Bleeding gums in pregnancy: what is safe to treat and when

What is safe, and when

Professional cleaning and treatment of inflamed gums are safe at any stage of pregnancy, and the second trimester is simply the most comfortable time to lie in a chair. Local anaesthetic is used routinely during pregnancy. Routine X-rays are deferred, and taken with shielding only where a diagnosis genuinely depends on them. Elective cosmetic work is postponed. Leaving an infection untreated out of a vague fear of dental care is the greater risk here.

Why gums bleed from the second month onwards

Pregnancy does not cause gum disease, but it strongly exaggerates the response to plaque that is already there. Rising oestrogen and progesterone increase the permeability of the small blood vessels in the gum and shift the bacterial balance inside the pocket, so the same amount of plaque produces far more swelling and bleeding than it did before. It usually begins around the second month, peaks in the third trimester, and settles within a few months of delivery.

The lump that alarms people

A pregnancy epulis, sometimes called a pregnancy tumour, is a soft red overgrowth that appears on the gum between two teeth, bleeds easily and looks far more sinister than it actually is. It is benign, and it usually shrinks after delivery, so it is removed during pregnancy only when it interferes with eating or bleeds persistently. What it does tell you is that the gum underneath is inflamed and cleaning around that area is not working.

Our honest advice about travelling

If you are pregnant and your gums are bleeding, treat it where you live rather than booking a flight. Periodontal inflammation has been associated with preterm birth and low birthweight, although whether treating it during pregnancy changes those outcomes is not settled, which is an argument for prompt local care, not for a medical trip. A course beginning now near home is worth more than a better price in three months.

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