Pregnancy and Gum Health: Why Gums Change and What to Do
For anyone pregnant with sore, swollen or bleeding gums: pregnancy gingivitis, pregnancy epulis, treatment safety and timing, morning sickness and general NHS entitlement. The NHS says it is important to get gum disease checked by a dentist. After vomiting, rinse and do not brush straight away.
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Clinically reviewed by Dr Ibraheem Ijaz, dentist · GDC 301711
Medical disclaimer: This page is for general information only. It does not replace an examination or treatment by a dentist.
Dr Ibraheem Ijaz, GDC 301711, a General Dental Practitioner and the principal dentist at Deepcar Dental Care, reviewed this page. His qualifications include BDS, BSc (Hons) and MSc (Leeds).
What is pregnancy gingivitis?
Pregnancy gingivitis is gum inflammation in pregnancy that leaves gums swollen, red and tender, and they may bleed when you brush or floss.
It is a form of gum disease; our page explains how gum disease develops. If not managed, the Oral Health Foundation warns, it can develop into more serious gum disease. The NHS says it is important to get gum disease checked by a dentist.
Why do gums change in pregnancy?
Gums change because pregnancy hormone changes can make them react more strongly to plaque, the Oral Health Foundation explains.
NHS inform (Scotland) says higher progesterone boosts blood supply to the mouth and makes gums more sensitive to bacteria. A 2013 systematic review of 33 studies confirmed that gum inflammation rises through pregnancy without a matching rise in plaque, on a limited number of pooled studies. However, a 2010 study of 48 pregnant women without periodontitis could not link this exaggerated inflammatory response to hormone levels in saliva.
When does pregnancy gingivitis start and settle?
A 2021 review says pregnancy gingivitis usually appears between the third and eighth month, and NHS inform says it should go away after the birth.
Leeds Teaching Hospitals says hormonal aggravation of existing gum disease starts in the first trimester, peaks in the final trimester, usually resolves soon after birth, and oral hygiene can often control it.
NHS guidance is to brush with fluoride toothpaste at least twice a day, spit without rinsing, and clean between your teeth every day.
What is a pregnancy epulis?
A pregnancy epulis is a small red swelling on the gum in pregnancy, also called a pregnancy tumour or pyogenic granuloma. The Oral Health Foundation says it is not cancer and often goes away after birth.
A 2008 review says it is usually watched unless it bleeds, interferes with chewing or does not resolve after delivery, and that lesions surgically removed during pregnancy are likely to recur.
Get a lump in your mouth checked by a GP or dentist, the NHS says; with gum disease, ask for an urgent dentist appointment.
When should you see a dentist about bleeding gums?
See a dentist if gums bleed when you brush or eat hard foods, are painful and swollen, or you have bad breath, the NHS says.
If you do not have a dentist or cannot get an emergency appointment, call 111 or visit 111 online. The NHS also advises:
- Gum disease and other symptoms such as very sore and swollen gums, teeth becoming loose or falling out, ulcers or red patches in your mouth, or a lump in your mouth or on your lip: ask for an urgent dentist appointment.
- Toothache lasting more than 2 days, not eased by painkillers, or with a high temperature, pain when you bite, red gums, a bad taste or a swollen cheek or jaw: see a dentist.
- Toothache with swelling around your eye or neck, or swelling in your mouth or neck that makes it difficult to breathe, swallow or speak: go to A&E. Do not drive; ask someone to drive you or call 999.
To ask about gum health, book online or call 0114 288 2121.
Is dental treatment safe in pregnancy?
Routine dental care, including gum treatment, is safe in pregnancy, the Oral Health Foundation says, though UK guidance advises avoiding unnecessary interventions as a precaution.
A 2013 European and American consensus found gum treatment safe, improving gum health without lowering premature birth or low birthweight rates overall. Cochrane's 2017 review of 15 trials, each at high risk of bias and mostly in periodontitis, found low-quality evidence that treatment may cut low birthweight under 2,500 g and no clear difference in premature birth. It found no adverse effects in the four trials that reported them, but was unsure about perinatal deaths (very low-quality evidence).
A 2008 analysis of women with periodontitis linked treating moderate to severe decay or fractured or abscessed teeth at 13 to 21 weeks with no increased risk, and called for larger studies.
When in pregnancy should you have dental treatment?
Urgent problems should be treated when they arise; for planned care, some reviews suggest the second trimester, while UK guidance advises postponing non-urgent restorative work.
- Pain or infection: the Scottish Dental Clinical Effectiveness Programme's (SDCEP) amalgam advice postpones non-urgent restorative work as a precaution but exempts urgent treatment.
- Second trimester: 2008 US and 2021 reviews favour it, while the American Dental Association says care is safe at any point.
The NHS advises regular check-ups, especially if you are pregnant. Speak to your midwife or GP about concerns beyond your teeth and gums.
What should you do after morning sickness?
After vomiting, rinse your mouth with water and do not brush straight away, because stomach acid softens enamel and brushing can damage the tooth surface.
Delivering Better Oral Health, the UK prevention toolkit, lists this among actions to consider for chronic vomiting in pregnancy with signs of tooth wear. Sources differ on the wait: at least 30 minutes, says the Oral Health Foundation, or about an hour, says an Oxfordshire NHS dental leaflet. The toolkit's tooth wear advice finds no strong evidence that toothbrushing timing is of great importance.
Our dental erosion page explains acid wear. The NHS says morning sickness usually clears up by weeks 16 to 20, and its page lists when to call your midwife, GP or 111.
Is NHS dental treatment free in pregnancy?
In England, NHS dental treatment is free if you are pregnant or have had a baby in the last 12 months.
This is general guidance from NHS and NHS Business Services Authority (NHSBSA) pages read on 1 November 2026.
- Timing: NHSBSA says this applies when you are accepted for your course of treatment.
- Proof: NHSBSA's list includes a maternity exemption certificate, which your midwife, doctor or health visitor applies for.
- Cover: NHS treatment only. You will need to pay for any private dental treatment, the NHS says, so check with your dentist which applies.
- Claims: NHSBSA says a penalty charge of up to £100 may apply if you claim when not entitled.
- After a stillbirth or miscarriage: the NHS list includes a stillbirth in the past 12 months, but NHSBSA's certificate page says you may need to pay NHS dental charges, so ask NHSBSA.
Where can you read more?
Our dental hygiene section covers hygiene appointments, and our gum disease and general health page sets out the research on pregnancy outcomes.
Frequently asked questions
Can gum disease in pregnancy affect the baby?
Scientists are still studying this. Periodontitis, the deeper form of gum disease, has been linked with premature birth, low birthweight and pre-eclampsia, but a 2013 European and American consensus calls the links modest, and the Oral Health Foundation says this does not mean gum disease directly causes these problems.
Can you have a local anaesthetic while pregnant?
Yes, the Oral Health Foundation says local anaesthetic for dental treatment is safe in pregnancy, and your dentist may choose one without adrenaline. A 2008 analysis of women with periodontitis found no link with adverse outcomes when used in gum treatment at 13 to 21 weeks, and called for larger studies.
Are dental X-rays safe during pregnancy?
Most dental X-rays need not wait for the birth, UK guidance says, but recommends offering to delay non-urgent ones. Our dental X-rays page explains why. A 2008 US review allowed acute diagnostic X-rays, advised delay past the first trimester when possible, and screening only after delivery. Tell the clinician if you are or might be pregnant, the NHS says.
Can amalgam fillings be placed or removed during pregnancy?
SDCEP's 2018 advice said UK rules restricted amalgam in pregnancy unless the dentist considered it strictly necessary. It cites mercury pollution and likely caution over even theoretical risk. It reports no evidence of harm from placing or removing it in pregnancy, but advises postponing non-urgent restorative work and removal, and finds evidence on alternatives' safety insufficient to guide urgent work.
Should you tell your dental team you are pregnant?
Yes, and what stage you are at, the Oral Health Foundation says. NHS guidance says your dentist should know before they prescribe or treat. Before taking any medicine, including painkillers, check with your pharmacist, midwife or GP that it is suitable, the NHS advises.
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