Increasing estrogen and progesterone levels can cause some discomfort:

• Gingivitis is a common and benign disease when treated in time. On the other hand, it tends to worsen during pregnancy, showing redder and darker gums, despite good oral hygiene. Almost a quarter of pregnant women have a form of gingivitis, which in this case is called “pregnancy gingivitis”. This often occurs when there is more plaque than before pregnancy;
• The epulis is a small, benign red, rounded and often bleeding growth. It usually takes up residence between two teeth;
• Cavities during pregnancy tend to get worse. It is often present at the same time as gingivitis;
• Diffuse, never localized pain (dentine hypersensitivity) felt by pregnant women. It can occur in the absence of cavities or any other disease. In this case, it should disappear ten to fifteen days after its manifestation. On the other hand, if this pain persists, it reveals damage to the pulp of one or more teeth;
• Dental erosion results from the dissolution of mineralized tissues such as enamel, under the influence of acidic substances produced by the degradation of food debris. This erosion is most often located at the collar.

• Some hormones associated with pregnancy, such as progesterone, have immunosuppressive properties: in the presence of large amounts of sex hormones, antibodies are affected;
• Also, due to this influx of hormones, pregnant women react more strongly, resulting in an influx of blood, inflammation and gums that often bleed. This may indicate the presence of gingivitis. This fragility of the gum allows the easy intrusion of microbes;
• It may also happen that some pregnant women have, for the same reasons, a benign tumour of the gums, called “epulis“, which should disappear spontaneously after the birth of the baby;
• Dental erosion occurs mainly in women who vomit very often, especially during the first trimester of pregnancy. The enamel deteriorates due to gastric juices and the acidity of the bile. Teeth become hypersensitive to cold and heat, and can be painful;
• In addition, nausea and vomiting at the beginning of pregnancy push women to change their eating habits: they eat more often and are more likely to eat sweet foods….;
• Finally, let us add that the saliva flow increases during the first three months and that saliva becomes more acidic, thus weakening the mother-to-be’s defences against oral bacteria; these bacteria take advantage of this to develop and give free rein to the development of cavities.

• During pregnancy, extra vigilance is required for everything, including the oral cavity: brushing after each meal, reducing the consumption of sweetened drinks, etc. are essential;
• The use of a soft toothbrush will prevent or aggravate frequent bleeding;
• After vomiting, it is best to wait a while before brushing your teeth. Indeed, it is better to allow a little time to pass in order to allow the saliva to protect the enamel again. To remove the bad taste in the mouth, it is possible to rinse your mouth with water and a teaspoon of baking soda;
• In your diet, avoid highly acidic foods such as lemon, orange, vinaigrette, etc;
• Gingivitis is a benign condition that can get complicated. It is essential to increase vigilance and care. Poor hygiene allows plaque to settle and bacteria in the mouth multiply, making the infection worse.

One urgent action: make an appointment with the dentist. Self-medication is never a good counsellor.

Dental care is not contraindicated during pregnancy. They are safe for the fetus and the dentist is well aware of the precautions to be taken in pregnant women. However, there is a more appropriate time for care: the second trimester of pregnancy. Between the 3rd and 7th month, dentists can provide routine care. The beginning and end of pregnancy are the most delicate periods for dental procedures. If the problems are mild, it may be more appropriate to wait until the second trimester or end of pregnancy to intervene. Everything will of course depend on the urgency and the intervention to be performed.

• Local anesthetics can be used. Indeed, they are targeted and precise, without any consequences for your baby;
• X-rays are generally reserved for emergencies. However, many dentists use digital radiography techniques, which are much less radiant than conventional radiography. Similarly, the wearing of a lead apron by the expectant mother during the taking of the picture prevents any radiation from the baby. Your dentist will decide whether an X-ray is necessary;
• Mercury-containing amalgams are likely to cross the placental barrier and contaminate breast milk if breastfed. In general, the dentist will prefer to avoid them and perform a cavity curettage, followed by a mercury-free temporary filling. The installation of amalgam will be postponed until after delivery. If necessary, the dentist will make the best decision. There are also other amalgams, notably in composite.

Common conditions

• Whether cavities are due to changes in eating habits, nausea, cravings or other reasons during pregnancy, they must be taken into account quickly, in order to avoid the release of bacteria into the bloodstream. These bacteria could reach the fetus. When pregnant, any risk of infection must be taken into consideration;
• Pain and/or infection: It is advisable to consult a dental professional. This one will be able, at least, to devitalize a tooth if necessary, without any consequence on the mother or her baby;
• The pregnancy epulis disappears after childbirth; having it removed during pregnancy will only be indicated if it is a real discomfort when chewing;
• In case of gingivitis or periodontal lesions, the dentist will emphasize the importance of removing the bacterial plaque and remind the patient of the brushing methods and techniques. He may be able to perform descaling and prescribe mouthwashes. Only a minimal treatment will be carried out;
• Dental erosions can be controlled by rinsing the oral cavity after vomiting with a sodium bicarbonate solution.

As soon as one of the symptoms described occurs, it is important to intervene. Otherwise, in the presence of plaque and/or tartar, there is a risk of aggravation of symptoms. Gingivitis can turn into periodontal disease, which can cause bone resorption and tooth mobility. Periodontal disease then continues to progress after childbirth.

At any time during pregnancy, the dentist can respond to a dental emergency. 

Gingivitis increases the risk of premature delivery

Opinions converge on the fact that pregnant women with gingivitis are more likely than others to give birth to a low birth weight baby before term. Indeed, especially during the first trimester, plaque releases bacteria that can be found in the pregnant woman’s blood, which will irrigate the placenta; this aggression will cause a hormonal defence that can trigger childbirth.

Some pregnant women suffer from “pre-eclampsia“, high blood pressure, one of the causes of which may be gingivitis or periodontal disease.

 Any inflammation, even of oral origin, is a risk factor for premature delivery.

There is no need to be alarmed: gingivitis is treatable and the dentist will be able to give you the necessary advice while waiting for the birth.

If you are followed regularly, problems will be better anticipated before pregnancy. This includes regular descaling and routine examinations. It is therefore important to reinforce dental hygiene before pregnancy (in case you plan it).

As soon as you become aware of your pregnancy, make an appointment with your dentist. You will have peace of mind about the condition of your oral cavity and the potential for bacterial transmission to your baby.

A visit to your dentist during the fourth month of pregnancy is recommended to prevent any discomfort due to cavities, aggravation of possible gingivitis or any risk of infection.

In general, at home:

• Brush your teeth after each meal and floss at least once a day. The latter removes bacterial plaque from between the teeth. Change your (soft) toothbrush every three months;
• Reduce the consumption of foods with added sugar, as they promote the development of bacterial plaque;
• If you vomit, always rinse your mouth with water with baking soda or with a mouthwash.

In practice, any dental problem must be treated by the dentist, ideally before pregnancy, but many dental treatments can also be undertaken for pregnant women during pregnancy.