Going to the Dentist While Pregnant: Safe Treatments and Bleeding Gums

A tooth that has been throbbing for three days, a gum that bleeds into the sink every time you brush, and that same question again: can you go to the dentist while pregnant, or should you grit your teeth until the birth? Many women put off the appointment for fear of the anaesthetic or the X-ray, sometimes on the advice of someone close to them.

Yet dental and obstetric sources agree: dental treatment is possible throughout pregnancy, and it is neglect that usually causes problems, not treatment. Here is what can be done, when, and how to look after your gums until the birth.

Can you go to the dentist during pregnancy?

Yes, at any time. The American Dental Association (ADA) says so unambiguously, and recalls its joint position with the American College of Obstetricians and Gynecologists: urgent treatment, extraction, root canal, filling a cavity, can be done during pregnancy, and delaying it can make things worse. In France, the UFSBD (the French union for oral health) considers that the benefits of treatment outweigh its risks.

Check-ups and scaling are safe too. Only in a high-risk pregnancy might the dentist and gynaecologist decide together to postpone certain non-urgent treatments (UFSBD).

When is the best time for dental treatment?

For treatment that can wait a few weeks, the second trimester is the most comfortable. Naître et grandir places it between week 15 and week 28: nausea has often settled, and lying on your back in the chair is still bearable. Purely cosmetic treatment, such as whitening, can wait until after the birth.

On the other hand, pain, an abscess or a broken tooth are treated when they happen, in the first trimester as in the third. An untreated infection, and the pain and lack of sleep that go with it, are good neither for you nor for the baby.

Local anaesthetic and dental X-rays: are they dangerous?

Local anaesthetic is considered safe during pregnancy, with or without adrenaline, according to the ADA, and Naître et grandir confirms this. It allows pain-free treatment, which is better than a treatment cut short or postponed. The choice of product and the amount are up to the dentist, who adapts them knowing that you are pregnant.

Dental X-rays are possible at every stage of pregnancy, according to both the ADA and Naître et grandir. The radiation dose of a dental X-ray is very low, and the beam targets the mouth, far from the womb. On protection, the sources differ:

• the UFSBD, in France, mentions the lead apron placed over the belly;
• Naître et grandir considers that the apron brings no real benefit, since the fetus is outside the X-ray field;
• the ADA reports that a 2023 recommendation no longer considers it necessary to shield the abdomen or thyroid.

If the apron reassures you, ask for it: it has no drawbacks. For medicines after treatment (painkiller, antibiotic), the dentist chooses those suitable during pregnancy; do not take anything on your own initiative, and ask for the dose to be specified.

Bleeding gums: pregnancy gingivitis

This is the most common dental problem in pregnancy. It affects more than one pregnant woman in three according to Naître et grandir, and the INSPQ even speaks of almost all pregnancies, to varying degrees. It often appears from the second month. Hormones make the gums more sensitive to plaque: they redden, swell and bleed easily when brushed.

The good news is that pregnancy gingivitis is reversible. The swelling and bleeding generally ease about a month after the birth (INSPQ). In the meantime:

• brush your teeth at least twice a day, with a soft toothbrush and fluoride toothpaste, gently on the inflamed areas;
• floss every day; a little bleeding at first is normal;
• cut down on sugary snacking and acidic drinks;
• have a scale and polish if your dentist suggests it, more often if needed (UFSBD).

Sometimes a small red lump that bleeds easily forms on the gum, often in the second trimester: this is an epulis, or pregnancy granuloma. It is harmless, generally disappears after the birth and can be removed if it is bothersome (UFSBD, Naître et grandir).

Why deal with it? Because neglected gingivitis can progress to periodontitis, a deeper gum disease. Reviews of studies have found an association between periodontitis and preterm birth, low birth weight or pre-eclampsia, although researchers consider that more work is needed before drawing conclusions (ADA). Gum treatment during pregnancy, for its part, is not associated with any adverse effect for mother or baby. The signs of labour starting too early are described in our article on threatened preterm labour.

Nausea, vomiting, cravings: protecting your enamel

Vomiting in the first trimester exposes the teeth to stomach acid, which softens the enamel. The right reflex is counter-intuitive: do not brush your teeth straight away. Rinse your mouth with water, water with baking soda or a fluoride mouthwash, then wait about 30 minutes before brushing (Naître et grandir). Our tips to ease pregnancy nausea can also help you through this period.

Sweet cravings and snacking throughout the day increase the risk of tooth decay. Some chewable antacids also contain sweeteners or sugars: talk to your pharmacist if you take them often for heartburn. A varied diet, with dairy products and simple snacks, also protects your teeth; our guide to eating well during pregnancy gives you ideas.

“A child, a tooth”: true or false?

False. The saying that every pregnancy costs a tooth is a stubborn myth, the CHUV university hospital in Lausanne points out. The fetus does not draw calcium from its mother's teeth, and teeth do not decalcify during pregnancy: if the baby needs calcium, it takes it from the reserves in the bones (Naître et grandir).

The CHUV puts it simply: with appropriate care, a balanced diet and regular check-ups, you keep healthy teeth and gums during pregnancy. It is untreated gums and cavities, made worse by vomiting and snacking, that damage the mouth.

After the birth: your teeth and your baby's

Keep up your check-ups after the birth. In France, the preventive check-up offered to pregnant women even runs until six months after the birth (ameli). In Morocco, ask your health insurer or your top-up insurance about cover for dental treatment.

A healthy mouth in the mother also limits the transmission of harmful bacteria to the infant (CHUV). When your baby's first tooth comes through, our article on brushing your baby's teeth will take over.