Pregnancy · gum changes
Pregnancy gingivitis: why are my gums bleeding?
Hormonal changes in pregnancy make gums respond more strongly to the same plaque, so swelling and bleeding when brushing or flossing are common, usually appearing around the second trimester. Keep cleaning gently and thoroughly rather than backing off, and have it looked at rather than waiting it out.
Why does it happen?
Not because pregnancy causes plaque, and not because you have started cleaning your teeth worse. Hormonal changes alter how gum tissue responds, so the same amount of plaque produces a bigger reaction than it did before: redder, puffier, more inclined to bleed.
The Victorian Government's Better Health Channel describes it as likely to occur during the second trimester, with swelling and bleeding mostly when brushing and flossing. That timing catches people out, because it arrives just as the first-trimester nausea is easing and everything else is getting easier.
The mistake that makes it worse
Brushing less because it bleeds.
It is an entirely reasonable instinct. Something bleeds when you touch it, so you stop touching it. With gums it does the opposite of what you want, because the bleeding is a response to plaque, and cleaning less leaves more plaque on the gum line. Within days the gums are angrier and bleed more, which makes the instinct stronger.
The way out is to clean gently and thoroughly rather than quickly and hard. Better Health Channel advises keeping brushing gently but thoroughly, with an extra soft toothbrush and fluoride toothpaste. Expect a week or so of it still bleeding as things settle, and if it is not improving by then, have it looked at.
What helps?
- An extra soft brush, used gently at the gum line rather than scrubbed across the teeth.
- Cleaning between the teeth, which is where it usually starts. Persist gently through the first bleeding week.
- A professional clean, which removes the hardened deposits you cannot reach. Safe during pregnancy, and one of the better uses of an appointment.
- Rinsing with water after snacks, particularly if cravings mean eating more often than usual.
- Telling us, so what is happening now is on your record and can be compared afterwards.
If brushing the back teeth sets off your gag reflex, say so. A smaller brush head and a different position usually solve it, and it is a very common pregnancy problem that people are oddly embarrassed to mention.
When is it more than gingivitis?
Gingivitis affects the surface of the gum and reverses completely once the plaque is under control. Periodontitis is the stage where the bone supporting the teeth has been affected, and bone does not grow back.
Pregnancy does not usually create periodontitis out of nothing, but it can unmask or accelerate what was already starting. Signs worth acting on quickly: gums receding, teeth feeling loose or moving, persistent bad breath, or a gum that is painful rather than tender. Our gum disease page sets out the difference and what treatment involves.
A lump on the gum is its own thing. A red, lumpy growth called a pregnancy epulis can appear, is usually harmless and often settles after the birth, but it should be looked at rather than assumed, especially if it bleeds or is growing.
About the research you may have read
Australian public health guidance describes a link between severe gum disease in pregnancy and premature birth with low birth weight, and the Australian Dental Association also mentions pre-eclampsia.
Stated carefully: that is an association reported in guidance, not a demonstrated chain of cause and effect, so we do not claim that gum treatment protects a pregnancy. What we will say plainly is narrower and still worth acting on. Gums are more likely to flare during pregnancy, the flare is easy to treat early and harder later, and healthy gums are worth having on their own account.
Principal dentist Dr Fatima Kurnaz, a general dentist rather than a registered specialist, reviews the clinical information on this page.
Other questions people ask
Should I stop brushing if my gums bleed?
No, and this is the single most common mistake. Bleeding gums are inflamed by plaque, so brushing less leaves more plaque and makes it worse. Use an extra soft brush and be gentle and thorough rather than quick and hard.
Will it go away after the baby is born?
Pregnancy gingivitis usually settles once hormone levels return to normal, provided the plaque is being cleaned off. What does not resolve on its own is gum disease that has already reached the bone, which is why having it assessed rather than assuming matters.
Can I have a clean while pregnant?
Yes, and it is one of the more useful appointments in a pregnancy, because it removes what the gums are reacting to. Dental treatment is described as safe during pregnancy by Australian health guidance.
I have a lump on my gum. What is that?
A red, lumpy growth on the gum during pregnancy is often a pregnancy epulis, which is usually harmless and often settles after the birth. It should still be looked at rather than assumed, particularly if it bleeds, gets in the way of eating, or is growing.
Does gum disease affect my baby?
Australian guidance describes a link between severe gum disease in pregnancy and premature birth with low birth weight, and the Australian Dental Association also mentions pre-eclampsia. That is an association described in guidance rather than proof of cause and effect. What is clear is that treating gum disease during pregnancy is safe and recommended for your own health, and healthy gums are worth having on their own account.
Is bleeding just normal in pregnancy?
It is common, which is different. Healthy gums do not bleed when cleaned normally, pregnant or not. Common means expect it and deal with it, not ignore it.