Sore and Bleeding Gums During Pregnancy

Your belly isn’t the only thing that’s swelling up these days. Your gums may also be extra tender, swollen, red, sensitive and prone to bleeding during pregnancy, especially when you brush and floss.

Don’t panic — it’s pretty normal. Your gums and teeth will likely go back to the way they used to be after delivery, but it’s a good idea to up your oral health game now.

When do your gums usually start bleeding during pregnancy?

Expect to see plenty of pink on your toothbrush during the second trimester. The same pregnancy hormones that cause your mucus membranes to swell and your sinuses to clog up also inflame your gums from around week 15 of pregnancy on, making them more likely to bleed easily.

What causes sore and bleeding gums during pregnancy?

Several factors could be contributing to your swollen gums and sore mouth during pregnancy:

• Surging hormones, swelling gums. No surprise here: Hormones are the likeliest culprit. They'll also leave your mouth more vulnerable to bacteria and plaque, both of which make for tender gums during pregnancy — and can cause gingivitis and tooth decay in some women if not treated properly.
• Changes to your mouth and eating habits. You may also be producing less saliva during pregnancy and eating more sweets and carbs, creating an oral environment that’s friendlier to plaque and cavities.
• Delayed reaction to morning sickness. If you experienced morning sickness with vomiting earlier in your pregnancy, your teeth and gums could be feeling the temporary effects of those less-than-pleasant acid baths. Aren’t you glad that’s over?
• Your newly finicky senses. Finally, you could simply be super sensitive to the smell or taste of mint during pregnancy. Having an aversion to oral care products isn’t all that common, but studies suggest this could help explain why some pregnant women avoid their usual brushing and rinsing routines. A more sensitive gag reflex might also be to blame.

What can I do about bleeding gums when I'm pregnant?

First, you’ve got a lot going on, so don’t worry too much about your gums. But there are simple steps you can take now to deal with this pregnancy symptom:

• Get checked. Try to visit your dentist at least once during your pregnancy for a checkup and cleaning — but be sure to tell your dentist and the hygienist you're pregnant. They’ll partner with you to make sure you get the pregnancy-safe care you need.
• Take care of your teeth. The rule of thumb: Brush twice a day for two minutes and floss on a regular basis. But don't confuse being thorough with being aggressive — your brush should be labeled “soft,” never “medium” or “hard.” You can use either a manual or an electric toothbrush, but be gentle. Overaggressive brushing and flossing can make tender gums even more sensitive and prone to bleeding. If the smell of mint makes you gag, try a fruit-flavored toothpaste designed for kids, or even baking soda. If those don’t appeal to you, ask your dentist to recommend another product.
• Brush your tongue. It’s not just your teeth that need care — brushing your tongue also helps minimize the amount of bacteria in your mouth.
• Swish it out. Ask your dentist to recommend a non-alcoholic “therapeutic” mouthwash — one that strengthens teeth, and doesn’t just freshen your breath — or rinse you can use daily to reduce bacteria and plaque in your mouth between brushings.
• Remember to rinse. If you're suffering from morning sickness during pregnancy, make sure to brush — or at least rinse — your teeth and mouth if you're throwing up. It'll not only get rid of the gross taste in your mouth, but it'll also remove the acid and bacteria that comes with getting sick.
• Eat right. Make sure you get plenty of vitamin C in your diet, which can strengthen gums and help them stay healthy. And fulfill your calcium requirement every day to keep your teeth and bones strong.
• Skip the sweets. While we support your right to reach for any foods you crave these days within reason, try to avoid too many sugary treats when possible. If you have to pick and choose, steer clear particularly of the chewy kind of sweets, especially when you won't be able to brush your teeth soon after indulging. Feed your sweet tooth with nutrient- and fiber-rich whole fruit if possible. Keep in mind that dried fruit, while a fairly healthy snack, also acts like sugar on your teeth — and because it's chewy, can stick in places you'd rather it didn't. So make sure your trail mix contains plenty of protein-packed nuts or that you chase it down with a piece of cheese (see below).
• Chew on it. Can't brush after a meal? Try chewing a piece of sugarless gum or, unless you're allergic, grabbing a handful of nuts or a small chunk of cheese. All have antibacterial properties.

Can I prevent bleeding gums during pregnancy?

Probably. Getting regular dental checkups and cleanings is as important during pregnancy as ever. But research suggests that some women skip the dentist when they're expecting. The reasons: They’re already dealing with nausea or acid reflux and don’t relish the thought of someone sticking something in their mouth, or they have an irrational fear of the effects of dental procedures on their baby-to-be.

Now is no time to let your oral health slide, though. Taking extra good care of your choppers and gums during pregnancy means both will stay strong and healthy longer.

When can I expect my gums to stop bleeding while I'm pregnant?

After delivery. While pregnancy does pose some risk to your mouth, if your gums were fine before you got pregnant, they’re likely to be fine after. In fact, the largest studies show that there are no major statistical differences in the prevalence of gum disease or cavities in pregnant and non-pregnant women.

When should I call the doctor or dentist about bleeding gums during pregnancy?

Some gum tenderness is normal, but if yours are bright red, very sore, and bleed easily — say, your toothbrush has taken on a pink tinge, or you're spitting blood out when you rinse — you may have gingivitis, or inflammation of the gums that’s mild and relatively harmless.

But gingivitis can eventually develop into the more serious but treatable condition called periodontitis, which you should tell your practitioner about. Research has also shown that periodontitis during pregnancy may increase the risk of going into premature labor, having a low birth weight baby, or even being diagnosed with preeclampsia.

If you notice a nodule on your gums that bleeds when you brush, have your dentist take a peek. It’s most likely either a canker sore or a pyogenic granuloma, also known as a “pregnancy tumor” — a scary term despite the fact that it’s totally harmless.

These small, round red bumps appear in about 5 percent of pregnant women, and can actually pop up all over your body during pregnancy — including on your arms, hands and face — but are especially common on your gums. It should usually regress on its own after delivery, though if it becomes especially annoying before then, it can usually be surgically removed.