If your gums bleed when you brush during pregnancy, you are in very large company. Rising hormone levels make gum tissue react more strongly to the plaque already on your teeth, and the result is often red, swollen, tender gums that bleed easily. Pregnancy gingivitis is common and usually manageable. It is also a good reason to keep up with dental care, not to avoid it.
Why does pregnancy gingivitis happen?
Pregnancy hormones increase blood flow to the gums and change how the body responds to plaque bacteria. The same amount of plaque that caused no trouble before can now cause inflammation. It tends to start in the second month or so and often becomes more noticeable in the second and third trimesters.
Other changes add to it. Morning sickness brings stomach acid into the mouth. Cravings and frequent small snacks mean more sugar exposure. Gagging while brushing may make you brush less. Tender gums make you want to skip flossing, which lets more plaque build up. It is a cycle, and you can break it.
What does it look like, and when is it a problem?
Typical signs are gums that look bright red or shiny, feel puffy, and bleed when you brush or floss. Some people notice a bad taste or breath. These changes usually improve after delivery.
Call your dentist if bleeding is heavy or constant, if gums hurt or pull away from the teeth, or if any tooth feels loose. Also call for a soft, red lump on the gum that bleeds easily. This is sometimes called a pregnancy tumor, although it is not cancer; it is an overgrowth of inflamed tissue. It often shrinks after birth, but a dentist should look at it, especially if it interferes with eating. Our red flags list covers signs that should not wait.
How can you protect your gums during pregnancy?
Keep the basics steady, and adapt them to how you feel.
- Brush twice a day with a soft brush and fluoride toothpaste. If a regular brush triggers gagging, try a smaller head or a different time of day.
- After vomiting, rinse with water, or a teaspoon of baking soda in a cup of water, and wait a while before brushing, since stomach acid softens enamel.
- Clean between teeth daily, gently. If floss is too tender, try an interdental brush or a water flosser. Bleeding is not a reason to stop; see when to pause and when to book.
- Pick snacks wisely and avoid sipping sweet drinks across the day.
Is dental care safe while you are pregnant?
Routine cleanings and exams are generally considered safe and recommended during pregnancy, and a cleaning can lower the plaque that drives the inflammation. Tell the office that you are pregnant and how far along you are, and mention your medications and prenatal vitamins. They may adjust positioning, timing and decisions about X-rays or medicines. Ask your own prenatal provider if you have questions about a specific treatment.
Schedule a visit early in pregnancy if you have not had a checkup recently, because treating a problem sooner is easier than during an emergency. More on gum disease in general is on the NIDCR gum disease page.
This article is general information and does not replace an exam or advice from your dentist and prenatal provider.