Dental Care While You Are Pregnant

Routine dental care during pregnancy is considered safe, and putting off a problem is usually the riskier choice. An untreated infection is a bigger concern for you and the pregnancy than the treatment that fixes it, which is the opposite of what many people assume.

Tell the practice you are pregnant and how many weeks as soon as you book. It changes small things: how you are positioned in the chair, how x rays are approached, and which appointments are best left until after the birth.

Bleeding gums in pregnancy are common and worth acting on

Hormonal changes make gum tissue react much more strongly to the same amount of plaque, so gums that were fine before can become red, puffy and quick to bleed. It often starts in the second month and peaks later in the pregnancy. This is usually called pregnancy gingivitis, and it is not a sign you have suddenly started cleaning badly.

It responds to the same things as ordinary gingivitis, done more consistently: a soft brush twice a day and cleaning between the teeth daily. Bleeding gums usually bleed more for the first week or two of proper cleaning before they settle, which puts people off at exactly the wrong moment.

A hygiene appointment during pregnancy is worthwhile and safe. Left alone, gingivitis is uncomfortable and makes the rest of the pregnancy harder than it needs to be.

A lump on the gum is usually harmless, and still needs looking at

Some people develop a soft red lump on the gum between teeth, often called a pregnancy tumor, which is an unfortunate name for something benign. It is an exaggerated inflammatory overgrowth, it can bleed when brushed, and it typically shrinks or disappears after the birth.

It should still be examined so somebody confirms what it is. It is occasionally removed during pregnancy if it interferes with eating or bleeds heavily, but the usual approach is careful cleaning and waiting.

Morning sickness is an enamel problem, not just an unpleasant one

Stomach acid is far stronger than anything you drink, and repeated vomiting softens enamel, particularly on the inside surfaces of the upper front teeth. Brushing straight afterwards scrubs off the softened layer, so the instinct to clean immediately does real harm over months.

Rinse with plain water, or with water and a little baking soda, to neutralize what is there, then wait about half an hour before brushing. A fluoride mouth rinse at a different time of day helps, and it is worth telling your dentist how often you are being sick, because they may recommend a high fluoride toothpaste.

If nausea makes brushing itself difficult, a smaller headed brush, a bland or unflavored toothpaste and brushing at a time of day when you feel better all help more than giving up on it.

• Rinse with water after being sick, do not brush right away
• Wait about thirty minutes before brushing
• Ask about a high fluoride toothpaste if sickness is frequent
• Sip water through the day rather than sweet drinks for nausea

Timing: the middle months are the most comfortable, not the only safe ones

Most planned treatment is scheduled in the second trimester, mainly because you feel better and lying back is easier than it will be later. Emergency and urgent treatment should happen whenever it is needed, including the first and third trimesters. Pain and infection are not things to wait out.

In the later months, lying flat can press on a major vein and make you feel faint. Say so if it happens, since tilting slightly to the left fixes it. Elective cosmetic work, whitening in particular, is normally deferred until after the birth, not because of a known danger but because there is no reason to do it now.

If a problem comes up and you are not registered with a practice, our directory searches every dental practice in the United States by town or ZIP code and shows the closest first, free and with no account.

X rays and numbing, which are the two questions everybody asks

Dental x rays use a very small dose, aimed at the jaw and away from the abdomen, and modern practices use protective shielding and digital sensors that need less exposure. Routine screening x rays are usually postponed simply because there is no urgency. If an x ray is needed to diagnose an infection or decide on treatment, it is generally considered safe to take one during pregnancy, and the risk of leaving a problem undiagnosed is the larger one.

Local anesthetic is routinely used during pregnancy. Numbing you properly is safer than treating you while you are in pain and tense. Tell the dentist about every medication and supplement you take, and expect them to check with your obstetrician before anything unusual, including some antibiotics and any sedation.

Signs that need same day attention

Call a dentist the same day for facial swelling, a tooth that has become severely painful or tender to bite on, or a bad taste of pus. Infection during pregnancy is treated promptly rather than watched.

Go to an emergency room if swelling is spreading toward your eye or down your neck, if you have difficulty breathing or swallowing, or if you have a fever with facial swelling. Those need medical care immediately, whether or not you are pregnant.

• Same day dental call: facial swelling, severe pain, a bad taste of pus
• Emergency room: swelling spreading toward the eye or down the neck
• Emergency room: trouble breathing or swallowing
• Emergency room: fever alongside facial swelling

Frequently asked

This is general information to help you ask better questions, not a diagnosis. Anything happening in your own mouth needs a dentist who can look at it.