can be extremely painful. Root canal treatment can stop the pain by removing the infected tissue and restoring the tooth with a natural-looking crown, so the tooth would not need to be extracted.

If you have a dental emergency, a root canal can be performed at any stage of pregnancy and shouldn’t be delayed. However, because x-rays are involved, the ideal time for dental surgery is during the second trimester.

Can I whiten my teeth while pregnant?

Can I whiten my teeth while pregnant

Teeth whitening can be performed while you’re pregnant, but your dentist may recommend waiting until after the birth for most non-emergency dental treatments.

Teeth whitening and other cosmetic treatments should ideally be avoided during the third trimester in particular, as you may find it uncomfortable to lie still while the whitening gel is applied and cured.

If you’re using a home teeth whitening kit, you should make sure that you check that the concentration of hydrogen peroxide is no more than six percent. Higher concentrations can potentially cause tissue damage unless applied by a professional.

Can I have orthodontic treatment while pregnant?

If you are already undergoing orthodontic treatment, you shouldn’t stop just because you are pregnant. You can even have new braces fitted during your pregnancy, although your dentist or orthodontist may recommend that you wait until after the birth, as there can sometimes be complications.

Getting braces requires x-rays, which your dentist might want to avoid during the first trimester. If your face and mouth change shape when you gain weight during your pregnancy, this could mean that your braces need to be adjusted or that new impressions need to be made of your teeth to create a new set of aligners. These changes can increase the overall cost.

Some women experience swelling of the gums and other facial tissues during pregnancy, which can sometimes cause irritation from brace wires and brackets. Your dentist or orthodontist can provide safe gels to help numb the pain, or you may prefer removable plastic aligners if you only need to fix a minor orthodontic issue.

What can you do to help prevent dental problems? 

What can you do to help prevent dental problems

Here’s how you can help keep your teeth and gums healthy:

  • Brush your teeth with fluoride toothpaste twice a day and floss once a day. Use a toothbrush with soft bristles. Regular brushing and flossing can remove plaque and help keep your teeth and gums healthy.
  • If you can’t brush your teeth because of vomiting, use antacids or rinse your mouthwith a mixture of 1 teaspoon baking soda in 1 cup of water. Rinsing can help reduce the amount of acid in your mouth. Antacids are medicines that help neutralize stomach acid. You can buy them over the counter without a prescription from your provider. But don’t take any medicine—even OTC medicine—without talking to your provider first.
  • Visit your dentist for a regular dental checkup every 6 months (twice a year), even during pregnancy. At your checkup, tell your dentist that you’re pregnant.
  • Eat healthy foodsand limit sweets. Healthy foods include fruits and vegetables, lean meat, whole-grain breads and pasta and low-fat dairy products. Limit sweets and sugary foods and drink water instead of sugary drinks. Eating healthy foods helps give you and your growing baby important nutrients. Your baby’s teeth start developing between 3 and 6 months of pregnancy. Nutrients like calcium, protein, phosphorus, and vitamins A, C and D, help your baby’s teeth grow healthy.
  • Don’t smoke.