Dental Problems During Pregnancy: What's Safe and What to Know

Pregnancy brings many changes to your body, and your mouth is no exception. Hormonal shifts, changes in eating habits, and morning sickness can all affect your oral health. The good news is that dental treatment during pregnancy is safe, and in the UK, NHS dental care is completely free for pregnant women and for 12 months after your baby is born. Here is what you need to know.

Common Dental Problems During Pregnancy

Pregnancy Gingivitis

The most common dental issue during pregnancy is pregnancy gingivitis — swollen, tender gums that may bleed when you brush or floss. This is caused by increased levels of progesterone and oestrogen, which make your gums more sensitive to the bacteria in plaque. You may notice that your gums look redder than usual, feel puffy, or bleed more easily. Pregnancy gingivitis typically develops between the second and eighth month of pregnancy.

While pregnancy gingivitis is common, it should not be ignored. Good oral hygiene and professional cleaning can usually keep it under control and prevent it from progressing to more serious gum disease. If you notice your gums bleeding more than usual, mention it at your next dental appointment. For more on gum health, see our article on bleeding gums myths and facts.

Pregnancy Epulis (Pyogenic Granuloma)

Some women develop a localised, red, rounded swelling on the gum during pregnancy, known as a pregnancy epulis or pyogenic granuloma. These are benign (non-cancerous) growths that occur in response to hormonal changes and local irritation. They can bleed easily and may look alarming, but they are harmless. In many cases, a pregnancy epulis will shrink or disappear after delivery. If it causes significant discomfort or bleeding, your dentist may remove it during pregnancy, though it can sometimes recur until after the baby is born.

Increased Risk of Tooth Decay

Several factors during pregnancy can increase your risk of developing cavities:

• Morning sickness: Frequent vomiting exposes your teeth to stomach acid, which can erode tooth enamel over time.
• Dietary changes: Cravings for sugary or starchy foods can feed the bacteria that cause decay.
• Fatigue and nausea: Feeling unwell or exhausted may make it harder to maintain your usual oral hygiene routine.
• Gagging: Some women find it difficult to brush, especially the back teeth, due to an increased gag reflex during pregnancy.

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Enamel Erosion from Vomiting

If you experience morning sickness, the acid from your stomach can gradually wear away the enamel on your teeth. This is particularly common on the inside surfaces of the upper front teeth. Over time, erosion can make teeth more sensitive, thinner, and more prone to decay. There are specific steps you can take to minimise this damage (see the tips section below).

Is Dental Treatment Safe During Pregnancy?

Yes. Dental treatment during pregnancy is not only safe but recommended. Delaying necessary treatment can allow problems to worsen, potentially leading to pain, infection, and more complex treatment later. Here is what you need to know about specific treatments:

• Check-ups and cleanings: Completely safe and recommended throughout pregnancy. A professional clean can help manage pregnancy gingivitis.
• Fillings and crowns: Safe at any stage of pregnancy. If you have a cavity, it is better to have it treated than to leave it to get worse.
• Extractions: Can be performed safely during pregnancy if needed. Your dentist will use appropriate local anaesthesia.
• Local anaesthesia: Lidocaine (the most commonly used local anaesthetic in UK dentistry) is safe during pregnancy. Your dentist will use the minimum effective dose.
• X-rays: Dental X-rays use a very low dose of radiation. With a lead apron to shield your abdomen, they are considered safe when clinically necessary. Most dentists will avoid routine X-rays during pregnancy, only taking them when needed for diagnosis or treatment.
• Second trimester is ideal: While treatment can be carried out at any stage, the second trimester (weeks 14–27) is often the most comfortable time. The first trimester carries the highest risk of nausea, and the third trimester can be uncomfortable due to the physical demands of lying back in the dental chair.

Medications to Be Cautious About

While most routine dental treatments are safe, certain medications should be avoided or used with caution during pregnancy. Your dentist will be aware of these, but it is important to always tell them you are pregnant:

• Tetracycline antibiotics: These can affect the developing baby's teeth and should be avoided during pregnancy.
• Aspirin and ibuprofen: These should generally be avoided during pregnancy. Paracetamol is the recommended pain relief option.
• Certain sedation medications: If you normally have sedation for dental treatment, discuss this with your dentist, as some sedatives are not recommended during pregnancy.

Free NHS Dental Care During Pregnancy

What to Tell Your Dentist

When you attend your dental appointment, make sure to inform your dentist that you are pregnant, even if you are in the early stages. They should also know:

• How far along you are in your pregnancy
• Any medications or supplements you are taking
• Whether you have experienced any complications or have been given specific medical advice
• If you have any history of dental anxiety, as this can be heightened during pregnancy

Tips for Protecting Your Teeth During Pregnancy

• After vomiting, rinse — do not brush immediately: Stomach acid softens your enamel. Brushing straight away can wear it down further. Instead, rinse your mouth with plain water or a fluoride mouthwash, and wait at least 30 minutes before brushing.
• Use a fluoride toothpaste: Brush twice a day with a fluoride toothpaste (1,350–1,500 ppm fluoride) to help strengthen enamel and prevent decay.
• Try a smaller toothbrush head: If you are struggling with gagging, switch to a smaller-headed brush. Some women find an electric toothbrush easier to use during pregnancy.
• Clean between your teeth daily: Interdental brushes or floss can help remove plaque from areas your toothbrush cannot reach, reducing the risk of gingivitis.
• Limit sugary snacks: If cravings strike, try to choose less sugary options where possible, and keep sugary foods to mealtimes rather than snacking throughout the day.
• Stay hydrated: Drinking plenty of water helps maintain saliva flow, which is your mouth's natural defence against decay.
• Do not skip dental appointments: Regular check-ups are particularly important during pregnancy. Take advantage of the free NHS dental care available to you.

Common Myths About Pregnancy and Dental Health

There are several persistent myths about pregnancy and teeth that are worth addressing:

• “The baby takes calcium from your teeth”: This is a myth. Your baby does not draw calcium from your teeth. However, if your dietary calcium intake is insufficient, your body will draw calcium from your bones (not your teeth) to support the baby's development. Eating a balanced diet with adequate calcium is important for both of you.
• “You should avoid the dentist during pregnancy”: This is incorrect and potentially harmful. Avoiding dental care can allow problems to worsen. Routine treatment is safe and recommended.
• “You lose a tooth for every pregnancy”: This old saying has no basis in fact. With good oral hygiene and regular dental care, there is no reason to lose teeth as a result of pregnancy.

Frequently Asked Questions

Is it safe to go to the dentist while pregnant?

Yes, dental treatment during pregnancy is safe and recommended. Routine check-ups, cleanings, fillings, and even extractions can be carried out safely. The second trimester is generally considered the most comfortable time for treatment, but dental care can be provided at any stage of pregnancy if needed. Local anaesthetic is safe for use during pregnancy. Always inform your dentist that you are pregnant so they can tailor your care appropriately.

Are dental X-rays safe during pregnancy?

Dental X-rays involve a very low dose of radiation and are considered safe during pregnancy when clinically necessary, especially with a lead apron to shield the abdomen. However, most dentists will postpone routine X-rays until after delivery if possible, only taking them when needed for diagnosis or emergency treatment. If an X-ray is required, the risk to your baby is extremely small.