Dental (Tooth and Gum) Problems During Pregnancy
Author: Arome David, BSc, MPH, Fellow – Media EIS
Reviewed by: Azuka Chinweokwu Ezeike, MBBS, FWACS, FMCOG, MSc (PH)
Highlights
Pregnancy causes hormonal changes that can affect the gums, making them more sensitive, swollen, and prone to bleeding.
- Frequent vomiting exposes the teeth to stomach acid, which can eat away enamel and increase the risk of decay and sensitivity.
- During pregnancy, cravings for sugary foods can fuel the growth of mouth bacteria, leading to increased acid production and, over time, tooth decay.
- Untreated tooth and gum infections have been linked to pregnancy complications such as preterm birth and low birth weight.
- Regular dental check-ups and cleaning are safe during pregnancy and can prevent infections that may harm both mother and baby.
- Brushing your teeth at least twice daily and flossing can keep both teeth and gums in good shape throughout pregnancy.
Introduction
Pregnancy brings a lot more excitement and changes that require extra dental care. At this crucial stage, dental health is more important than ever for pregnant women not to skip. Safeguarding your oral health will keep you away from oral health issues.
As hormonal changes set in, pregnant women become more vulnerable to an increased risk of tooth and gum diseases, such as gingivitis and periodontitis, among others. Regular oral check-ups would help prevent these diseases from manifesting. Just as it is expected that individuals see their dentist every six months for cleaning and examination, the same applies even more to pregnant women.
Prioritising dental health during pregnancy not only makes you comfortable, but it also offers protection for your baby. Understanding dental problems, safe dental care, and treatment options are important in maintaining good oral hygiene for the overall health of both the mother and baby.
Common Dental Problems in Pregnancy
Gingivitis
Gingivitis is one of the most common oral issues in pregnancy, characterised by swollen and tender gums. The swollen gums can easily bleed when brushing the teeth.
It’s widespread during pregnancy because of the big change in hormones. Though it does affect all women, it is important that they keep up with good oral hygiene to prevent gingivitis.
Gingivitis not only affects oral health but may also have negative effects on the entire pregnancy process and the health of the baby [1]. About 60-75% of pregnant persons are affected by gingivitis.
Periodontitis
Periodontitis, in simple terms, is the inflammation (swelling of the gums) that damages soft tissues around the teeth. It’s caused mainly by Porphyromonas gingivalis, bacteria that destroy the supporting structures of the tooth.
Gingivitis, left untreated, can easily progress to periodontitis. which affects the structure supporting the teeth [2]. This often leads to tooth loss and pregnancy complications such as preterm and low birth weight [3]. About 30 to 40% of women of childbearing age have periodontitis.
Tooth erosion
Tooth erosion, which is the loss of tooth hard tissue due to acid without bacterial involvement, is a major concern during pregnancy. This dental disease sometimes gets worse with increased exposure to stomach acids caused by morning sickness and stomach acid coming up during pregnancy.
Research shows that about 30%–50% of pregnant women report experiencing morning sickness, which contributes to enamel erosion [4]. Also, research evidence has established that pregnant women commonly experience increased rates of tooth erosion in comparison to non-pregnant women [4].
Tooth decay
Tooth decay is another common dental problem during pregnancy, largely due to hormonal changes and food habits. Hormonal changes during pregnancy can reduce saliva flow and alter saliva composition, making it harder for the mouth to fight germs.
Morning sickness, which causes frequent vomiting, brings stomach acid into the mouth that weakens the tooth enamel. This further creates a conducive environment for mouth bacteria like Streptococcus mutans, which facilitates tooth decay.
Pregnancy cravings for sugary and acidic foods can further contribute to tooth decay. Mothers are often the main source of bacteria that cause tooth decay in their babies [5].
Pregnancy tumour or pyogenic granuloma
It’s another rare oral condition of concern during pregnancy that appears as a red, round growth on the gum. It’s prone to bleeding, makes one uncomfortable, and is frequently sensitive to touch. The tumours affect about 5% of pregnant women, and they are more common during pregnancy [6].
Causes of Dental Problems during Pregnancy
Pregnancy-related dental conditions are occasioned by different factors:
Hormonal changes
During pregnancy, numerous changes occur in the body of pregnant women. The most notable change is the increase in circulating hormones, such as oestrogen and progesterone. Oestrogen increases by 10-fold, while progesterone increases by up to 30-fold [7].
Hormonal changes during pregnancy influence how the gums react, making them more sensitive and prone to dental problems. As a result, many pregnant women experience swollen, tender and bleeding gums. These increases worsen existing oral conditions such as gingivitis and periodontitis. It is important to know that pregnancy itself does not cause dental problems but increases the risk of them [7].
Morning sickness
Morning sickness is a common problem that is encountered by women early in their pregnancies. During the first trimester of pregnancy, the body produces more hormones to support the baby’s growth. While morning sickness is a sign of a healthy pregnancy, it can take a toll on dental health.
Over time, this can lead to sensitivity, decay, and other dental problems if proper care is not taken.These hormone changes can upset the stomach and often cause nausea and vomiting. The content of the vomit is acidic, which can wear away and weaken tooth enamel.
Dietary habit
The pregnancy period is not a time to throw every sugary food into the mouth. Sugary-containing foods serve as a rich source of food reservoirs for mouth bacteria like Streptococcus mutans and others.
The higher the consumption of sugary foods, the more the mouth becomes friendly for the bacteria to thrive. As the bacteria multiply, they form a sticky layer around the teeth and gums, setting the pace for decay to start.
These bacteria feed on the food and produce acid. Prolonged exposure to the acid further weakens the tooth enamel, leading to tooth decay. Cravings for sugary diets during pregnancy can contribute to tooth decay [8].
Risks of Dental Problems in Pregnancy
Pregnant women are at risk of dental problems and birth complications:
Risk to the mother
- Increased risk of gingivitis (swollen and tender gums) that causes bleeding.
- Higher chances of periodontal disease, an infection that damages the gums and bone underneath.
- Tooth cavity due to frequent consumption of high-sugar-containing foods and beverages.
- Tooth erosion from the stomach acid flooding the mouth during morning sickness.
- Pain and discomfort in the mouth.
- Infection in the mouth that can spread or worsen if left untreated.
Risk to the baby
- Increased risk of preterm birth (baby born too early)
- Increased risk of low birth weight. (baby born too small)
- Higher chances for developing early childhood tooth decay if bacteria is transferred from mother to baby.
Preterm birth and low birth weight
Oral health problems, when left untreated, especially periodontal diseases (infection and swelling of the gums and tissues that hold the teeth in place), can increase the chances of preterm birth (giving birth too early) or having a baby with low birthweight.
The unchecked gum infection can go beyond the mouth to influence the pregnancy outcomes. The baby bears the impact of the outcomes, often being born preterm or with low birthweight.
Studies have established that a strong link exists between periodontal disease and these birth complications [9]. Mothers with periodontal disease have a high possibility of giving birth to a baby with low birth weight (LBW) and premature birth [10].
Barriers to Dental Care
- Failure of maternity and healthcare providers to refer pregnant women for dental care.
- Reluctance of the dentist to manage pregnant patients.
- Lack of information on the importance of dental care during pregnancy.
- Financial challenges, as many pregnant women cannot afford the dental costs.
Safe Dental Care in Pregnancy
Dental care is safe and important during pregnancy.
When to see a dentist
Consult the dentist at any given point when you feel uncomfortable with your oral health. Though the second trimester is mostly considered the best time for dental procedures, this should not stop you from seeing a dentist for routine oral check-ups.
Safety of dental treatments, medications, and x-rays
Are dental treatments safe during pregnancy?
Routine dental care, such as examinations, check-ups, and cleaning, is an important aspect of oral health that serves as a preventive against dental cavities and is considered safe in all trimesters. Treatment can also be initiated during dental emergencies, such as pain, infection, and abscess, at any stage of pregnancy.
Are medications safe during pregnancy?
Some medications used in dental care include:
- Antibiotics and analgesics such as amoxicillin and paracetamol.
- Local anaesthetics like lidocaine, procaine, etc.,
They are considered safe to use during pregnancy. Always remember to talk to your dentist and obstetrician about your pregnancy so they can choose the safest options.
Are X-rays truly safe during pregnancy?
X-rays are also considered safe, especially when a protective cover is used to shield the abdomen and throat from radiation exposure. An X-ray is a medical test that uses radiation to make a picture on film. X-rays are used to identify cavities, abscesses, or bone loss.
The second trimester is considered a safe time for the use of X-rays. It’s good to inform the dentist that you are pregnant to guide him/her on appropriate precautions during treatment. All these treatment options are considered safe, as no research has shown or linked any negative effect to their use during pregnancy.
Self-Care Tips
- Practise good oral hygiene.
- Limit consumption of sugary foods and drinks; rather, go for healthy foods and drinks.
- Chew chewing gum four to five times per day after eating.
- Get regular dental check-ups.
- Brush your teeth with a soft toothbrush at least twice a day with fluoride toothpaste.
- Practise flossing; clean between your teeth every day using a thin thread.
- See the dentist for dental advice.
When to Seek Help Urgently
- When you feel uneasy and uncomfortable, and have persistent pain in the mouth.
- Anytime you sense potential oral issues.
- Fever with accompanying oral pain.
- Tooth bleeding with just a little pressure or touch.
- Rapid growth or a lump in the mouth.
- Difficulty in swallowing and breathing [11].
Conclusion
You do not have to suffer from a dental problem for every pregnancy. Regular oral check-ups with the dentist will make a lot of difference in alleviating pain and achieving good oral health. Good oral hygiene guarantees a safe, healthy mouth during pregnancy.
References
1. Le QA, Eslick G, Kimberly, Coulton M, Akhter R, Condous G, et al. Does Treatment of Gingivitis During Pregnancy Improve Pregnancy Outcomes? A Systematic Review and Meta-Analysis. Oral Health Prev Dent [Internet]. 2021;19:565–72. Available from: https://pubmed.ncbi.nlm.nih.gov/34673848/
2. Kurgan S, Kantarci A. Molecular basis for immunohistochemical and inflammatory changes during progression of gingivitis to periodontitis. Periodontology 2000. 2017 Nov 29;76(1):51–67. Available from: https://onlinelibrary.wiley.com/doi/10.1111/prd.12146
3. Moliner-Sánchez CA, Iranzo-Cortés JE, Almerich-Silla JM, Bellot-Arcís C, Ortolá-Siscar JC, Montiel-Company JM, et al. Effect of per Capita Income on the Relationship between Periodontal Disease during Pregnancy and the Risk of Preterm Birth and Low Birth Weight Newborn. Systematic Review and Meta-Analysis. International Journal of Environmental Research and Public Health. 2020 Oct 30;17(21):8015. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC7662804/
4. Godínez-López MJ. Oral health in pregnancy. Mexican Journal of Medical Research ICSA [Internet]. 2024 Jan 5;12(23):27–32. Available from: https://repository.uaeh.edu.mx/revistas/index.php/MJMR/article/view/10653/10592
5. Bhaskar B, Thomas S, Kumar J, Gomez MS. Self-perception on oral health and related behaviours among antenatal mothers attending a public antenatal clinic – Kerala. Journal of Family Medicine and Primary Care. 2020;9(8):4396. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC7586543/
6. Gondivkar S, Gadbail A, Chole R. Oral pregnancy tumor. Contemporary Clinical Dentistry. 2010;1(3):190. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC3220110/
7. Dellinger TM, Livingston HM. Pregnancy: Physiologic Changes and Considerations for Dental Patients. Dental Clinics of North America. 2006 Oct;50(4):677–97. Available from: https://pubmed.ncbi.nlm.nih.gov/17000280/
8. Islam B, Haque A. Pregnancy-related dental problems: A review. Heliyon. 2024 Jan 1;10(3):e24259–9. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10845246/
9. Padilla-Cáceres T, Arbildo-Vega HI, Caballero-Apaza L, Cruzado-Oliva F, Mamani-Cori V, Cervantes-Alagón S, et al. Association between the Risk of Preterm Birth and Low Birth Weight with Periodontal Disease in Pregnant Women: An Umbrella Review. Dentistry Journal. 2023 Mar 7;11(3):74. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10047843/
10. Teshome A, Yitayeh A. Relationship between periodontal disease and preterm low birth weight: systematic review. Pan African Medical Journal. 2016;24. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5075444/
11. VT H. Dental Considerations in Pregnancy – A Critical Review on Oral Care. Journal Of Clinical And Diagnostic Research [Internet]. 2013; 7(5). Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC3681080/
Disclaimer:
The information provided on this website is for general educational and informational purposes only. It is not intended to replace professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
Published 30, 2025