Pregnancy and your teeth and gums

Reviewed by Dr. Samar Fadavi, DDS

Short answer: Dental care is safe and important during pregnancy. Hormone changes make gums more likely to swell and bleed, and morning sickness can expose teeth to stomach acid. Keep brushing twice a day with fluoride toothpaste, clean between your teeth daily, rinse with water after vomiting, and keep your check-ups. Cleanings, fillings, local anesthetic and needed x-rays can all be done during pregnancy.

Why pregnancy affects your mouth

Pregnancy brings big changes in hormones, blood flow, eating habits and energy levels. Higher levels of progesterone and estrogen change how gum tissue reacts to plaque, so gums can become red, puffy and tender even with the same brushing routine you had before. Nausea, cravings, tiredness and a busy schedule can also make it harder to keep up with daily care.

The good news is that most pregnancy-related mouth changes are temporary and very manageable. Taking care of your teeth and gums now protects your own health and helps set up good habits for your baby. This guide explains common changes, what dental care is safe, how to handle morning sickness, what to expect at visits in each trimester and how to prepare for your baby’s first teeth. It is general information for patients in Scarborough, the Danforth and East Toronto, and it does not replace advice from your dentist, physician or midwife.

Common mouth changes during pregnancy

Pregnancy gingivitis

Many pregnant people notice gums that bleed when they brush or floss, look redder or feel swollen. This is called pregnancy gingivitis. It often starts in the second month and can peak in the third trimester. It is caused by the gum tissue’s stronger reaction to plaque, not by pregnancy alone, so good plaque control makes a real difference. Our guide on gum bleeding explains more.

Pregnancy granuloma

Some people develop a small, red, raised growth on the gum, often between teeth, that bleeds easily. It is sometimes called a pregnancy tumour, but it is not cancer. It is an overgrowth of gum tissue linked to hormones and plaque. Most shrink after the baby is born. If one bleeds a lot, gets in the way of eating or does not go away after delivery, your dentist can remove it.

Enamel erosion from morning sickness

Vomiting and reflux bring stomach acid into the mouth. Acid softens enamel, and repeated exposure over weeks can wear it away, especially on the inside surfaces of the upper front teeth. Teeth may become sensitive or look more yellow as enamel thins.

Cavity risk

Cravings for sweet or starchy snacks, eating small meals often to manage nausea, and a drier mouth can all raise cavity risk. Brushing may also feel harder if toothpaste triggers gagging.

Dry mouth

Some people notice a drier mouth during pregnancy. Low saliva means less natural protection for teeth. Our salivary glands guide explains why saliva matters.

Loose-feeling teeth

Hormones affect the ligaments and bone around teeth, so teeth may feel slightly loose. This usually settles after pregnancy, but a tooth that becomes very loose should be checked, since it can be a sign of gum disease.

Is dental care safe during pregnancy?

Yes. Canadian and international health organizations agree that preventive, diagnostic and needed restorative dental care is safe at any stage of pregnancy. Putting off treatment for an infection or a deep cavity can be more harmful than having it treated.

• Check-ups and cleanings are safe and recommended. Removing plaque and tartar helps control pregnancy gingivitis.
• Fillings for cavities are safe and prevent infection later.
• Local anesthetic used in dentistry is considered safe during pregnancy. Our dental anesthesia guide explains how numbing works.
• Dental x-rays for a specific problem can be taken safely. The beam is aimed at the mouth, the dose is very small, and routine x-rays are usually postponed until after delivery. Our dental x-rays guide explains the low dose.
• Root canals and extractions can be done when needed to treat pain or infection.

Elective cosmetic treatment, such as whitening, is usually postponed until after pregnancy and breastfeeding, simply because there is no need to add anything that is not necessary.

Planning visits by trimester

First trimester

You can have check-ups and urgent care. Many people feel tired and nauseous, so short morning or afternoon visits may be easier depending on when your nausea is worst. Tell us you are pregnant as soon as you know, even before you tell others, so we can plan safely. Your information is kept private.

Second trimester

This is often the most comfortable time for routine treatment such as fillings. Nausea has often eased, and lying back in the chair is still easy.

Third trimester

Check-ups and urgent care continue. Lying flat for a long time can make you feel faint or short of breath, because the baby presses on a large blood vessel. A slight tilt to your left side, a small pillow under your right hip and a more upright chair help. Shorter visits and breaks to change position are welcome. Our ergonomics guide covers comfort in the chair.

Steps to protect your teeth during pregnancy

1. Brush twice a day with fluoride toothpaste. Use a soft brush and pay extra attention to the gum line, where plaque irritates swollen gums.
2. Clean between your teeth once a day. Floss, interdental brushes or a water flosser all work. Our flossing guide shows how.
3. Keep your dental appointments. A cleaning during pregnancy helps control gingivitis. Some people benefit from an extra cleaning.
4. Choose tooth-friendly snacks. Cheese, yogurt, vegetables, nuts (if no allergy), eggs and whole grains are kinder to teeth than sweets and crackers.
5. Drink water often. Toronto tap water contains fluoride, and water helps with dry mouth.
6. Chew sugarless gum with xylitol after meals and snacks, if it does not trigger nausea.
7. Tell your dentist about your pregnancy, due date, any complications and all medicines and supplements you take.

Morning sickness: how to protect your enamel

• Rinse right away with water after vomiting, or with a mix of one teaspoon of baking soda in a cup of water, which helps neutralize acid.
• Wait about 30 minutes before brushing after vomiting. Brushing right away can wear acid-softened enamel.
• Use a fluoride rinse or extra fluoride toothpaste if your dentist recommends it, to help strengthen enamel.
• Try a bland toothpaste or a small amount of toothpaste if the taste or foam makes you gag. A children’s-size brush can also help.
• Brush slowly and breathe through your nose, and try brushing at times of day when nausea is lower.
• Mention reflux to your doctor or midwife if you have frequent heartburn.

What to avoid

• Do not skip dental care because you are pregnant. Infection and untreated cavities are not good for you or your baby.
• Avoid sipping sweet drinks or grazing on sweets through the day.
• Do not brush right after vomiting. Rinse first, then wait.
• Do not take any medicine, including over-the-counter pain relievers, without checking with your doctor, midwife or pharmacist. Some common pain relievers are not recommended in later pregnancy.
• Avoid whitening products until after pregnancy and breastfeeding.
• Do not ignore swelling, a bad taste, fever or a toothache. Call the same day.

Gum health and pregnancy outcomes

Research has found associations between gum disease and some pregnancy complications, such as preterm birth and low birth weight. Studies have not proven that gum disease directly causes these problems, and treating gums during pregnancy has not been shown to prevent them in every case. What is clear is that healthy gums are part of good overall health, and gum care during pregnancy is safe. Our guide to oral health and overall health explains these links.

Nutrition for strong teeth

Your baby’s teeth start forming early in pregnancy. A balanced diet with calcium, vitamin D, protein, phosphorus and vitamins A and C supports healthy tooth development. Prenatal vitamins as recommended by your doctor or midwife, along with dairy or fortified alternatives, leafy greens, fish, eggs, beans and fruits, help. A common myth says a baby takes calcium from the mother’s teeth. That is not true. Teeth do not lose calcium during pregnancy; changes in the mouth come from hormones, plaque and acid.

Preparing for your baby’s teeth

The bacteria that cause cavities can be passed from parent to baby through saliva, for example by sharing spoons or cleaning a soother in your mouth. Treating your own cavities and keeping your mouth healthy during pregnancy lowers the amount of these bacteria and helps protect your child later.

• Wipe your baby’s gums with a clean, damp cloth after feedings, even before teeth come in.
• Once the first tooth appears, brush with a soft baby brush and a rice-grain smear of fluoride toothpaste.
• Avoid putting your baby to bed with a bottle of milk, formula or juice.
• Book your child’s first dental visit by their first birthday or within six months of the first tooth.

Our guides to your child’s first dental visit and fluoride toothpaste explain early care.

After your baby arrives

Life with a newborn is busy, and dental care is easy to postpone. Gum changes from pregnancy usually settle within a few months after delivery. Book a check-up within the first few months to make sure gums have recovered and to catch any cavities that started during pregnancy. Local anesthetic and most dental medicines are compatible with breastfeeding. Tell us if you are breastfeeding so any prescriptions can be chosen with that in mind.

Coverage during pregnancy

Many workplace dental plans cover check-ups, cleanings and fillings, often with limits. The Canadian Dental Care Plan also includes preventive and restorative care for eligible patients. We bill insurers directly where possible and explain your coverage before treatment. See our CDCP page and insurance and billing page.

When to see a dentist

Book a visit if:

• You are pregnant or planning a pregnancy and have not had a check-up in the past six months.
• Your gums bleed a lot, are very swollen or sore.
• You notice a red lump on the gums that bleeds easily.
• Your teeth are newly sensitive, especially after weeks of morning sickness.

Call us the same day if you have a toothache, facial swelling, a bad taste, pus or fever. Our emergency dentist page explains same-day care, and our family dentistry page covers check-ups and cleanings.

Questions about pregnancy and oral health

Is it safe to see the dentist while pregnant?

Yes. Check-ups, cleanings, fillings and needed treatment are safe throughout pregnancy. Tell us you are pregnant so we can plan your care.

Why do my gums bleed more during pregnancy?

Hormone changes make gums react more strongly to plaque. Careful brushing, daily flossing and a professional cleaning usually help.

Can I have dental x-rays while pregnant?

Routine x-rays are usually postponed, but x-rays needed to diagnose pain or infection can be taken safely.

Is dental freezing safe during pregnancy?

Yes. Local anesthetic used in dentistry is considered safe during pregnancy and breastfeeding.

What is the most comfortable time for dental treatment?

Many people find the second trimester most comfortable for non-urgent treatment. Urgent care should not wait.

Does pregnancy take calcium from my teeth?

No. That is a myth. Changes come from hormones, plaque and acid, not from calcium loss.

Should I whiten my teeth while pregnant?

Whitening is usually postponed until after pregnancy and breastfeeding.

How can I brush if toothpaste makes me gag?

Try a small brush, a mild-flavoured fluoride toothpaste, a smaller amount of paste and brushing at times when nausea is lower.

Can I take pain relief for a toothache while pregnant?

Ask your doctor, midwife or pharmacist before taking any pain reliever, since some are not recommended at certain stages of pregnancy. Call us the same day so the cause of the pain can be treated.

Is fluoride toothpaste safe during pregnancy?

Yes. Brushing with fluoride toothpaste is safe and recommended during pregnancy to protect your teeth from cavities and acid.

Should my partner see the dentist too?

It helps. Cavity-causing bacteria can pass to a baby from any caregiver, so a healthy mouth for every adult at home protects your child.