Pregnancy Gingivitis: Are Bleeding Gums Normal During Pregnancy?

Fortunately, having sore and bleeding gums while you’re expecting (known as pregnancy gingivitis) is nothing to freak out about. You’re definitely not alone on this leg of the trip toward motherhood.

Let’s get into the details of this less glamorous aspect of pregnancy, including what causes gingivitis and how you can minimize your discomfort with good oral health practices.

As frustrating as bleeding gums can be, especially if you’re already contending with other uncomfortable pregnancy symptoms, they’re often a normal part of carrying a baby.

You certainly wouldn’t be the first to deal with pregnancy gingivitis, with the American Dental Association (ADA) estimating that 60%–75% of pregnant women experience it. 1

Technically, pregnancy gingivitis is the first stage of periodontal disease, also called gum disease. Luckily, this first stage is easily reversible with proper dental care. 2

What causes bleeding gums during pregnancy?

As with many pregnancy symptoms, you can put the majority of the blame on your surging hormones, especially progesterone. This hormone makes your gums more sensitive and vulnerable to inflammation and the buildup of plaque. Your inflamed gums are more likely to bleed when you brush or floss. 3

Other factors that also make bleeding gums more likely when you’re pregnant include: 3 4

• Increased blood volume: When you’re pregnant, your blood volume increases by about 1250 ml (42.27 oz). 5 With that increased volume comes extra blood flow to your mouth’s mucus membranes, causing your gums to become swollen and vulnerable to bleeding in response to the bacteria in plaque.
• Morning sickness: If you’re dealing with the dreaded morning sickness (nausea) during pregnancy, stomach acid can weaken the enamel on your teeth, which, in turn, can cause bleeding gums and tooth decay.
• Poor oral hygiene: It’s no secret that pregnancy can be exhausting. If you’re constantly battling pregnancy fatigue, it’s easy to let your oral hygiene fall by the wayside. However, this will only exacerbate any existing dental concerns you already have.

When does gum bleeding start during pregnancy?

Bleeding gums can hit at any point during your pregnancy, but they become more noticeable when your hormone levels peak during your second trimester.

Don’t be surprised if you run into this issue sooner, though, as some women report gum tenderness as early as the second month. In fact, other than missing your period and getting a positive pregnancy test, this can be one of the first signs that you have a baby on the way. 3

While you can’t change your hormonal levels during pregnancy, you can often reduce your risk of pregnancy gingivitis by maintaining good oral hygiene.

Be sure to: 6

• Brush gently and thoroughly: Brush your teeth at least 2 times a day (especially after meals) with a soft-bristle toothbrush and fluoride toothpaste. Gentle brushing is key here. Being too aggressive with your scrubbing will irritate your sensitive gums and worsen bleeding.
• Break out the floss: This helps remove plaque and food in areas your toothbrush can’t reach.
• Address morning sickness: After vomiting, clear your mouth with a mixture of water and a teaspoon of baking soda. Give it about 30 minutes to settle and then brush your teeth. This will keep stomach acids from eroding your tooth enamel and making it more susceptible to damage. 7
• Consider an alcohol-free mouth rinse: This reduces bacteria and plaque and provides an extra layer of protection against gum disease.

Consider documenting your routine in a pregnancy tracker app with notes and pictures so that you can accurately report any concerning gum changes to your doctor or dentist.

Other ways to look after your teeth and gums during pregnancy

Outside of regularly brushing and flossing your teeth, you can look after your teeth and gums by maintaining a pregnancy diet full of vitamin C and calcium. You should also do your best to limit sugary foods and drinks to prevent plaque from forming and reduce mouth bacteria. 6

If you’re dealing with bleeding gums, you can rinse your mouth with a mix of warm water and half a teaspoon of salt to kill bacteria and reduce inflammation.

While pregnancy gingivitis is common, it can lead to complications if you don’t address it right away.

As mentioned, gingivitis is the first stage of gum disease. If left untreated, gum disease can lead to loose teeth and, eventually, tooth loss.

Book an appointment if you have: 8

• Persistent toothaches: This can signal a cavity, infection, or other problem needing prompt treatment.
• Painful gums that bleed frequently: If your gums are extremely tender, bright red, swollen, or bleeding, even with gentle brushing and flossing, you might have a more serious gum infection. Also, look out for gums that pull away and expose more of the tooth root.
• Persistent bad breath: If brushing, flossing, and mints don’t dent the stench, it could be a sign of an underlying condition that your dentist needs to check out.
• Growths in your mouth: Watch out for red, nodular-like bumps on your gums. These are called pregnancy tumors (pyogenic granulomas). While they’re usually painless, they can become uncomfortable if they get large enough to disrupt chewing or brushing. Such growths typically disappear after your baby arrives.
• Numbness in the mouth: This isn’t directly related to gingivitis, but losing sensation or feeling tingling in your mouth might signal nerve damage or another serious medical condition. If you have this symptom, get checked out promptly.

Your dentist can recommend pregnancy-safe treatments ranging from prescription mouthwashes to antibiotics. Let them know how far along you are in your pregnancy and if you have any allergies.

Can pregnancy gingivitis affect your baby?

While mild pregnancy gingivitis isn’t a threat to your little one, experts have linked more severe gum disease to complications like preterm labor, low birth weight, and preeclampsia.

However, studies are still ongoing and some have returned conflicting results, so your best bet is to discuss any concerns with your doctor. 9

Fortunately, there’s a light at the end of the tunnel when it comes to pregnancy gingivitis. After you give birth, your gums should return to normal, along with any bleeding and sensitivity. 10

If you find that your gums are still swollen or bleed frequently after delivering your baby, book an appointment with your dentist.

Like most of the body changes upending your life during pregnancy, your bleeding gums and other symptoms of pregnancy gingivitis should resolve on their own after you give birth.

In the meantime, practice good oral hygiene habits at home and stop by your dentist for some extra care. As long as you’re proactive, your winning smile will be ready to go when your baby arrives.