Dental health in pregnancy: gums, nausea and dental treatment

Dental health is often something we put off in pregnancy. Yet hormone changes can make the gums more sensitive, which makes routine care even more valuable now. The good news: seeing a dentist in pregnancy is generally safe.

How hormones affect the gums

Higher hormone levels can make the gums react more strongly to plaque. Many people notice redness, swelling and bleeding when brushing, known as pregnancy gingivitis. In some people a small, harmless lump called a pregnancy tumour can appear on the gum. It usually shrinks after birth, but it is still worth showing to your dentist.

Nausea and your teeth

Frequent vomiting brings stomach acid into contact with your teeth, and brushing straight afterwards can wear down the enamel. Rinse your mouth with water first, wait about half an hour, then brush. If brushing itself triggers nausea, a smaller brush head or a milder-tasting toothpaste may help.

Is dental treatment safe?

The generally accepted view is that routine work such as cleanings, fillings and gum treatment can be done in pregnancy. Leaving pain and infection untreated often carries more risk than the treatment itself. A few practical points:

• Tell your dentist that you are pregnant and how many weeks along you are.
• The second trimester is usually seen as the more comfortable time for planned work, but emergencies do not wait.
• If local anaesthetic is needed, talk it through; your dentist and obstetrician decide together what is suitable.
• If an X-ray is needed, a protective apron and proper care are used, and unnecessary images are avoided.
• Lying flat on your back for long can be uncomfortable; tilting slightly to your left side in the chair may help.
• Do not decide on medication yourself; if a painkiller or antibiotic is needed, your dentist and obstetrician decide together.

What you can do

Daily care is still your strongest tool:

• Brush twice a day for at least two minutes with fluoride toothpaste.
• Floss or use interdental brushes once a day.
• Keep the brush soft, and keep going even if the gums bleed, because cleaning reduces bleeding.
• Cut down on how often you have sugary snacks; sweets spread through the day raise the risk of cavities.
• Try to have one dental check-up during pregnancy, and plan one before pregnancy if you can.
• Ask your dentist about the ingredients before using a mouthwash.

Why it matters

Gum disease may be linked with preterm birth, although the exact reason is not yet clear. So there is no need to be afraid. The aim is simple: keep your mouth and gums healthy and stay free from pain and infection.

When to contact your doctor

• If you have severe tooth pain, facial swelling or signs of infection with fever, see a dentist without waiting.
• If you notice constant gum bleeding, a bad smell or a growing lump.
• If facial or neck swelling makes swallowing or breathing difficult, call 112 or go to the emergency department.
• If vomiting is so frequent that it affects your teeth and your eating, let your obstetrician know.

This article is for information only; your dentist's and obstetrician's advice for your personal situation always comes first.