Should you worry about bleeding gums during pregnancy?

By: Ronnie Koenig

Morning sickness, swollen feet, insomnia… there are plenty of not-so-pleasant symptoms you might experience during pregnancy. But did you know that bleeding gums can also be one of them?

Pregnancy increases the risk of periodontal (gum) disease, according to the Centers for Disease Control and Prevention (CDC). About 60 to 75% of pregnant people have gingivitis, an early form of periodontal disease characterized by inflammation of the gums that causes redness, swelling, tenderness, and bleeding.1

If left untreated, gum disease can lead to more serious dental issues, including bone loss and infection. Studies have also linked severe gum disease to negative pregnancy outcomes, like low birthweight and preterm birth—though more research needs to be conducted.2

Naturally, you're probably wondering how your oral health could impact your growing fetus. If you’re expecting or planning to become pregnant, here’s what you should know about gum disease and pregnancy, and what to do if you're experiencing bleeding gums.


What causes bleeding gums during pregnancy?

There are several reasons why pregnant people have an increased risk of bleeding gums and gingivitis, including the following:

  • Hormonal Factors: The primary cause of pregnancy gingivitis is hormonal changes, especially involving estrogen and progesterone. High levels of these hormones "correlate with an increase in dental plaque, a sticky mixture of bacteria, food, and debris,” says Joseph Dill, DDS, MBA, chief dental officer of the Delta Dental Plans Association. Plaque can harden, breed bacteria, and inflame the gingival tissue.3
  • Dietary Changes: Some pregnant people crave super-sweet items or other foods that aren't otherwise part of their regular diet, which might increase the risk of dental plaque.
  • Morning Sickness: Queasiness can cause an aversion to toothpaste. Morning sickness sufferers may also avoid brushing their teeth for fear of gagging.
  • Salvia Production: Pregnant people may produce less saliva, which can also lead to increased plaque and therefore gingivitis.4


When might pregnant people have bleeding gums?

In many cases, gingivitis starts to become evident in the second trimester, and it peaks in the third trimester. If you had gingivitis before your pregnancy, the condition will likely worsen while expecting.


Why is gum health important while pregnant?

With all the things to consider when you’re pregnant, your oral health may not be at the top of the list—but it should be. “Gum health is related to overall wellness, especially during pregnancy,” says Leena Palomo, DDS, MSD, professor and chair of the Ashman Department of Periodontology & Implant Dentistry at NYU College of Dentistry.

More research needs to be conducted to determine direct causes, but some studies have shown that severe periodontal (gum) disease may be associated with poor pregnancy outcomes like preterm birth and low birth weight.5 Severe gum disease can also lead to loosened teeth, tooth extractions, or bone loss.

It's especially important to take care of dental problems when you're pregnant, as lingering infections can harm your baby’s oral health, says Dr. Dill. The CDC reports that pregnant people with high numbers of cavity-causing bacteria could transmit these bacteria from their mouth to the baby's mouth; contact with the bacteria has been linked to childhood cavities and dental issues.1


How to handle bleeding gums while pregnant

If you’re pregnant and experiencing bleeding gums or other symptoms of gingivitis, it’s vital to see your dentist. They'll give you a thorough cleaning to get rid of harmful plaque, tartar, and bacteria. Scaling and root planing (cleaning procedures that reach deeper beneath your gums) may sometimes be necessary.6

During your appointment, the dentist may also repair any damaged dental work. They'll advise you on proper oral care since prevention goes a long way toward keeping your mouth healthy while pregnant. Finally, the dentist may give you prescription mouthwash.

Rest assured that treatment of pregnancy gum disease isn't associated with adverse maternal or birth outcomes, according to the American College of Obstetricians and Gynecologists.7

Furthermore, the American Dental Association says that dental X-rays are safe, as long as the provider uses abdominal and thyroid shielding.8


Pregnancy gingivitis symptoms 

Symptoms of pregnancy gingivitis affect the gums, and they might include the following:9

  • Bleeding, especially when brushing or flossing
  • Redness
  • Tenderness
  • Swelling
  • Bad breath
  • Gums that appear shiny


Tips for healthy gums

During pregnancy, you can take several steps to foster healthy gums and prevent gum disease, including the following:

  • Brush your teeth with fluoride toothpaste, at least twice a day for two minutes, with special attention to the gum line
  • Floss once a day to clean out harmful bacteria between teeth and under the gum line, where a toothbrush cannot reach
  • Use a soft-bristled toothbrush
  • Consider using an alcohol-free mouthwash
  • Avoid too many sugary items
  • Don't smoke or vape
  • Rinse your mouth after vomiting if you have morning sickness; the American Academy of Pediatrics recommends using 1 tsp of baking soda in a glass of water10
  • See your dentist regularly even before trying to conceive

Dr. Dill adds that it’s advisable to have a professional cleaning in the first or second trimester. Make sure to tell your dentist about the pregnancy, and rest assured that oral health care is safe while expecting.

For optimal oral health, pregnant people should eat a nutritious diet, says Dr. Dill, and they should avoid smoking, using tobacco products, and vaping (which you can't do while expecting anyway). “Vaping non-tobacco products is just as harmful as smoking, so do not be fooled into thinking that it is safe to vape,” he says.

Expectant parents should feel empowered to take charge of their oral health. While hormones associated with pregnancy can’t be easily controlled, you can largely control the oral bacteria in the mouth and prevent gum disease. “Let your dentist know that you're pregnant or planning to get pregnant and that you want to take the proper preventative steps,” says Dr. Palomo. “This will help the dentist personalize the treatment to you as an individual based on your specific needs.”


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