Dental treatment during pregnancy: what can be done and when

Why oral health matters in pregnancy

Pregnancy brings changes that also show in the mouth. Higher hormone levels make the gums more sensitive to plaque. Cravings and more frequent meals, often with sweet snacks, increase the number of acid attacks on the teeth. Nausea, vomiting and reflux bring stomach acid into contact with the enamel, and tiredness or nausea when brushing can make oral hygiene less thorough.

All of this increases the risk of decay and gum inflammation. Studies have also shown an association between untreated gum disease and some pregnancy complications, such as premature birth or low birth weight. The link is not fully understood, but it is one more reason why healthy gums matter during this time.

Can dental treatment be done during pregnancy?

Yes. Pregnancy is not a reason to postpone necessary treatment. Decay, toothache and infections need to be treated, because an untreated infection, together with pain and unsupervised medication, carries more risk than the treatment itself. A dental check-up is in fact recommended early in pregnancy.

What matters is telling us from the start that you are pregnant and how many weeks. Based on that, we choose the right timing, anaesthetic and medication.

Before pregnancy

If you are planning a pregnancy, the ideal time for a full dental check-up is before conception. X-rays, root canal treatment, removal of troublesome wisdom teeth or prosthetic work can then be carried out without any restrictions. This greatly reduces the risk of pain or infection appearing during the pregnancy itself.

What is the best time?

• First trimester. Check-ups and urgent treatment are carried out. Treatment that can wait is planned for the second trimester.
• Second trimester, roughly weeks 14 to 27. This is the most comfortable time for treatment such as fillings, root canal treatment or professional cleaning.
• Third trimester. Treatment can still be carried out, but sessions are shorter and the chair position is adjusted, tilted slightly to the left, to avoid pressure on the major blood vessels.

Which treatments can be done during pregnancy

• check-ups and professional cleaning, recommended in every pregnancy
• treatment of decay with composite fillings
• root canal treatment, when the nerve of the tooth is inflamed or infected
• extractions of teeth that cannot be saved or are causing an infection
• gum treatment, including deep cleaning if needed
• temporary repairs, such as re-cementing a crown or a temporary restoration, until after the birth

Anaesthesia and medication

Local anaesthesia can be used during pregnancy. Lidocaine is the most studied local anaesthetic in pregnancy and is considered safe at the usual doses used in dentistry. Treatment without pain is better for both mother and baby than treatment carried out with pain and stress.

If medication is needed, it is chosen with the pregnancy in mind. Paracetamol is usually used for pain, while anti-inflammatories such as ibuprofen are avoided, especially in the third trimester. If an antibiotic is needed, those considered safe in pregnancy, such as amoxicillin, are chosen, and tetracyclines are contraindicated. Any medication should be taken only on a doctor's advice, and in special situations we consult your obstetrician.

X-rays

Dental X-rays involve a very low dose of radiation and are aimed at the teeth, not the abdomen. We take them only when they are needed for diagnosis, for example before root canal treatment, and always with a protective apron. Routine X-rays and more extensive imaging, such as CT scans, are usually postponed until after the birth.

Fillings and amalgam

Decay is treated with composite fillings, which are tooth-coloured. Amalgam, the grey filling that contains mercury, is not used in women who are pregnant or breastfeeding, in line with European regulations. Since 2025 its use in the European Union has been almost entirely banned.

If you have old amalgam fillings in good condition, replacing them during pregnancy is not recommended, because removing them releases mercury vapour. Replacement can be planned after the birth and after breastfeeding.

What is postponed until after the birth

• tooth whitening
• cosmetic treatment such as veneers
• dental implants and bone grafting
• extensive prosthetic work that is not urgent
• planned extractions, such as wisdom teeth without symptoms
• replacement of old amalgam fillings in good condition

Gums during pregnancy

Hormonal changes in pregnancy make the gums more sensitive to plaque. Many women notice that their gums swell and bleed more easily, a condition called pregnancy gingivitis. Professional cleaning and careful home care keep the inflammation under control. If gingivitis is not treated, it can progress to gum disease, which I describe in the article on periodontitis.

Sometimes a small red growth that bleeds easily appears on the gum, called a pregnancy granuloma. It is benign and usually shrinks after the birth. If it gets in the way of chewing or brushing, the dentist may decide to remove it.

Care at home

• brush twice a day with a soft brush and fluoride toothpaste
• clean between your teeth every day with floss or interdental brushes
• if toothpaste makes you feel sick, use a milder-flavoured one and a small-headed brush
• after vomiting, rinse with water or with water and a teaspoon of baking soda, and wait about 30 minutes before brushing. Stomach acid temporarily softens the enamel, and brushing straight away could erode it.
• limit sweet snacks between meals and drink water afterwards

After the birth and while breastfeeding

After the birth, postponed treatment can be resumed. Breastfeeding is no reason to avoid the dentist: local anaesthesia is compatible with breastfeeding, and medication is chosen with it in mind. Whitening and cosmetic treatment can usually be carried out once breastfeeding has ended.

A mother's oral health also matters for the baby. The bacteria that cause decay can be passed on through saliva, for example when tasting from the baby's spoon or cleaning a dummy with your mouth. Untreated decay in parents increases the child's risk of decay.

On this topic, on Kanal D

I talked about which dental treatments are allowed during pregnancy in a Kanal D report filmed at ARTeeth Dental Clinic (in Romanian). You can watch it on kanald.ro.

Frequently asked questions

This article provides general information and does not replace a consultation. Always tell your dentist that you are pregnant; in special situations the treatment plan is agreed together with your obstetrician.

About the author

Dr. Paul Nicu Dobrescu

Dentist with over 20 years of practice dedicated to prosthodontics and dental aesthetics. Founder of ARTeeth Dental Clinic, Bucharest.

LinkedIn · Instagram · Facebook · Profile on the ARTeeth website