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# 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.

Updated Nov 12, 2026

## Key points

- Dental care is safe in pregnancy; elective work in the second trimester.
- Lidocaine with adrenaline is safe; paracetamol is the analgesic of choice.
- Do not delay treatment of dental infection.

## 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.

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## Connections

## Related 4

- [Gingivitis: bleeding gums](https://durgical.com/en/dentistry/gingivitis-bleeding-gums/)
- [Local anaesthetics in dentistry](https://durgical.com/en/dentistry/local-anaesthetics-in-dentistry/)
- [Analgesics for dental pain: NSAIDs first, opioids last](https://durgical.com/en/dentistry/analgesics-for-dental-pain-nsaids-first-opioids-last/)
- [Dental imaging: bitewing, periapical, panoramic and CBCT](https://durgical.com/en/dentistry/dental-imaging-bitewing-periapical-panoramic-and-cbct/)

## Related conditions 2

- [Periodontitis](https://durgical.com/en/conditions/periodontitis/)
- [Dental caries](https://durgical.com/en/conditions/dental-caries/)

## In Pharmacology 3

- [Lidocaine](https://durgical.com/en/pharmacology/lidocaine/)
- [Paracetamol](https://durgical.com/en/pharmacology/paracetamol/)
- [Amoxicillin](https://durgical.com/en/pharmacology/amoxicillin/)

[← All of dentistry](https://durgical.com/en/dentistry/)

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](https://www.ncbi.nlm.nih.gov/books/NBK557422/) (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](https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/DE/DIJ/resolucion-3280-de-2018.pdf) (Ministerio de Salud y Protección Social de Colombia, 2018); [Local Anesthetic Drugs Used In Dentistry](https://www.ncbi.nlm.nih.gov/books/NBK610935/) (StatPearls Publishing (NCBI Bookshelf), 2025).

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Representative model, for educational purposes only.

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/dentistry/pregnancy-and-oral-health/