Pregnancy and oral health
- Mouth and systemic disease
Pregnancy inflames the gums and can cause a bleeding lump. Dental care is safe and recommended, best in the second trimester for elective work.
What it is
Hormonal changes in pregnancy amplify the gum's response to plaque, so gingivitis is very common, and a pyogenic granuloma (pregnancy epulis) may grow from the gum. Vomiting and reflux add acid erosion, and snacking increases caries risk. Untreated dental infection is a risk for the mother. Dental treatment, including local anaesthesia with lidocaine and adrenaline and necessary radiographs with shielding, is safe throughout pregnancy; elective work is best done in the second trimester, and emergencies are treated at any time. Colombia's maternal-perinatal pathway (Resolución 3280 de 2018) includes dental assessment during prenatal care.
Oral findings
- Pregnancy gingivitis and pyogenic granuloma are common and usually regress after birth.
- Local anaesthetics such as lidocaine with adrenaline are considered safe in pregnancy.
- Paracetamol is the analgesic of choice; NSAIDs are avoided, especially in the third trimester.
- Penicillins and cephalosporins are preferred antibiotics; tetracyclines are avoided.
- Rinse with water after vomiting and wait before brushing.
What the doctor does
- Delaying treatment of a dental abscess in pregnancy is more dangerous than treating it.
- Late in pregnancy, lying flat can compress the vena cava: tilt the patient to the left.
- Mothers with active caries can transmit cariogenic bacteria to their infants.
Next step / Initial management
- Refer every pregnant woman for dental assessment as part of prenatal care.
- Dental pain or infection: treat at any stage of pregnancy; refer promptly to the dentist.
- Advise twice-daily fluoride toothpaste, limiting sugar, rinsing after vomiting, and a dental visit for the baby by the first birthday.
Test yourself
Think of the answer, then tap the question to see it.
When is elective dental treatment best performed in pregnancy?
In the second trimester; emergencies are treated at any time.
Which analgesic is preferred for dental pain in pregnancy?
Paracetamol (acetaminophen); NSAIDs are avoided, especially in the third trimester.
Why should a pregnant patient be tilted to the left in the dental chair late in pregnancy?
To avoid compression of the inferior vena cava by the uterus, which causes hypotension.
Connections
In Pharmacology3
Educational content; it does not replace assessment by a dentist or doctor and is not a clinical instruction. For facial or neck swelling with difficulty swallowing or breathing, a knocked-out tooth or bleeding that will not stop, go to an emergency department at once.
Sources: Gingivitis (StatPearls Publishing (NCBI Bookshelf), 2026); Resolución 3280 de 2018: Rutas Integrales de Atención en Salud para la Promoción y Mantenimiento de la Salud y Materno Perinatal (Ministerio de Salud y Protección Social de Colombia, 2018); Local Anesthetic Drugs Used In Dentistry (StatPearls Publishing (NCBI Bookshelf), 2025).
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Representative model, for educational purposes only.