Pregnancy is a unique time in a woman's life—a time when many women begin to make behavioral changes that affect both their health and their baby. Oral health care should be an integral part of overall health care for these women. According to the American College of Obstetrics and Gynecology (ACOG), routine oral health care is essential to general health. It should continue during pregnancy and throughout a woman's life.1 Approximately 40%–60% of women surveyed in the postpartum data from the Pregnancy Risk Assessment Monitoring System (PRAMS) reported having their teeth cleaned by a dentist or dental hygienist.2 This article aims to examine the impact of pregnancy on oral health and whether dental procedures are safe during pregnancy.
The impact of pregnancy on oral health
Several physiological changes can alter the oral cavity during pregnancy.3 One significant change is the increased levels of estrogen and progesterone. The increase in hormones causes the vasodilation of the vascular system, which increases blood flow and can lead to heightened gum sensitivity and inflammation.1 Tender, swollen gums are often a response to the bacteria in the gum tissue.4 When gingivitis is left untreated, it can lead to periodontitis, which can increase the risk of adverse birth outcomes.5
Hormonal changes can also cause the development of a pyogenic granuloma.3 A pyogenic granuloma, also known as a pregnancy tumor, is a raised, round growth located in the anterior portion of the mouth on the gingiva.4 These tumors are usually benign and typically resolve after pregnancy.4 Tooth erosion and dental caries are other prevalent conditions in pregnant women. Tooth erosion is common due to increased exposure to gastric acid from morning sickness.1,4 Pregnancy can lead to a reduction in salivary pH and flow rate which, combined with frequent snacking, elevates the risk of dental caries development.6
The safety of routine dental procedures during pregnancy
According to the American Dental Association (ADA) and ACOG, dental care—including restorative and dental hygiene—is safe and recommended throughout all trimesters of pregnancy to maintain optimal oral health.1,4 Preventing gingivitis and periodontitis can reduce systemic inflammation in the body.1 Due to the increased risk of gingivitis and dental caries, oral health professionals may recommend that pregnant women visit the dentist more frequently.3
Routine visits should include fluoride varnish, such as Profluorid Varnish by VOCO, which aids in remineralization by strengthening enamel, creating a protective barrier, and releasing fluoride over time. Profluorid Varnish contains 5% sodium fluoride plus xylitol in a nonmessy, single-dose delivery system. Its advanced Pro-Colophony provides a thin, clear application for lasting fluoride release. Rapid release is achieved in the first 15 minutes of the application.7
Fluoride varnish also benefits pregnant patients suffering from dentinal hypersensitivity.7 According to the ACOG and the ADA, dental radiographs and local anesthetics are safe during pregnancy.1,4 Dental radiographs are deemed safe at any stage of pregnancy when using an abdominal and thyroid shield.4 Zhou et al. suggest that standard local anesthetic agents, such as 2% lidocaine with 1:200,000 epinephrine, provide the best balance of safety and efficacy for pregnant patients.8 The benefits of dental treatment during pregnancy outweigh the risks. Delaying dental care may lead to infections, increased pregnancy complications, and the transfer of caries-causing bacteria to the baby.1,4
Pregnancy can lead to significant physiological changes that affect oral health, increasing the risk of gingivitis, periodontitis, and dental caries. Despite common misconceptions, routine care—dental hygiene treatments, fluoride, and dental procedures—is not only safe, but essential for the well-being of both mother and fetus.
Editor's note: This article appeared in the March 2026 print edition of RDH magazine. Dental hygienists in North America are eligible for a complimentary print subscription. Sign up here.
References
- American College of Obstetricians and Gynecologists. Oral health care during pregnancy and through the lifespan. August 2013. Accessed February 22, 2025. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2013/08/oral-health-care-during-pregnancy-and-through-the-lifespan
- Centers for Disease Control and Prevention. Selected 2016–2022 maternal and child health (MCH) indicators: Pregnancy Risk Assessment Monitoring System (PRAMS). August 22, 2024. Accessed February 23, 2025. https://www.cdc.gov/prams/php/data-research/mch-indicators-by-site.html
- Silk H, Douglass AB, Douglass JM, Silk L. Oral health during pregnancy. Am Fam Physician. 2008;77(8):1139-1144. Accessed February 23, 2025. https://www.aafp.org/pubs/afp/issues/2008/0415/p1139.html
- American Dental Association. Pregnancy. Accessed February 23, 2025. https://www.ada.org/resources/ada-library/oral-health-topics/pregnancy
- Centers for Disease Control and Prevention. Pregnancy and oral health facts. June 17, 2024. Accessed February 23, 2025. https://www.cdc.gov/oral-health/data-research/facts-stats/fast-facts-pregnancy-and-oral-health.html
- Yilmaz F, Carti Dorterler O, Eren Halici S, Kasap B, Demirbas A. The effects of pregnancy on oral health, salivary pH and flow rate. BMC Oral Health. 2024;24(1):1286. doi:10.1186/s12903-024-05057-0
- VOCO GmbH. VOCO Profluorid Varnish—fluoride varnish/desensitizer. Accessed February 23, 2025. https://www.voco.dental/us/products/preventive-care/fluoride-varnish/voco-profluorid-varnish.aspx
- Zhou X, Zhong Y, Pan Z, Zhang J, Pan J. Physiology of pregnancy and oral local anesthesia considerations. 2023;11:e15585. doi:10.7717/peerj.15585
