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Bleeding gums during pregnancy

My gums bleed now when I floss and brush. Is that normal?

Having swollen, red, tender gums that bleed when you floss or brush is a common complaint during pregnancy. About half of moms-to-be have these symptoms – a condition known as pregnancy gingivitis. Your gums are more likely to become inflamed during pregnancy in part because of hormonal changes that make them more sensitive to the bacteria in plaque.

You may also develop a benign nodule on your gums that bleeds when you brush. This relatively rare nodule is called a pregnancy tumor or pyogenic granuloma – scary names for something that's harmless and usually painless. Pregnancy tumors can actually pop up anywhere on your body during pregnancy, but they show up most often in the mouth.

A pregnancy tumor can grow to up to three-quarters of an inch in size and is more likely to appear in an area where you have gingivitis. Typically, it disappears after you have your baby, but if it doesn't, you'll need to have it removed. If it causes discomfort, interferes with chewing or brushing, or starts to bleed excessively, you can have it removed while you're pregnant.

Can gum disease affect my pregnancy?

Possibly, but the evidence is inconsistent. Many studies show a link between severe gum disease and preterm birth and low birth weight. And there is some research suggesting an association with preeclampsia, too. However, other studies show no relationship between gum disease and these serious complications.

In any case, it's important to take good care of your teeth and gums during pregnancy. If you don't treat gingivitis, it can get worse and develop into periodontitis, a more serious form of gum disease in which the infection goes beyond your gums into the bone and other tissue that supports your teeth.

What can I do?

Prevention is key. Practice good oral hygiene and get regular preventive dental care.

  • Brush thoroughly but gently at least twice a day (after every meal if possible), using a soft-bristled brush and toothpaste with fluoride.
  • Floss daily.
  • Get regular preventive dental care. Your dentist or periodontist can remove plaque and tartar that brushing can't get to. If you haven't seen your dentist recently, schedule a visit now for a thorough cleaning and checkup. Be sure to let her know that you're pregnant and how far along you are. She'll probably want to see you once more during your pregnancy, too – or even more often if you already have gum disease, since pregnancy will likely make the problem worse.
  • Don't put off getting treatment for dental problems. If necessary, local anesthesia such as Novocain is safe throughout pregnancy. And if antibiotics are needed, there are pregnancy-safe drugs available.

When should I call the dentist?

In addition to regular checkups, schedule a dental appointment right away if you have any of the following:

  • A toothache
  • Gums that bleed frequently and cause you pain
  • Other signs of gum disease, like swollen, tender gums; receding gums; persistent bad breath; or loosening teeth
  • Growths in your mouth, even if they're not painful or causing any other symptoms

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