Patient Guide
Dental care during pregnancy
Check-ups, cleanings and most dental treatment are safe during pregnancy, and your gums will thank you for keeping them. Here is what changes, what is safe, and what we prefer to postpone.
Reviewed by Dr. Ray Han, General Dentist, Dentistry at Vitality Health
Yes, dental care is safe during pregnancy, and it is recommended. Check-ups and cleanings can and should continue, and problems such as cavities or infections should be treated rather than left to wait. The second trimester is the most comfortable time for anything elective, and we postpone purely cosmetic work, such as whitening, until after the baby arrives.
Pregnancy changes your mouth. Hormones make the gums more sensitive to plaque, morning sickness bathes the teeth in acid, and cravings and snacking can raise the risk of cavities. Ontario dental and dental hygiene guidance is clear that pregnant patients should not be denied oral health care, and that looking after your mouth is part of looking after your pregnancy.
This page answers the questions we hear most: what to tell us, what is safe, why your gums bleed, how to protect your teeth from morning sickness, and what the evidence says about gum disease and pregnancy outcomes.
What should I tell the dental team?
Tell us as soon as you know you are pregnant, or if you are trying to become pregnant. Let us know how far along you are, whether your pregnancy is considered high-risk, the name of your obstetrician or midwife, and every medication and supplement you take. That lets us time treatment well, choose medications carefully, and check with your care provider if anything is unusual.
Also tell us if you have nausea, if lying back makes you dizzy or breathless, or if you need frequent bathroom breaks. We can shorten appointments, sit you more upright, and let you turn onto your left side, which relieves pressure on the large blood vessels in later pregnancy.
Are cleanings and check-ups safe?
Yes, at every stage. A professional cleaning is one of the most useful things you can do during pregnancy, because it removes the plaque and hardened tartar that inflamed gums react to. Many pregnant patients benefit from a cleaning every three to four months rather than every six until the baby is born.
Bring your questions. This is a good time to review your brushing and flossing, because the gums will be more reactive than usual for the next several months. Our home care guide covers technique in detail.
Why do my gums bleed more now?
About half of pregnant women develop pregnancy gingivitis: gums that are red, puffy and bleed easily when brushed. Rising levels of the hormones estrogen and progesterone increase blood flow to the gums and change the way they respond to plaque. It usually begins in the first trimester and peaks in the third.
The plaque is still the cause; the hormones just amplify the reaction. Thorough, gentle daily cleaning and more frequent professional cleanings keep it in check, and it settles after delivery. Left alone, gingivitis can progress to periodontitis, the deeper form of gum disease that damages the bone around the teeth. Occasionally a small, red, easily bleeding lump appears on the gum between two teeth, known as a pregnancy tumour. Despite the alarming name it is harmless and usually shrinks after the birth, but let us look at it. Read more about bleeding gums.
How do I protect my teeth from morning sickness?
Stomach acid is strong enough to soften tooth enamel. Brushing immediately after vomiting scrubs that softened surface away. Instead:
- Rinse your mouth with water, or with a teaspoon of baking soda stirred into a cup of water, to neutralize the acid.
- Wait about 30 minutes, then brush gently with fluoride toothpaste.
- If toothpaste itself triggers nausea, try a milder flavour, a smaller amount, or brushing at a different time of day, but do not stop brushing.
- If you are snacking often to manage nausea, choose foods low in sugar where you can, and rinse with water afterwards.
Frequent vomiting or acid reflux over several months can leave teeth sensitive. Tell us; a fluoride varnish or a prescription-strength toothpaste can help.
Are x-rays, freezing and fillings safe during pregnancy?
Dental x-rays. The dose from a dental x-ray is very small, and the beam is aimed at the mouth, well away from the abdomen. Ontario guidance is that dental imaging does not increase risk to the baby when it is done with care: a lead apron over the abdomen, a thyroid collar, and a narrow beam. Even so, in line with the Canadian Dental Association's position, we take the minimum number of x-rays needed to diagnose or treat a problem during pregnancy, and we defer routine check-up x-rays until after the birth. Our digital x-rays use a fraction of the dose of older film.
Local anaesthetic (freezing). Standard dental anaesthetics, including those with epinephrine, are considered safe in pregnancy and have been used for decades. Being properly numb also matters: pain and stress are worse for you and the baby than the anaesthetic. If needles worry you, see our page on fear of needles.
Fillings, root canals and extractions. Treating a cavity or an infection is safer than leaving it. An untreated dental infection can spread and may need antibiotics or urgent care later in the pregnancy. The second trimester is the most comfortable time for planned treatment; urgent problems are treated whenever they arise.
Medications. Acetaminophen is the usual choice for pain. Most common dental antibiotics are considered safe. We avoid certain drugs, such as tetracyclines, and we will check with your care provider when there is any doubt.
What do you usually postpone?
Anything that is purely elective or cosmetic waits until after the baby arrives, not because it is proven harmful, but because there is no reason to take even a small uncertainty when the treatment can simply wait. That includes teeth whitening, veneers, elective crown replacement, and cosmetic gum procedures.
Large planned procedures, such as implant surgery or extensive reconstruction, are also usually deferred. If a tooth cannot be saved during pregnancy we will remove it and protect the site for a future implant, then plan the implant once you are ready.
Common myths, corrected
“You lose a tooth for every baby”
Not true. The baby does not draw calcium from your teeth. Tooth loss in pregnancy comes from untreated gum disease and cavities, both of which are preventable with care that is safe to receive.
“Avoid the dentist until after the birth”
The opposite is recommended. Pregnancy raises the risk of gum problems, so this is a time for more attention to the mouth, not less. Postponing care lets small problems become urgent ones.
“Freezing and x-rays harm the baby”
Standard local anaesthetics and properly shielded dental x-rays are considered safe. We still use x-rays only when they change your treatment, and we shield you every time.
Does gum disease affect pregnancy outcomes?
Studies have found that women with periodontitis are more likely to have babies born early or with a low birth weight. What is less clear is whether the gum disease causes those outcomes, or whether both share other causes. Trials that treated gum disease during pregnancy have been mixed: reviews describe low-quality evidence that treatment may reduce low birth weight, and no clear effect on preterm birth.
Our position is the cautious one. Treating gum disease in pregnancy is safe and is good for your own health, whatever it may or may not do for the birth. We do not claim it will change your pregnancy outcome. We do recommend that you keep your gums healthy throughout.
Common questions
Which trimester is most suitable for dental treatment?+
Cleanings and urgent care are fine at any stage. For planned, non-urgent treatment the second trimester (weeks 14 to 27) is preferred: nausea has usually settled, and lying back is still comfortable. In the third trimester we keep appointments short and sit you more upright.
Should I keep my six-month check-up while pregnant?+
Yes, and consider an extra cleaning. Pregnancy gingivitis affects about half of pregnant women, and more frequent cleanings are the simplest way to keep it under control.
Is it safe to have a tooth removed during pregnancy?+
Yes, when it is needed. An infected tooth is a greater risk to you than the extraction. We will coordinate with your care provider if your pregnancy is complicated, use standard local anaesthetic, and choose pain relief and any antibiotics that are considered safe in pregnancy.
Can I have my teeth whitened while pregnant?+
We recommend waiting. Whitening has not been shown to be harmful, but it is purely cosmetic, so there is no reason to do it before the baby arrives. Book it for a few months after the birth.
Does the baby take calcium from my teeth?+
No. Calcium for the baby comes from your diet and, if needed, from your bones, not from your teeth. Tooth problems in pregnancy are caused by plaque, acid and sugar, all of which you can manage.
Sources: College of Dental Hygienists of Ontario: Advisory on pregnancy · Canadian Dental Association: position on control of x-radiation in dentistry · Iheozor-Ejiofor Z, et al. Treating periodontal disease for preventing adverse birth outcomes in pregnant women. Cochrane Database of Systematic Reviews 2017
Expecting? Book a cleaning.
Tell us you are pregnant when you book and we will plan the visit around you. Call (905) 479-7777.