Morning sickness and your teeth

What does acid do to a tooth?

Stomach acid is considerably stronger than anything you would drink, and enamel dissolves in it. The Victorian Government's Better Health Channel puts it plainly: repeated reflux and vomiting can damage the surface of the teeth and increase the risk of decay.

It happens in a particular pattern. Enamel does not chip away in pieces, it thins, so the first signs are subtle: edges that look slightly see-through, surfaces that feel smoother than they used to, teeth that look a little yellower because the layer underneath is showing through, and sensitivity that creeps up. Most people do not notice any of it. A dentist looking at your teeth every six months notices the change.

What should you do straight after vomiting?

The instinct is to brush immediately, and it is the wrong one. Acid leaves the enamel surface temporarily softened, and brushing a softened surface takes some of it away. You would be scrubbing at the damage rather than cleaning it.

Australian health guidance gives a clear sequence instead:

• Rinse thoroughly with plain tap water. This is the part that matters most and it is always available.
• Follow with a fluoride mouthwash if you have one.
• Wait an hour before brushing. Both Better Health Channel and the Australian Dental Association give the same instruction.

A practical variation some people find easier: rub a smear of fluoride toothpaste onto the teeth with a finger and do not rinse it off. It leaves fluoride against the enamel while it recovers, without any scrubbing.

If you are being sick several times a day, keep water and a fluoride mouthwash where it actually happens, rather than in the bathroom cabinet.

Reflux counts too

Vomiting is obvious. Reflux is the quieter version and it is easy to dismiss as just another pregnancy annoyance, particularly when it happens at night.

For teeth it does the same kind of damage, spread over more occasions, and night-time reflux is worse in one respect: saliva flow drops while you sleep, so there is less to wash the acid away. If you have heartburn most days, mention it to your doctor or midwife as well as to us, because managing the reflux is more useful than managing its consequences.

Cravings, grazing and decay

Pregnancy often changes both what you eat and how often. The frequency is the part that matters for teeth: each time you eat or drink something sweet, the acid attack restarts, so six small snacks do more damage than one larger one.

Better Health Channel suggests avoiding sugary snacks where you can, and rinsing with a fluoride mouthwash or brushing afterwards. Two things we would add from what people actually find workable: water after a snack rather than a plan to snack less, and watching fruit juice and soft drink in particular, since they bring their own acid alongside the sugar.

None of this is a lecture about what to eat while pregnant. Eat what you can keep down. Just rinse afterwards.

What can be done about wear that has already happened?

Enamel that has gone does not come back. That is why the priority is stopping the process rather than repairing it.

Where wear has already made teeth sensitive, thin at the edges or noticeably shorter, it can usually be rebuilt with tooth-coloured material bonded onto the tooth, which removes nothing further. Composite bonding covers that. Timing is worth discussing: often the sensible order is to protect and monitor during the pregnancy, then rebuild afterwards once the sickness has passed and the picture is stable.

Come and be looked at during the pregnancy rather than waiting until after the birth. Principal dentist Dr Fatima Kurnaz, a general dentist rather than a registered specialist, reviews the clinical information on this page, and dental care during pregnancy covers what else changes.