Gum Inflammation in Pregnancy: Why it Happens and What To Do About It

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Some women, while they’re pregnant, will notice swollen and bleeding gums.

Gum Inflammation in Pregnancy

The gums will appear swollen throughout the day while the gum bleeds during brushing and flossing.

Increased levels of blood progesterone, which is the sex hormone, is responsible for gingivitis mainly between 2 to 8 months of pregnancy.

Understanding and treating gingivitis in its early stages during pregnancy is important to prevent its progression into periodontal disease and to prevent oral care neglect in your infants. Poor oral health of the mother has the potential to pass oral-based bacteria to the fetus as the baby and the mother are linked through an umbilical cord in the placenta. 

Early treatment is crucial to maintain the brightest smile during and after pregnancy and to provide the best parental care to the nourishing soul in the belly. 

Understanding Gum Inflammation During Pregnancy

What causes gum inflammation during pregnancy?

Normal gingivitis is something your dentist must have told you you’ve had before. In almost all of the cases, we all may have had gingivitis due to the lack of oral care, an increase in sugary foods, or missing a few dental appointments.

Gingivitis is simply the swelling of the gum tissues. The swelling typically accompanies tenderness to the touch and increased bleeding whenever you brush or floss; in the end, you see bleeding in the sink. 

Pregnancy gingivitis is a little different, though. Even if the pregnant woman is very diligent at taking care of her gums during pregnancy, they can still notice gingivitis. Almost 60 to 75% of pregnant woman suffer from pregnancy gingivitis at any stage of their pregnancy. However, most pregnant have reported this condition in the second trimester of pregnancy, which is between 3 and 6 months. 

This is due to increased estrogen and progesterone levels in the blood, which increases the blood flow to all your organs, including the gum tissues, making them prone to bleeding.

estrogen and progesterone levels in the blood

The hormonal changes facilitate the growth of certain bacteria, which makes the gum tender and sensitive. The hormonal changes also hinder the body’s capacity to fight away the bacteria, increasing the plaque buildup on the teeth and increasing the overall susceptibility to gingivitis. 

Symptoms of gum inflammation in pregnant women

The symptoms of pregnancy gingivitis are similar to the symptoms of gingivitis or any other gum disease that you might have had in the past. Here are these: 

  • Red or swollen gums
  • Bleeding gums during brushing 
  • Small, red, raw-looking lumps along the gum line
  • Shiny, smooth gums
  • Pian on touching the gums 
  • Persistent bad breath
  • Metallic taste 
  • Sensitive tooth 
  • Pain on eating 
  • Pockets between the teeth and the gums 
  • Pregnancy epulis, commonly known as pregnancy tumors

Certain habits like smoking and alcohol consumption can aggravate the condition. Women with diabetes will experience more of these symptoms because of the increased blood sugar levels and the bacterial load.

What is a pregnancy tumor or pregnancy epulis? 

The term tumor is misleading. Although it’s called a tumor, it’s not cancerous. It’s a soft, round, smooth-looking swelling that’s fleshy red in appearance. It starts growing around the gum line and starts appearing between your teeth. It usually appears between your upper teeth; depending on how old it is,

it seems somewhere between red to purplish color. These are not always painful, but they bleed easily. As these grow big, they become tender on chewing and upon contact with the lips. 

Sometimes, even after removing it completely, epulis may grow back on its own. 

The importance of addressing gum inflammation during pregnancy

Gum inflammation during pregnancy

As soon as you experience these symptoms, you must schedule an appointment with your dentist. This will allow you to get your complete oral health evaluation done before you are told to manage and treat the condition.

If pregnancy gingivitis is neglected, you may experience periodontal disease characterized by gum and bone loss, which can ultimately lead to teeth loss. Oral gum diseases are also associated with poor pregnancy outcomes, including preterm birth and low birth weight.

Which factors determine oral health during pregnancy?

Here are a few factors that  directly affect oral health;  

  • During the first few months of pregnancy, women tend to have an increased craving for certain foods, such as sweets and sugars. Multiple food portions at various times of decay decrease the overall pH of the mouth several times, paired with neglected brushing habits after each meal.
  • With increased bleeding from gums during pregnancy under the influence of hormones, women tend to avoid brushing their teeth. This ultimately increases the bacterial plaque asking for more care.
  • Vomiting during the early months of pregnancy makes the environment acidic. If the teeth are not brushed properly, the acidic environment will stay in the mouth.
  • Salivary flow decreases in pregnancy.

How to naturally prevent gum diseases during pregnancy? 

It is important to have a full oral examination before conceiving, as there’s a relationship between hormonal changes during pregnancy and plaque accumulation. This can ultimately affect the nourishing fetus in the baby. Monitoring good oral hygiene routine along with regular dental visits are crucial in optimizing oral health.

Tooth development in the fetus starts in the 5th and 6th week of pregnancy. A good nutritional diet can help overcome the deficiency in the mother’s body and, ultimately, in the fetus.

Vitamins A and D play crucial roles in the development of enamel, so one must improve the intake of these vitamins.


As these vitamins are fat-soluble, one must take these vitamins with their meals for better absorption in the body. Intake of vitamins C and A-rich foods like oranges, carrots, or supplements can help combat gum diseases. 

A mother should take 1200 to 1500 mg of calcium daily to make the bones and teeth of your baby healthy. This can be obtained through calcium-rich foods like milk, dairy products, and green vegetables.

Sugary foods like toffees, candies, and soft drinks must be avoided during pregnancy to decrease bacterial load in the mouth that leads to cavities and gum diseases. 

You must avoid tobacco products and alcohol as well to prevent adverse pregnancy outcomes. 

How to manage swollen gums during pregnancy? 

According to the American Pregnancy Association, one must practice good oral health during pregnancy. It means increasing whatever you’re doing to maintain your oral hygiene. If you’re brushing once daily, start brushing twice a day.

It’s better if you brush after every meal. Floss once daily with with soft toothbrush and fluoridated toothpaste. To reverse the inflammation of the gums in its early stages, schedule regular dental cleaning appointments with your dentist or dental hygienist

Warm salt water rinses are known to relieve gingivitis-associated pain and symptoms. Gargling with therapeutic mouthwashes will also help reduce the symptoms. 

The Connection Between Gum Inflammation and Pregnancy Complications

There is a deep connection between gum inflammation and pregnancy and it’s been studied since 1960. The gum inflammation is adversely related to pregnancy outcomes as these are closely related.

 Mechanisms that Link Pregnancy & Gum Diseases

1) Inflammation:

Gum diseases initiate a cascade of inflammatory events in the body that directly affect the placenta and the fetus. 

2) Bacterial Transmission:

The bacteria from the pockets enter into the blood, increasing the bacterial load overall. This directly affects the blood going to the fetus, causing the transfer of oral bacteria to it. 

3) Immune System Modulation:

The inflammation markers that are released in response to gum inflammation will alter the maternal immune system, leading to altered fetal development and pregnancy.

Healthy Pregnancy

Pregnancy Conditions Associated with Gum Diseases

1) Preterm birth:

The inflammatory markers that are produced in gum diseases have the potential to induce labor. Premature birth is promoted by the production of prostaglandins and cytokines as seen in multiple research carried out in the past. 

2) Low Birth Weight:

Inflammatory markers like prostaglandins and cytokines cause the body’s immune system to get active. As this is activated, all the energy is spent in fighting the bacteria, neglecting the fetus’s health already. This leads to low birth weight of the baby. 

3) Preeclampsia:

Gum diseases, especially periodontal disease, are closely linked to this condition, which is characterized by high blood pressure and potential organ damage. The inflammatory response in gum disease is thought to cause endothelial dysfunction in this condition.

4) Gestational Diabetes:

The Infmamtory and immune response of the body influence glucose metabolism and insulin resistance in the body, which leads to gestational diabetes

How will pregnancy-induced gingivitis go away? 

Usually, after delivery, pregnancy-induced gingivitis comes to an end. This is because the hormonal fluctuations come to an end. This will only happen if the hygiene is maintained to its best to prevent plaque accumulation. 

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