Teeth Pain During Pregnancy

Introduction

Are you pregnant and suffering from an oral health condition? Teeth pain during pregnancy can happen to many pregnant women susceptible to a wide range of oral health conditions. Do you know that 1 in 4 people assigned female at birth and in childbearing age have untreated dental cavities? Teeth pain can result from hormonal and physical changes that can have an impact on women's organ system. This article will provide you with answers regarding the common causes, the type of pain, and ways to cope with tooth pain during pregnancy.

Common causes

Hormonal changes

There is a direct relationship between hormonal changes and developing gingivitis. Pregnant women face changes in hormonal levels that can lead to plaque accumulation and gingival disease. Gingivitis and periodontal disease are the most common types of gum disease. It occurs when the gums become red and swollen as a result of the inflammation triggered by hormonal changes. These changes make the mouth mucosa sensitive to bacterial plaque. The increased tendency of having severe oral inflammation is a result of the increase in estrogen and progesterone hormones making oral vascular structures more vulnerable to infection and reducing the immune system’s efficacy during the pregnancy period.¹ 

Increased blood flow

The cardiovascular system changes significantly at the time of pregnancy. Blood volume increases to meet the metabolic demand of both the fetus and the mother. The increased heart rate and stroke volume increase the cardiac output by 50%. This increased blood flow can lead to sensitive swollen gums that are hard to touch. During later gestational periods, hot and cold food or drinks may cause pain and sensitivity that has not been experienced before the pregnancy.² 

Dental issues

You might have heard that the fetal consumption of calcium is taken from the mother’s teeth or that every pregnancy can cause tooth loss. However, there is no scientific proof to support this belief. A dentist might explain it by saying that vomiting and nausea are recorded in 70% of pregnancies. Repetitive vomiting affects oral hygiene and causes erosion of the enamel layer. A decrease in calcium concentration occurs during pregnancy, however, the ionized calcium levels are not different from the pre-pregnancy levels. The ionized calcium is called free calcium because it is in the blood and is not attached to proteins. It helps build strong teeth and bones. Several factors contribute to dental issues during pregnancy like craving food containing carbohydrates and neglecting to toothbrush afterwards. Bleeding readily is common owing to hormonal changes and women may avoid brushing their teeth to prevent bleeding. The acidic environment in the mouth occurs owing to the neglect of oral care after vomiting in the first few months. Cavities develop when the saliva flow decreases in the mouth during pregnancy. Mothers may neglect their own oral and dental health which can lead to the deterioration of their dental health status.

Nutritional deficiencies

Good nutritional habits are a must during pregnancy to have good general and oral health. Inadequate nutrient intake affects the mother and baby’s health. Pregnant women are advised to have calcium-rich food like dairy, milk, and greenleafy vegetables. The fifth and sixth weeks of pregnancy are when the development of the baby's teeth begins. Pregnancy nutrition is important to balance the body's nutritional needs and provide the energy and nutrients needed for the fetus to grow normally.

Acid reflux

The most common health changes are nausea and vomiting also known as morning sickness. In the later stages of the pregnancy, heartburn and gastroesophageal reflux are common and thought to be caused by the growing fetus's physical changes. Vomiting and acidic reflux increases susceptibility to acid erosion.Scheduling dental appointments may be beneficial for patients who suffer from nausea and morning sickness.³

Types of teeth pain during pregnancy

There are different types of tooth pain that you might experience during pregnancy:

• Sensitivity to hot and cold which is caused by increased blood flow.
• Toothache and infection. Around 60-70%of women develop gingivitis. If it is left without treatment, the bone supporting the teeth deteriorate and the gum can become infected. The teeth with little bone can become loose and may need to be extracted. Periodontitis is a serious gum infection and it causes damage to the soft tissue around the teeth. Periodontitis has been linked to adverse pregnancy outcomes such as preterm birth and low birth weight. However, the mechanisms by which periodontitis may contribute to these outcomes are still poorly understood
• Swollen and bleeding gums. Swollen and bleeding gums can occur as a result of the built-up plaque on the teeth

Coping with teeth pain during pregnancy

What helps to cope with teeth pain during pregnancy is maintaining personal and professional treatment: 

• Maintaining good oral hygiene daily and continue taking care of your dental health
• Using a soft-bristled toothbrush and dental floss at least twice a day
• Avoiding acidic and sugary foods that can trigger your sensitive gums
• Applying a warm compress on the affected area
• Rinsing your mouth with warm salt water or mouthwash. Salty water can relax your gums and reduce their sensitivity
• Using over-the-counter pain relievers (if approved by a doctor)

To achieve optimal oral hygiene and establish the habit of maintaining it, a comprehensive oral examination must be performed before pregnancy because hormonal changes during pregnancy are directly linked to plaque accumulation and gingival diseases. The increase in pregnancy hormones makes the mouth mucosa more susceptible to external factors, particularly bacterial plaques.

When to see a dentist

Severe and persistent teeth pain

You should see a doctor if your teeth pain is severe and does not go away. Paying a visit to the dentist while you are pregnant is safe and recommended.

Swelling in the mouth or face

You should contact your midwife or doctor if you have unusual swelling in your mouth or face. During pregnancy, cervico facial cellulitis can cause obstetrical problems such as preterm birth. It can be life-threatening for both the mother and the fetus.

Fever and chills

Fever and chills can be symptoms of an infection. It is best to consult your doctor as soon as possible.

Difficulty swallowing or breathing

Your breathing may be affected by an increase in the hormone progesterone, which causes you to breathe in more deeply. You might think you're working harder to breathe because of this. As your expanding uterus takes up more space and presses against your diaphragm the muscle below your lungs—breathing may also become more difficult. You should see a doctor when it is sudden, severe, or happens with a cough, wheeze, or irregular heartbeat. 

Summary

Pregnancy is a special period of a woman’s life. Women should take care of their oral health,an important part of their general health, especially during pregnancy  as it affects both the mother’s andthe fetus's health. Teeth pain during pregnancy is normal and is caused by several factors like hormonal changes, increased blood flow, dental issues, nutritional deficiencies, and acidic reflux. Pain occurs in different areas like the sensitivity of gums, toothache and infection, and swollen and bleeding gums, and the severity of the pain varies. The best way to cope with this pain is by taking care of your oral health and following daily healthy habits to protect your teeth from oral health-related pregnancy side effects. You should seek medical help and call your doctor if you have severe or persistent tooth pain, swelling in your mouth, fever and chills, and if you have difficulty swallowing or breathing.

References

1. Krüger MSM, Lang CA, Almeida LHS, Bello-Corrêa FO, Romano AR, Pappen FG. Dental pain and associated factors among pregnant women: an observational study. Matern Child Health J [Internet]. 2015 Mar 1 [cited 2023 Mar 24];19(3):504–10. Available from: https://doi.org/10.1007/s10995-014-1531-y.
2. Ouanounou A, Haas DA. Drug therapy during pregnancy: implications for dental practice. British dental journal. 2016 Apr 22;220(8):413-7.
3. Dragan IF, Veglia V, Geisinger ML, Alexander DC. Dental care as a safe and essential part of a healthy pregnancy. Compendium. 2018 Feb;39(2):86-92.

This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Aamal Alshihawi

Bachelor of Science in Public Health, Asian University for Women, Bangladesh

Aamal is a public health practitioner with experience in research and management roles in the NGO sector. She has two years of experience in health promotion, mental health, and research. Also, she works in the education sector and has over two years of experience in curriculum content development and design. She is working now as an internship coordinator.

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