Guides · General
Dental health during pregnancy: what can be done, what to watch for
Gum changes in pregnancy, which treatments are safe in which trimester, X-rays and anaesthesia, and care during morning sickness.
Dental treatment during pregnancy is safe and should not be postponed when needed; the most comfortable period is the second trimester (weeks 14–27). Local anaesthesia, fillings, root canal treatment, scaling and necessary extractions can all be done; X-rays are taken with a lead apron when required. Because pregnancy hormones increase gum bleeding, at least one periodontal check during pregnancy is advised.
Hormonal changes in pregnancy make the gums more sensitive to plaque; bleeding and swelling are common. The belief that "every pregnancy costs a tooth" is not true — dental problems come not from the pregnancy itself but from the increased inflammation and lapses in care during this period.
Pregnancy gingivitis
It can start from the second month and increase until the eighth. It is controlled with regular brushing, flossing and, if needed, scaling. Some women develop a benign gum overgrowth ("pregnancy tumour"); it usually shrinks after the birth.
What can be done in which trimester?
- First trimester: The period of organ development; non-urgent treatment is postponed. Examination, cleaning and urgent pain relief can be done.
- Second trimester (weeks 14–27): The best time for treatment. Fillings, root canal treatment, extractions and gum treatment can be done safely.
- Third trimester: Lying flat for long is uncomfortable and can press on the main vessels; short sessions and a slight tilt to the side are preferred. Non-urgent procedures can wait until after the birth.
Anaesthesia and medicines
Local anaesthesia (lidocaine) is considered safe in pregnancy; leaving a painful tooth untreated is the greater risk. Paracetamol is the painkiller of first choice; if an antibiotic is needed, the penicillin group can be used. All medicines should be taken with the knowledge of your obstetrician.
X-rays
Digital dental X-rays are very low dose and, taken with a lead apron, the dose reaching the baby is negligible. Even so, they are taken only when necessary; always say that you are pregnant.
During nausea and vomiting
Stomach acid erodes enamel. Rather than brushing straight after vomiting, rinse with water or water with a teaspoon of bicarbonate of soda and brush 30 minutes later. If the smell of toothpaste triggers nausea, try an unflavoured children's paste.
Diet
Frequent snacks and sweet cravings raise the caries risk; sugary snacks should be taken with main meals and the mouth rinsed with water afterwards. Calcium and vitamin D matter for the baby's tooth development.
When planning a pregnancy
Where possible, a dental check and any needed treatment before pregnancy reduce the chance of problems during it.
Common oral problems in pregnancy
- Pregnancy gingivitis: In more than half of pregnant women; bleeding and swelling increase in the second trimester and ease after the birth. Treatment: cleaning and careful home care.
- Pregnancy tumour (pyogenic granuloma): A red, easily bleeding, harmless growth on the gum; most shrink after delivery and are removed if troublesome.
- Enamel erosion: Frequent vomiting dissolves enamel with stomach acid; not brushing straight away but rinsing with bicarbonate water protects it.
- More decay: Frequent snacks and sweet cravings; fluoride toothpaste and water between meals.
- A feeling of loose teeth: Due to ligament loosening, temporary; must be distinguished from gum disease.
Which procedure in which trimester?
| Trimester | Can be done | Postponed |
|---|---|---|
| First | Examination, cleaning, urgent treatment (pain, abscess) | Elective procedures |
| Second | Fillings, root canals, extractions, gum treatment, crowns — the best period | — |
| Third | Urgent and short procedures; slightly turned to the left, short sessions | Long procedures, elective surgery |
Medicines
Local anaesthesia (lidocaine, including with adrenaline) is safe. Paracetamol is the first-choice painkiller; ibuprofen is avoided, especially in the third trimester. Antibiotics such as the penicillin group and clindamycin can be prescribed when needed; tetracyclines are contraindicated. Every medicine should be used with your obstetrician's knowledge.
After the birth and breastfeeding
Dental treatment and local anaesthesia are safe while breastfeeding; the amount passing to the baby is negligible. Elective procedures such as whitening can wait until after breastfeeding. The mother's caries bacteria pass to the baby via spoons and dummies; the mother's oral health directly affects the baby's decay risk. See Teething in babies.
Pregnancy and preterm birth
An association between untreated periodontitis and preterm birth or low birth weight has been reported, and periodontal treatment during pregnancy has been shown to be safe. Having an examination before conceiving reduces the need for urgent treatment during pregnancy.
This article is for general information only; diagnosis and treatment tailored to you require a dental examination.
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