During pregnancy, the surge of the hormones estrogen and progesterone in your body makes you more susceptible to gingivitis, which is a common issue for many expecting folks. In fact, according to the Centers for Disease Control and Prevention (CDC), gingivitis affects 60% to 75% of pregnant people. Pregnancy gingivitis is an inflammation of the gums that is often caused by a sticky film of bacteria called plaque. This accumulation of plaque along your gum line causes your gums to become red, swollen, and tender. “Pregnancy causes an increased host response (inflammation) to dental plaque,” says Binnaz Leblebicioglu, DDS, MS, PhD, a professor and interim chair in the division of periodontology for the College of Dentistry at The Ohio State University. “This can be detected by gingival [or gum] swelling, redness, and increased bleeding spots around your teeth or implants. Pregnancy-related [gingivitis] may get worse through trimesters.” When gingivitis is not treated, the bone that supports your teeth can be lost, and the gums can become infected. Teeth that do not have bone support can become loose and may eventually have to be extracted.
Symptoms of Pregnancy Gingivitis
The main symptoms of pregnancy gingivitis involve changes to your gums. Some signs that you may have pregnancy gingivitis include experiencing bleeding when you are brushing or flossing, displaying redness, and having a shiny gum surface. You also may notice swelling and tenderness in your gums. Sometimes lumps appear along the gum line or between teeth that can bleed easily and are characterized by a red, raw-looking “mulberry-like” surface. Although these growths are sometimes called “pregnancy tumors,” they are not cancerous and are usually harmless. After pregnancy, these lumps usually go away on their own. But, if they bother you, they can be removed under a local anesthetic.
Identifying Pregnancy Gingivitis
Most of the time pregnancy gingivitis is identified during a routine dental exam. However, your OB/GYN may discuss the possibility of the condition during one of your prenatal visits. They may even encourage you to see a dentist regularly throughout your pregnancy as a preventative measure. “It’s important to maintain good oral health all of the time, especially during pregnancy,” says Erin Issac, DMD, a board-certified pediatric dentist. “By not taking care of your oral health, women are at risk for pregnancy gingivitis. Hormones are fluctuating and this can lead to the potentially severe swelling of the gums, which is exacerbated by plaque buildup.” If you experience bleeding in your gums when you brush or you notice swelling or sensitivity, it is important to see a dental health professional. They can not only clean your teeth, but they also can recommend treatments for good oral health during pregnancy.
Causes of Pregnancy Gingivitis
Pregnant people experience hormonal changes during pregnancy largely due to higher levels of estrogen and progesterone. This causes the gingiva—or the tissue that surrounds the teeth known as the gums—to experience excessive sensitivity. In pregnancy, gingivitis as well as epulis gravidarum—commonly known as pregnancy tumors—can be seen very often. Typically, pregnancy gingivitis starts at the second month of gestation and reaches the highest level at the eighth month. Then, it heals spontaneously after birth. “The main etiological factor for gingivitis (pregnancy or not) is dental plaque/biofilm,” says Dr. Leblebicioglu. “Existing gingivitis may get worse during pregnancy and this is mainly due to hormonal changes. [But the] bottom line is that if a [person’s] oral hygiene was good prior to pregnancy, they should not experience these types of problems during pregnancy.”
Treatment of Pregnancy Gingivitis
Unfortunately, people often wrongly assume that visiting the dentist during pregnancy is risky. But that is not the case. In fact, according to the American Dental Association, preventive, diagnostic, and restorative dental treatment is safe throughout pregnancy. Likewise, local anesthetics with epinephrine—such as lidocaine—also may be used during pregnancy. “Prevention is key for success,” says Dr. Leblebicioglu. “So the recommendation is that [people] who are planning for pregnancy should seek a dental and periodontal examination if they do not routinely receive these types of oral health care. Professional cleaning and routine oral hygiene home care to control dental plaque accumulation can predictably prevent pregnancy gingivitis.” When pregnancy gingivitis and periodontitis are present, they can safely be treated with either regular dental cleaning or deep cleaning, Dr. Leblebicioglu adds. Even minor periodontal surgeries can be performed to remove excess gum tissue to eliminate discomfort during pregnancy or to allow brushing and flossing, she says. “Leaving any type of chronic inflammation untreated is not a good idea for general well-being, and gingivitis/periodontitis during pregnancy is not an exception,” says Dr. Leblebicioglu. “First, it would cause discomfort as well as eating and speech problems to the expecting [person]. Secondly, there is now significant published work reporting some levels of co-existence between low birth weight and/or premature babies and periodontal disease.” There also is some evidence that a pregnant person’s oral health during pregnancy can lead to preeclampsia. And it can even impact a baby’s health during the first year, says Dr. Isaac. “Besides pregnancy gingivitis, [people] with high levels of the bacteria that cause cavities can pass that to their babies, so it is best to take care of any cavities prior to the baby being born,” Dr. Isaac adds. Additionally, according to Dr. Leblebicioglu, pregnant people with dental or periodontal issues should be followed-up more frequently by dentists during and after the pregnancy.
Coping With Pregnancy Gingivitis
While there is nothing you can do to change your hormone levels during pregnancy, you can take other steps to maintain optimal oral health. This means brushing twice a day with a soft-bristled brush for two minutes, using a fluoride toothpaste, and cleaning between the teeth once a day. “[Pregnant people] should continue at-home oral care, but they should also have a dental checkup and cleaning as well,” says Dr. Isaac. “The best time for this is during the second trimester.” You also can focus on eating a nutritious diet with adequate amounts of calcium, and limit your consumption of sugary foods and beverages. Brushing after eating sticky, sweet foods such as raisins and other dried fruit can also help keep gingivitis from progressing. Keep in mind that a baby’s tooth development during pregnancy starts around week five or six. Consequently, getting enough essential nutrients during pregnancy can help you balance your body’s nutritional requirements as well as provide the necessary energy and nutrients for normal growth of the fetus. “One thing that we should consider is that a [person] who does not seek regular dental care has higher risk of developing dental as well as gingival/periodontal problems during pregnancy,” Dr. Leblebicioglu says. “There is also a common belief that receiving dental treatment during pregnancy can harm the fetus (which is not correct). Then, oral health-related problems turn into emergencies, which cause more stress as the pregnancy progresses.” To prevent this, Dr. Leblebicioglu believes that pregnant people should be educated about the importance of oral health and its effect on maintaining general health. “These [educational efforts] should be a part of public health policies,” she says.
A Word From Verywell
Pregnancy gingivitis, which can lead to bleeding and swollen gums, is a common problem in pregnancy. Left untreated, it can lead to a host of issues for you and your baby. For this reason, it is important to practice good oral health as well as see a dentist—preferably in the second trimester. Contrary to popular belief, getting regular dental care is safe, as well as a great way to ensure your gums and teeth are as healthy as possible during pregnancy. Keep in mind that without good dental care, you run the risk of having a baby with low birthweight or experiencing pre-term birth. If you suspect that you have pregnancy gingivitis, talk to your healthcare provider about your treatment options.
