Have your gums been bleeding for a few weeks, and you are pregnant? What you are going through has a name: pregnancy gingivitis, a gum inflammation linked to pregnancy that, according to studies, affects between 30 and 50 % of pregnant women. Rest assured, it is neither inevitable nor a sign that you brush your teeth badly. But it deserves to be understood, monitored and supported with the right habits.
Why does pregnancy make gums so reactive?
The answer comes down to two words: oestrogen and progesterone. During pregnancy, these two hormones soar — progesterone can reach levels several dozen times higher than in a normal cycle. And gum tissue has receptors for these hormones. It is therefore directly sensitive to them.
Three things then happen at the same time. Blood flow to the gum increases: the vessels dilate and become more permeable, hence the swelling and the redder, almost purplish colour. The local inflammatory response is amplified: faced with the same amount of plaque as before the pregnancy, the gum reacts far more strongly. Finally, the bacterial balance shifts slightly, with certain anaerobic bacteria favoured by this new hormonal environment.
The key point to remember: pregnancy does not create the inflammation, it amplifies the reaction to plaque that is already there. No dental plaque, no pregnancy gingivitis. That is precisely what makes daily hygiene so decisive during these nine months.
When it appears and what it looks like
Pregnancy gingivitis typically shows up from the second trimester onwards, often around the 3rd or 4th month, with a peak frequently observed around the 8th month. It usually recedes in the weeks that follow the birth, when hormone levels come back down.
The most common signs:
- Bleeding when brushing or when using floss, when that did not happen before;
- Swollen gums, smooth and shiny, redder than usual, particularly between the teeth;
- Sensitivity to contact, which is exactly what makes people brush less well — and makes the vicious circle worse;
- Bad breath that lingers more towards the end of the day.
If these signs also ring true outside of pregnancy, our article on the first signs of gingivitis and what to do about them sets out the general benchmarks.
The tip that changes everything: when a gum bleeds, the natural reflex is to avoid the area. It is exactly the opposite that you should do. Brush that area more gently but just as carefully — the bleeding usually decreases within one to two weeks of regular brushing, because you are removing the plaque that keeps the inflammation going.
Pregnancy epulis: that little lump on the gum
In around 1 to 5 % of pregnant women, a localised growth appears on the gum, generally between two teeth and most often on the upper jaw. It is called a pregnancy epulis (or pregnancy granuloma). It is red, soft, bleeds easily at the slightest contact, and can reach the size of a small pea, sometimes more.
Two essential pieces of information. First: it is a benign lesion, even if the medical vocabulary can sound frightening. Second: it goes away on its own in the vast majority of cases after the birth, when the hormonal surge ends. Practitioners therefore usually prefer to wait rather than to intervene during pregnancy, unless the epulis interferes with chewing, bleeds a lot or becomes painful.
That said, any growth in the mouth must be shown to a dentist, who alone can confirm what it is. Never make this diagnosis yourself from a blog article, this one included.
Nausea and vomiting: the trap of brushing straight away
The first trimester often comes with morning sickness and vomiting. Gastric juice has an extremely acidic pH — around 1.5 to 3.5 — well below the threshold of 5.5 at which enamel begins to demineralise. After an episode of vomiting, the surface of your teeth is therefore temporarily softened.
And that is where the most logical reflex becomes the most harmful: brushing your teeth immediately after being sick abrades weakened enamel. You are not cleaning, you are shaving down.
| Moment | The right move | To avoid |
|---|---|---|
| Right after vomiting | Rinse with plain water, or with water and a pinch of baking soda to neutralise the acidity | Brushing straight away |
| Within the following 30 minutes | Let saliva remineralise the enamel; a glass of water, possibly a sugar-free chewing gum | Drinking a fruit juice or a soda |
| After 30 minutes | Normal, gentle brushing with a fluoride toothpaste | Scrubbing hard "to make up for it" |
What routine should you adopt during these nine months?
The goal is twofold: remove plaque consistently, without irritating a gum that is already raw.
- A soft-bristled, or even extra-soft, toothbrush. Hard bristles do not clean better, they injure more. Change it as soon as the bristles start to splay.
- Two two-minute brushings a day. Quality beats force: bristles angled at 45° towards the gum, small movements, never horizontal scrubbing.
- Cleaning between the teeth every day. That is where plaque builds up. If the floss makes you bleed, do not give it up: keep going, gently.
- A fluoride toothpaste at 1450 ppm, the standard adult dose, to protect the enamel from repeated acid attacks.
- A taste you can put up with. If the toothpaste makes you gag, you will brush less well and for less time.
On that last point, two options work well depending on what you can tolerate at the time. Classic Mint offers a clean freshness and a gentle formula, with no marked abrasive effect. If your sense of smell is all over the place and mint is hard to take, Pomegranate & Sakura Blossom offers a fruity, floral profile, sugar-free, often better tolerated when you feel nauseous. If you are hesitating, our two-minute quiz will point you in the right direction.
One reminder that matters: toothpaste is a hygiene product, not a treatment. It helps control plaque day to day, but it never replaces a dental consultation for a medical problem — a painful gum, heavy bleeding, a loose tooth or any growth.
Seeing a dentist while pregnant: yes, it is recommended
Many women put off their appointment for fear of harming the baby. It is a misconception that comes at a high price: routine dental care is safe during pregnancy and is even explicitly recommended — scaling, treating a cavity, local anaesthetic. In France, the national health service also offers a covered oral health examination for pregnant women, generally from the 4th month onwards.
Simply tell your practitioner that you are pregnant and how far along you are: they will adjust the position of the chair and avoid non-essential X-rays. The second trimester is the most comfortable window for planned treatment.
FAQ
Is bleeding gums during pregnancy serious?
Light bleeding when brushing is common during pregnancy and usually settles down with regular hygiene. On the other hand, bleeding that is spontaneous or heavy, or comes with pain and a loose tooth, is not ordinary: see your dentist without delay.
Does pregnancy gingivitis go away after the birth?
In most cases, yes: the inflammation recedes in the following weeks, when hormone levels come back down. Be careful, though, it only disappears completely if the dental plaque has been kept under control. Neglected gingivitis can develop into a deeper condition which, for its part, does not resolve on its own.
Can I have a scaling during my pregnancy?
Yes. It is a safe procedure and often a beneficial one, since it removes precisely the tartar that keeps the inflammation going. The second trimester is the most comfortable time to schedule it.
Do you need to change toothpaste when you are pregnant?
Not necessarily. A standard fluoride toothpaste is fine, as long as it is spat out — you do not swallow it. The only real reason to change is comfort: if the taste makes you feel sick, a milder flavour will help you keep brushing properly.
My gums are swollen but they are not bleeding, is that normal?
Swelling can come before the bleeding, or exist on its own. We go through the various possible causes in our article on swollen gums. If the swelling lasts beyond two weeks despite good hygiene, have it assessed by a professional.
Key takeaways
Pregnancy gingivitis is not your fault: it is an amplified hormonal reaction to dental plaque that, before, was not causing any trouble. The levers stay simple — gentle but thorough brushing twice a day, cleaning between the teeth daily, the 30-minute rule after being sick, and a dental appointment in the second trimester. Any growth or pain is a matter for your dentist's opinion, not for a blog article.
Choose a toothpaste you will be able to put up with for nine months: Classic Mint for a gentle freshness, or Pomegranate & Sakura Blossom if mint no longer works for you. Not sure? Take the quiz, it only takes two minutes. If you would rather alternate, the Gums & Gentleness Pack brings together the three gentlest formulas in the range, all under an RDA of 70.