Welcome to the second trimester! Your trusted guidebook says this is going to be the most comfortable phase of your pregnancy, and you’re looking forward to it. Radiating a spirit of confidence, you begin the day with your toothbrushing routine. All of a sudden, your effervescent demeanor seems to be replaced by a sense of uneasiness. You realize that what you’ve just rinsed out looks unmistakably blood-tinged! Leaning toward the mirror, you peer anxiously into your mouth. If your gums look noticeably redder and slightly swollen, don’t panic. Unfortunately, gum infections can be a common problem during pregnancy. Here’s what you need to know about pregnancy, gum infections, and neonatal health.

Pregnancy and Gum Infections

Pregnancy itself doesn’t cause gingivitis or gum inflammation. The hormonal changes during pregnancy alter the response of the gum tissues to oral bacteria.⁴ Increased levels of estrogen and progesterone can dilate the small blood vessels present in the gums and make them more permeable.^4,5 These mechanisms increase the risk of inflammation, leading to a condition called “pregnancy gingivitis.”^1,4

If left untreated, this condition may worsen and involve the deeper supporting tissues, leading to gum disease.⁴ Gum infections are silent infections that go undiagnosed until irreparable damage occurs.⁶ One or more of the following changes may become noticeable from the second or third month of pregnancy and increase in severity by the eighth month:^4,7,8,9,10

• Redness, tenderness, and swelling of the gums
• Bad breath
• Gums that bleed when brushing, flossing, or eating
• Discharge from gums
• Tooth mobility
• Inflammatory overgrowths on the gums (In some cases, these may occur in response to bacterial irritation. If these growths interfere with the bite, ulceration and pain may occur.)

Gum Infections and Neonatal Health

Multiple studies have reported that bacteria associated with gum disease in pregnant women have the ability to increase the levels of certain inflammatory mediators in the blood circulation.^2,11,12 These, in turn, can affect neonatal health by stimulating dilation of the cervix and labor, leading to premature births and low birth weight babies.^5,12,13

Pregnancy complications like this are a source of emotional trauma to the expectant mother and the family. For instance, one study from 2017 found that women who have experienced pregnancy complications may have a higher risk of heart and metabolic diseases later on.¹⁴ These types of complications also substantially escalate the nation’s health care costs. For instance, a 2021 report from The Commonwealth Fund shows that health complications from pregnancy have cost the United States billions of dollars.¹⁵

How To Maintain Healthy Gums During Pregnancy

Keeping your teeth and gums healthy and infection-free should be a part of everyone’s daily routine — but especially pregnant women.¹⁶ Here are some tips for maintaining a healthy mouth and gums during your pregnancy from the Journal of Midwifery & Women’s Health:³

• Brush your teeth twice a day using a soft-bristled toothbrush (since your gums are likely tender).¹⁷
• Floss once per day.
• Chew gum that’s sugarless or has xylitol (can do this up to a few times a day).
• If you vomit, rinse your mouth afterward with a teaspoon of baking soda mixed in a cup of water.
• Limit your sugar intake, including foods and drinks that are high in sugar.
• Choose healthy and nutritious snacks like fruits, vegetables, yogurt, or cheese.¹⁸
• Avoid beverages that are carbonated.¹⁹

Be sure to let your dentist know if you’re pregnant. Most dental work can be done safely at any point during pregnancy, so don’t let fear keep you from seeing your dentist regularly.²⁰ In fact, it may be more important to visit your doctor during your pregnancy so they can make sure your teeth and gums (and, therefore, your growing baby) are getting the care.