Pregnancy can bring unexpected changes to your mouth, including swollen or bleeding gums, increased sensitivity, and shifts in your oral microbiome. This episode examines how hormones, changes in the immune system, and daily habits affect your oral health during pregnancy. Learn why symptoms like bleeding gums are common, what you can do to prevent gum disease, and why dental care is both safe and essential while you are expecting. Whether you are currently experiencing symptoms or just want to stay ahead of potential issues, this episode will help you understand how to care for your teeth and gums throughout pregnancy.

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40% OFF the Zahler Prenatal +DHA and a FREE copy of the Your Birth Plan Book. Choosing the right prenatal vitamin is one of the most important things you can do for a healthy pregnancy, and the Zahler Prenatal +DHA is my top recommendation. This exclusive offer is only good through May 31, 2025.

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Hi Vanessa,

I’m in my second trimester and lately I’ve noticed that my gums seem swollen and they bleed pretty easily when I brush or floss. It’s honestly kind of gross and a little scary. I’ve always brushed and flossed regularly and never had issues like this before. I’ve read that pregnancy can cause some weird changes in your mouth, but I’m not sure if this is something normal or if it means I should see a dentist. Do I need to worry about this, or is it just another one of those pregnancy things that goes away after the baby is born?

-Samantha

Samantha, thank you for your email. I hope the second trimester is treating you well. Pregnancy can cause some changes in your mouth, and swollen or bleeding gums are very common. This inflammation of the gums is known as gingivitis, and this is estimated to affect 60-75% of pregnant women. Oral health is an essential and often overlooked aspect of your prenatal care. Let’s talk about the symptoms you are experiencing and answer your questions.

What is Pregnancy Gingivitis?

Pregnancy gingivitis typically shows up in the first trimester, peaks in the third trimester and should subside after you have your baby. Like so many things during pregnancy, one of the causes of pregnancy gingivitis is an increase in hormones. Higher levels of estrogen and progesterone increase vascular permeability and promote the growth and dilation of blood vessels in mucous membranes, including the gums. This leads to increased blood flow and can cause gums to appear redder, swell more easily, and bleed during brushing or flossing. Changes to your immune system during pregnancy make your gums more sensitive to plaque and bacteria and cause an exaggerated inflammatory response in your gums.

Risks of Untreated Gum Disease

Untreated pregnancy gingivitis can progress to periodontitis, a more severe form of gum disease. Some early studies suggested a link between maternal periodontal disease and adverse outcomes like preterm birth and low birth weight. The theoretical concern is that bacteria or inflammatory markers from infected gums may travel through the bloodstream and trigger inflammation in the uterus or placenta, potentially leading to complications. Although more recent evidence does not support a causal relationship between periodontal disease and adverse pregnancy outcomes, there is no downside to treating periodontal disease during pregnancy. Even though treating gum disease may not lower your risk of complications like preterm birth, it still plays an important role in supporting your long-term oral and overall health.

Gum disease does not just impact your mouth. When gum inflammation becomes chronic, harmful bacteria and inflammatory markers can enter your bloodstream. This has been linked to increased risks of heart disease, diabetes complications, and respiratory infections.

Safety of Dental Care During Pregnancy

Visiting the dentist is not only safe during pregnancy, it is recommended by organizations like the American College of Obstetricians and Gynecologists and the American Dental Association. You should continue to visit your dentist regularly and have routine cleanings during pregnancy. Please inform your dentist that you are pregnant, and they can adjust their care accordingly.

Preventive Measures for Gum Health

In addition to regular dentist visits, there are simple things you can do at home to maintain optimal gum health during pregnancy. Brush your teeth twice per day. If your gums are sensitive, consider switching to a softer toothbrush and being gentle when brushing. You should also floss every day.

During pregnancy, it is critical to eat a healthy diet and take a high-quality prenatal vitamin to ensure you are getting the nutrients you need to support your health. Vitamins C and D, in particular, are critical for your gum health. Vitamin C supports the structure and healing of gum tissue. Vitamin D supports the bone and immune defenses that protect your gums.

Understanding the Oral Microbiome

You have likely heard of the gut microbiome. You also have an oral microbiome, a diverse community of bacteria, fungi, and other microorganisms that naturally inhabit your mouth. A healthy microbiome is a balance of both beneficial and potentially harmful microbes. Beneficial bacteria can prevent the overgrowth of disease-causing microbes that can contribute to conditions like gum disease and tooth decay. A healthy microbiome is crucial for your immune system to effectively fight infections without triggering excessive inflammation.

Some microbes help regulate enzymes and proteins involved in maintaining healthy gum tissue. We are still learning about the oral microbiome, and ongoing research is investigating new treatments involving microbes that could help with periodontal disease.

How to Protect Your Oral Microbiome

Pregnancy and elevated hormones like estrogen and progesterone can disrupt your oral microbiome. While you may not be able to control hormone levels, there are other factors within your control. Other disruptors include poor oral hygiene, unhealthy diet, smoking, and stress. Pathogenic bacteria in your mouth thrive on sugar. Sugar can also create a more acidic environment in your mouth, which can cause cavities.

Some of the products we regularly use in our mouths can also disrupt the oral microbiome. If you use a mouthwash that kills 99.9% of bacteria, it is also killing the good bacteria that are essential for a healthy mouth. As our understanding of oral health improves, there may be a push away from traditional products like mouthwashes that contain alcohol or toothpastes with ingredients like SLS. SLS stands for sodium lauryl sulfate, which gives toothpaste its foaming properties. SLS can also irritate sensitive tissues and disrupt the oral microbiome. There are many options for SLS-free toothpaste.

Is It Something to Worry About?

Samantha, you asked whether this is something to worry about. The good news is that gum swelling and bleeding during pregnancy are very common and typically temporary. While it is not usually a cause for alarm, it is also not something to ignore. Maintaining good oral health is important, especially during pregnancy, because untreated gum issues can worsen over time. If you notice significant bleeding, persistent pain, or signs of infection, it is a good idea to contact your dentist or healthcare provider to rule out anything more serious.

Takeaways for a Healthy Smile During Pregnancy

Pregnancy is the perfect opportunity to assess your habits and make positive changes that support your health now and in the future. With consistent hygiene and routine dental care, symptoms such as gum swelling and bleeding often improve and typically subside after the birth of your baby. Small daily choices, such as brushing, flossing, and eating a healthy diet, can have a lasting impact on your oral health. Be sure to schedule at least one dental checkup and cleaning during your pregnancy. Caring for your teeth and gums also helps protect your baby. You can actually pass cavity-causing bacteria to your child, which can affect their dental health later on. If you have any questions or concerns about your oral health, please talk to your dentist, doctor, or midwife.

A Note on Functional Dentistry

Functional dentistry is a growing movement that is a holistic, patient-centered approach to oral health. It focuses on how the mouth is connected to the rest of the body. Plus aims to prevent and treat the root causes of dental issues, not just the symptoms. A big focus of this area is the oral microbiome. If you are interested in learning more about the oral microbiome and functional dentistry, a fantastic podcast from the Huberman Lab, featuring Dr. Staci Whitman, provides a deep dive into this topic: Oral Care for Brain and Body Health.

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