Bleeding gums during pregnancy

For many women, the less pleasant experiences during pregnancy include bleeding gums. They are often the first sign of inflammation. Pregnant women have an increased risk of developing inflammation of the gums: around 60 to 75 per cent are affected¹. Since inflammation is such a common occurrence, it is also referred to as pregnancy gingivitis.

Bleeding and inflammation of the gums are not usually harmful to the mother or the unborn baby. But they should not be ignored either. If left untreated, gingivitis can develop into periodontitis, which damages the periodontium and, in the worst cases, can lead to tooth loss.

This article describes measures you can take to help maintain healthy gums. It also includes tips on what to look out for in your dental hygiene routine when you are pregnant and detailed information on the topic of inflammation and bleeding of the gums during pregnancy.

1. What to do if you suffer from bleeding gums during pregnancy
2. When to see a dentist during pregnancy
3. Causes of bleeding gums during pregnancy
4. Are bleeding and inflammation of the gums during pregnancy harmful?
5. What other dental problems can occur during pregnancy?

Hormonal changes during pregnancy increase blood flow to the gums, making them more sensitive. As a result, they can bleed more quickly when touched or if they come into contact with hard objects. Typical situations where gums start to bleed include:

• Cleaning the teeth
• Using dental floss
• Eating harder foods – such as when biting into an apple

If toothpaste becomes mixed with blood while brushing, many pregnant women instinctively cut their daily oral hygiene routine short. That is exactly what not to do! If plaque and harmful bacteria are not properly removed, they can spread, penetrate into the soft tissue of the gums and cause inflammation.

Daily oral care routine during pregnancy

In order to prevent or minimise bleeding of the gums and stop them becoming inflamed, pregnant women should ensure that they have a gentle but thorough oral care routine. Below, we have summarised a few tips on how you can gently care for your teeth and gums every day, not just during pregnancy but also after the birth:

Other tips and home remedies for inflamed gums during pregnancy

There are other ways to help keep teeth and gums healthy besides dental care. Nutrition in particular has an impact on the health of teeth and gums.

• Balanced and nutritious diet: Bleeding gums are often a sign of a vitamin C deficiency. During pregnancy, the body needs a third more vitamin C to absorb the much needed iron from food. So make sure your meal plan includes plenty of fruit and vegetables.
• Reduce sugar: Try to avoid sugary drinks and foods where possible. These attack the enamel that is already weakened during pregnancy.
• Home remedies: Gentle massages with a finger can help strengthen the gums and prevent inflammation. Camomile tea also soothes and disinfects bleeding and inflamed gums.

Whether you are experiencing bleeding gums or just want a check-up, you should make a dentist appointment in the first trimester of your pregnancy to have the health of your gums checked and other dental diseases treated early on.

You can usually receive the dental treatment you need during pregnancy. Local anaesthesia is generally safe. Your dentist can select an anaesthetic that is suitable for use during pregnancy. However, larger procedures should be performed before pregnancy or postponed until after pregnancy.

If you suffered from gum problems before becoming pregnant, you should let your dentist know and ensure regular check-ups. In addition, antenatal care in some countries includes a consultation on oral health with your midwife or doctor.

Did you know?
The risk of gingivitis (inflammation of the gums) continues to increase up to the last trimester of pregnancy. Gum health usually returns to normal after the birth. To be on the safe side, you should go for a dental check-up at the beginning of your pregnancy as well as at the end and also ensure that you are diligent with your dental care at home.

Why do the gums bleed more easily during pregnancy? Hormone levels change during pregnancy. The body produces large quantities of oestrogen and progesterone. These two hormones are important for the healthy development of the baby. However, they do affect the health of the gums:

• Oestrogen causes inflammation to develop in the gums
• Progesterone promotes chronic inflammation processes

Additionally, the tissue becomes softer and there is an increased blood flow to the gums. This causes them to become softer, more sensitive and to bleed more easily.

At the same time, they become more susceptible to infections as bacterial plaque can colonise more easily on the gums and in the gingival pockets. As a result, bleeding can be a symptom of inflammation of the gums that can develop into periodontitis (gum disease) if left untreated.

Normally, bleeding gums are not harmful to either the mother or the unborn baby. Pregnant women can also prevent the gums from bleeding and bleeding can usually be controlled with simple measures.

If the gums bleed heavily and frequently during pregnancy and are swollen and dark red, it is imperative that pregnant women see their dentist, as this may be a sign of inflammation.

If the gums have been inflamed over a longer period of time, this can cause deeper gingival pockets to form where bacteria can collect and avoid being removed by daily brushing.

As a result, the inflammation of the gums increases and can also attack the periodontium. Even the jawbone can regress and the molars or incisors can become loose. In the worst cases, the affected teeth have to be removed.

“Gain a child, lose a tooth”
Have you come across this myth? We can put your mind at ease since there is no scientific evidence for a direct link between pregnancy and tooth loss. In fact, many factors contribute to the deterioration of oral health in pregnant women.

Periodontitis and premature birth

Earlier studies assumed that untreated gingivitis could affect the development of the unborn baby. Periodontitis was long considered a risk factor for premature births and was associated with a low birth weight of the infant.

More recent findings cast doubt on this and have not found any link between pregnancy gingivitis and an increased risk of a premature birth. However, a possible link has not yet been conclusively established.

Still, early preventative measures should be a top priority in oral care for pregnant women. This includes thorough oral hygiene with the daily use of toothpaste and mouthwash that support the health of the gums as well as regular visits to the dentist during pregnancy.

Sensitive teeth

Morning nausea and sickness are common symptoms during pregnancy. Morning sickness can start in the first weeks of pregnancy and last for several weeks or even up to the birth. During this time, several dental and gum problems can occur:

The acidic pH of the gastric acid attacks the tooth enamel. In addition, the gums become irritated, which can cause inflammation. Pregnant women with reflux problems also often suffer from sensitive teeth. This is because the necks of the teeth are exposed due to frequent vomiting and so external stimuli can directly reach the tooth nerve.

If you have been sick, you should wait before brushing your teeth. The acidic vomit attacks the enamel. It is best to rinse your mouth out with water or a mouthwash first. Then you can brush your teeth without damaging the enamel. Alternatively, sugar-free chewing gum can also leave your mouth feeling fresh.

Caries

Many pregnant women are particularly susceptible to caries. Cravings for sweet and sour foods increase the risk of acid damage and can literally cause a hole to develop in your tooth.

Even though the caries bacteria are not transmitted from mother to child during pregnancy, scientific studies have shown than the risk of caries in children is higher if they came into contact with these bacteria early on. The bacteria are often transmitted by saliva – for example by licking a dummy.

Therefore, carious teeth should ideally be treated before pregnancy or, at the latest, very soon after giving birth. During pregnancy, a thorough dental hygiene routine can prevent caries from developing or becoming worse.

Pregnancy epulis

In rare cases, a bump on the gums can occur during pregnancy. This benign growth is referred to by dentists as a pregnancy epulis or granuloma. It may cause pain, but usually goes away after the birth. It is rarely necessary for it to be surgically removed by a dentist after pregnancy.

Sources: 

1. Centers for Disease Control and Prevention: Pregnancy and Oral Health Feature | CDC