Pregnancy is when people most often put off going to the dentist, and it is exactly when gums are most easily inflamed. Putting it off is not the safer option: untreated inflammation does not stand still, and what is a simple procedure in the fifth month can take more time and more effort in the eighth.
Why gums bleed in pregnancy
Hormonal changes alter how the gums respond to the same deposits you had before. The same amount of plaque that caused no trouble before pregnancy can now bring redness, swelling and bleeding when you brush. This is called pregnancy gingivitis and it usually appears between the second and the eighth month.
Bleeding is not a reason to skip that spot when brushing — quite the opposite. A spot that bleeds should be brushed gently, but every day; once the deposits are gone the bleeding stops. We have written about this in the article on receding gums.
Some women also develop a localised swelling of the gum between the teeth, which settles after the birth. An examination is what separates that from something that needs treating.
When to come in
It is best to come as soon as you know you are pregnant, and without symptoms: that is when it is clear what needs doing and how much time there is. The second trimester is the most comfortable for planned work, because the nausea has usually passed and lying back is not yet uncomfortable.
- First trimester: examination, removal of deposits, and anything that cannot wait.
- Second trimester: planned work — fillings, root canal treatment if needed.
- Third trimester: short appointments; lying back for long can be uncomfortable, so the appointment is planned differently.
Pain, swelling and an injured tooth do not wait for a trimester. That is an emergency at any point in pregnancy and is dealt with straight away.
X-rays and anaesthetic
An X-ray is taken in pregnancy only when the decision about treatment depends on it, with a protective apron and the smallest possible field. If it can wait, it waits. If it cannot, it is taken, because undetected infection is the greater risk.
Local anaesthetic is used in pregnancy too. Tell us you are pregnant and how far along before anything begins, because it changes the choice of agent and how we work. The same goes for medicines: nothing is taken on your own initiative, painkillers included.
Nausea, acid and enamel
With morning sickness, stomach acid reaches the teeth. Afterwards do NOT brush straight away: softened enamel is more easily damaged by a brush. Rinse with water or a bicarbonate of soda solution and wait about thirty minutes.
Frequent small meals and sweet things between them are common in pregnancy, and it is exactly how often that does more harm than how much. We have written about that in the article on foods that harm teeth.
After the birth
A check-up after the birth shows what settled by itself and what did not. Whatever was postponed can then be planned calmly, and any gum inflammation that remains is treated like any other, through periodontics.
- Can I see a dentist while pregnant?
- Yes. Examinations and removal of deposits are done in every trimester, and planned work most comfortably in the second. Tell us you are pregnant and how far along when you book.
- Can an X-ray be taken?
- Only when the decision about treatment depends on it, with a protective apron and the smallest possible field. If it can wait, it waits.
- Does anaesthetic harm the baby?
- Local anaesthetic is used in pregnancy, with the agent chosen accordingly. A procedure without anaesthetic, with pain and stress, is not a safer substitute.
- Why are my gums bleeding only now?
- Hormonal changes heighten the gums' response to the same deposits you had before. Removing the deposits and brushing regularly stops the bleeding.
- Does the baby take calcium from my teeth?
- A tooth is not a source of calcium for the baby; enamel is not drawn on. Trouble in pregnancy comes from gum inflammation, acid from nausea and more frequent meals, not from calcium leaving the teeth.