News & Information

Support WHEN.
Support Women.

DONATE

Oral Health After a Pregnancy loss

Expert Insights from Dr Fiona Tan, Dentist background research for this episode was prepared by Dr Annika Wilson

Oral Health After a Pregnancy loss

What’s going on, why it might still be happening, and what you can do

After a pregnancy loss, there can be physical changes that don’t get mentioned. Gum symptoms are one of them, often unexpected, and easy to overlook, but they can still affect how you feel day to day.

What you might notice

Some women tell us they experience sore gums, bleeding when brushing, or a swollen feeling in the mouth, sometimes even weeks after a pregnancy loss. While there’s no direct research on gum health after pregnancy loss, we do know these symptoms are common in pregnancy and may continue while your hormones are settling.

This kind of gum irritation is usually caused by inflammation, also known as gingivitis, and is linked to changes in hormone levels and how your body responds to bacteria in the mouth.

Why it can still be happening

Hormones don’t switch off immediately after a pregnancy loss. They gradually settle back to pre-pregnancy levels, and that process can affect the way your immune system responds to bacteria, including in your mouth.

In pregnancy, around 40–50% of women experience gum disease. After a pregnancy loss, some of those same changes may still be playing out, even if they aren’t talked about.

If it’s left untreated, early gum disease (gingivitis) can sometimes lead to periodontitis, a deeper inflammation that affects the tissues holding your teeth in place.

What helps

You don’t need to do anything extreme, but looking after your gums while your body is settling can make a big difference:

  • Brush gently twice a day with a soft toothbrush.
  • Floss every day, even if your gums bleed slightly.
  • If it’s been a while, consider a dental check-up. Routine dental care is safe and helpful at any stage.
  • If you notice ongoing bleeding, pain, or loose teeth, speak to your dentist sooner rather than later.

 

These changes are common and manageable. Giving your mouth a little extra care now can help you feel more comfortable as your body settles.

  1. Silva de Araujo Figueiredo C, Gonçalves Carvalho Rosalem C, Costa Cantanhede AL, Abreu Fonseca Thomaz ÉB, Fontoura Nogueira da Cruz MC. Systemic alterations and their oral manifestations in pregnant women. J Obstet Gynaecol Res. 2017;43(1):16-22.
  2. Council of Australian Governments Health Council. Healthy Mouths, Healthy Lives: Australia’s National Oral Health Plan 2015-2024. Adelaide, SA: South Australian Dental Service; 2015.
  3. Pihlstrom BL, Michalowicz BS, Johnson NW. Periodontal diseases. The Lancet. 2005;366(9499):1809-20.
  4. Sanz M, D’Aiuto F, Deanfield J, Fernandez-Avilés F. European workshop in periodontal health and cardiovascular disease—scientific evidence on the association between periodontal and cardiovascular diseases: a review of the literature. Europ Heart J Suppl. 2010;12(suppl_B):B3-B12.
  5. Chen P, Hong F, Yu X. Prevalence of periodontal disease in pregnancy: A systematic review and meta-analysis. J Dent. 2022;125:104253.
  6. Macones GA, Parry S, Nelson DB, Strauss JF, Ludmir J, Cohen AW, et al. Treatment of localized periodontal disease in pregnancy does not reduce the occurrence of preterm birth: results from the Periodontal Infections and Prematurity Study (PIPS). Am J Obstet Gynecol. 2010;202(2):147.e1-8.
  7. Morelli EL, Broadbent JM, Leichter JW, Thomson WM. Pregnancy, parity and periodontal disease. Aust Dent J. 2018;63(3):270-8.
  8. Kornman KS, Loesche WJ. The subgingival microbial flora during pregnancy. J Periodontal Res. 1980;15(2):111-22.
  9. Regezi JA, Sciubba J, Jordan RC. Oral pathology: clinical pathologic correlations. Elsevier Health Sciences; 2016. p. 118-9.
  10. Armitage GC. Bi-directional relationship between pregnancy and periodontal disease. Periodontol 2000. 2013;61(1):160-76.
  11. Siqueira FM, Cota LOM, Costa JE, Haddad JPA, Lana ÂMQ, Costa FO. Maternal periodontitis as a potential risk variable for preeclampsia: A case‐control study. J Periodontol. 2008;79(2):207-15.
  12. Offenbacher S, Boggess KA, Murtha AP, Jared HL, Lieff S, McKaig RG, et al. Progressive periodontal disease and risk of very preterm delivery. Obstet Gynaecol. 2006;107(1):29-36.
  13. Cruz SS, Costa MdCN, Gomes‐Filho IS, Rezende EJ, Barreto ML, Dos Santos CAS, et al. Contribution of periodontal disease in pregnant women as a risk factor for low birth weight. Community Dent Oral Epidemiol. 2009;37(6):527-33.
  14. Srinivas SK, Sammel MD, Stamilio DM, Clothier B, Jeffcoat MK, Parry S, et al. Periodontal disease and adverse pregnancy outcomes: is there an association? Am J Obstet Gynecol. 2009;200(5):497. e1-. e8.
  15. Bassani D, Olinto M, Kreiger N. Periodontal disease and perinatal outcomes: A case‐control study. J Clin Periodontol. 2007;34(1):31-9.
  16. Michalowicz BS, Novak MJ, Hodges JS, DiAngelis A, Buchanan W, Papapanou PN, et al. Serum inflammatory mediators in pregnancy: changes after periodontal treatment and association with pregnancy outcomes. J Periodontol. 2009;80(11):1731-41.
  17. Newnham JP, Newnham IA, Ball CM, Wright M, Pennell CE, Swain J, et al. Treatment of periodontal disease during pregnancy: A randomized controlled trial. Obstet Gynecol. 2009;114(6):1239-48.
  18. Offenbacher S, Beck JD, Jared HL, Mauriello SM, Mendoza LC, Couper DJ, et al. Effects of periodontal therapy on rate of preterm delivery a randomized controlled trial. Obstet Gynecol. 2009;114(3):551.
  19. Madan MS, Liu ZJ, Gu GM, King GJ. Effects of human relaxin on orthodontic tooth movement and periodontal ligaments in rats. Am J Orthod Dentofacial Orthop. 2007;131(1):8.e1-10.
  20. Bernabe E, Marcenes W, Hernandez CR, Bailey J, Abreu LG, Alipour V, et al. Global, Regional, and National Levels and Trends in Burden of Oral Conditions from 1990 to 2017: A Systematic Analysis for the Global Burden of Disease 2017 Study. J Dent Res. 2020;99(4):362-73.
  21. Kamate WI, Vibhute NA, Baad RK. Estimation of DMFT, Salivary Streptococcus Mutans Count, Flow Rate, Ph, and Salivary Total Calcium Content in Pregnant and Non-Pregnant Women: A Prospective Study. J Clin Diagn Res. 2017;11(4):Zc147-zc51.
  22. Australian Institute of Health and Welfare. Oral health and dental care in Australia. AIHW, Australian Government; 2023.
  23. Silk H. Diseases of the mouth. Prim Care. 2014;41(1):75-90.
  24. Vergnes JN, Kaminski M, Lelong N, Musset AM, Sixou M, Nabet C. Frequency and risk indicators of tooth decay among pregnant women in France: a cross-sectional analysis. PLoS One. 2012;7(5):e33296.
  25. Fakheran O, Saied-Moallemi Z, Khademi A, Sahebkar A. Oral Health-Related Quality of Life during Pregnancy: A Systematic Review. Curr Pharm Des. 2020;26(32):4014-21.
  26. Cho GJ, Kim S-y, Lee HC, Kim HY, Lee K-M, Han SW, et al. Association between dental caries and adverse pregnancy outcomes. Sci Rep. 2020;10(1):5309.
  27. Khader Y, Jibreal M, Burgan S, Amarin Z. Risk indicators of pre-eclampsia in north Jordan: is dental caries involved? Gynecol Obstet Invest. 2007;63(4):181-7.
  28. Ryalat S, Sawair F, Baqain Z, Barghout N, Amin W, Badran D, et al. Effect of oral diseases on mothers giving birth to preterm infants. Med Princ Pract. 2011;20(6):556-61.
  29. Mumghamba EG, Manji KP. Maternal oral health status and preterm low birth weight at Muhimbili National Hospital, Tanzania: a case-control study. BMC Oral Health. 2007;7:8.
  30. Clark SM, Costantine MM, Hankins GD. Review of NVP and HG and early pharmacotherapeutic intervention. Obstet Gynecol Int. 2012;2012.
  31. Einarson TR, Piwko C, Koren G. Quantifying the global rates of nausea and vomiting of pregnancy: a meta analysis. J Popul Ther Clin Pharmacol. 2013;20(2):e171-83.
  32. Turner M, Aziz SR. Management of the pregnant oral and maxillofacial surgery patient. J Oral Maxillofac Surg. 2002;60(12):1479-88.
  33. Ebrahimi N, Maltepe C, Einarson A. Optimal management of nausea and vomiting of pregnancy. Int J Women’s Health. 2010:241-8.
  34. Mazzotta P, Stewart D, Koren G, Magee L. Factors associated with elective termination of pregnancy among Canadian and American women with nausea and vomiting of pregnancy. J Psychosom Obstet Gynecol. 2001;22(1):7-12.
  35. Richter JE. Gastroesophageal reflux disease during pregnancy. Gastroenterol Clin. 2003;32(1):235-61.
  36. Carvalho TS, Colon P, Ganss C, Huysmans MC, Lussi A, Schlueter N, et al. Consensus report of the European Federation of Conservative Dentistry: erosive tooth wear—diagnosis and management. Clin Oral Investig. 2015;19(7):1557-61.
  37. Lowe SA, Bowyer L, Beech A, Robinson H, Armstrong G, Marnoch C, et al. Guideline for the management of nausea and vomiting in pregnancy and hyperemesis gravidarum. Sydney, NSW: Society of Obstetric Medicine of Australia and New Zealand (SOMANZ); 2019.
  38. Maltepe C, Koren G. Preemptive Treatment of Nausea and Vomiting of Pregnancy: Results of a Randomized Controlled Trial. Obstet Gynecol Int. 2013;2013:809787.
  39. Australian Dental Association. Pregnancy: ADA; 2022 [Available from]: https://www.teeth.org.au/pregnancy.
  40. American College of Obstetricians and Gynecologists: Committee on Health Care for Underserved Women. Committee Opinion No. 569: Oral health care during pregnancy and through the lifespan. Obstet Gynecol. 2013;122(2):417-22.
  41. Australian Government Department of Health. Clinical Practice Guidelines: Pregnancy Care. Canberra, ACT: Australian Government; 2020.
  42. Scaramucci T, Carvalho JC, Hara AT, Zero DT. Causes of Dental Erosion: Intrinsic Factors. In: Amaechi BT, editor. Dental Erosion and Its Clinical Management. Cham: Springer International Publishing; 2015. p. 35-67.
  43. Neville BW, Damm DD, Allen CM, Bouquot JE. Odontogenic cysts and tumors. Oral Maxillofac Pathol. 2002;3:678-740.
  44. Yuan K, Wing LYC, Lin MT. Pathogenetic roles of angiogenic factors in pyogenic granulornas in pregnancy are modulated by female sex hormones. J Periodontol. 2002;73(7):701-8.
  45. Mussalli N, Hopps RM, Johnson N. Oral pyogenic granuloma as a complication of pregnancy and the use of hormonal contraceptives. Int J Gynecol Obstet. 1976;14(2):187-91.
  46. Janier M. Infection and angiomatous cutaneous lesions. J des Maladies Vasculaires. 1999;24(2):135-8.
  47. Bachmeyer C, Devergie A, Mansouri S, Dubertret L, Aractingi S, editors. Pyogenic granuloma of the tongue in chronic graft versus host disease. Annales de Dermatologie et de Venereologie; 1996.
  48. Milano M, Flaitz C, Bennett J. Pyogenic granuloma associated with aberrant tooth development. Texas Dent J. 2001;118(2):166-72.
  49. Witjaksono W, Al Ani BTS. Epulis and pyogenic granuloma with occlusal interference. Dent J (Maj Ked Gigi). 2005;38:52-5.
  50. Dojcinovic I, Richter M, Lombardi T. Occurrence of a pyogenic granuloma in relation to a dental implant. J Oral Maxillofac Surg. 2010;68(8):1874-6.
  51. Ojanotko‐Harri A, Harri MP, Hurttia H, Sewoón L. Altered tissue metabolism of progesterone in pregnancy gingivitis and granuloma. J Clin Periodontol. 1991;18(4):262-6.
  52. Demir Y, Demir S, Aktepe F. Cutaneous lobular capillary hemangioma induced by pregnancy. J Cutan Pathol. 2004;31(1):77-80.
  53. Steelman R, Holmes D. Pregnancy tumor in a 16-year-old: case report and treatment considerations. J Clin Pediatr Dent. 1992;16(3):217-8.
  54. Gnepp DR. Diagnostic Surgical Pathology of the Head and Neck E-Book: Expert Consult-Online and Print. Elsevier Health Sciences; 2009. p. 205-7.
  55. Wang P, Chao H, Lee W, Yuan C, Ng H. Severe bleeding from a pregnancy tumor. A case report. J Reprod Med. 1997;42(6):359-62.
  56. Taira JW, Hill TL, Everett MA. Lobular capillary hemangioma (pyogenic granuloma) with satellitosis. J Am Acad Dermatol. 1992;27(2):297-300.
  57. Muñoz M, Monje F, del Hoyo JA, Martín-Granizo R. Oral angiosarcoma misdiagnosed as a pyogenic granuloma. J Oral Maxillofac Surg. 1998;56(4):488-91.
  58. Ramirez JR, Seoane J, Montero J, Esparza Gómez GC, Cerero R. Isolated gingival metastasis from hepatocellular carcinoma mimicking a pyogenic granuloma. J Clin Periodontol. 2003;30(10):926-9.
  59. Dolić O, Obradović M, Kojić Ž, Sukara S. Caries risk assessment in pregnant women using cariogram. Srpski arhiv za celokupno lekarstvo. 2017;145(3-4):178-83.
  60. Karnik AA, Pagare SS, Krishnamurthy V, Vahanwala SP, Waghmare M. Determination of salivary flow rate, pH, and dental caries during pregnancy: A study. J Indian Acad Oral Med Radiol. 2015;27(3):372-6.
  61. Naveen S, Asha M, Shubha G, Bajoria A, Jose A. Salivary flow rate, pH and buffering capacity in pregnant and non pregnant women–a comparative study. JMED Res. 2014;2014(2014):1-7.
  62. Yousefi M, Parvaie P, Riahi SM. Salivary factors related to caries in pregnancy: A systematic review and meta-analysis.J Am Dent Assoc. 2020;151(8):576-88.e4.
  63. Rio R, Sampaio-Maia B, Pereira ML, Silva MJ, Azevedo Á. Pregnancy as a period of enhanced risk for non-cavitated caries lesions. Oral Health Prev Dent. 2020;18(2):387-93.
  64. Chaffee BW, Gansky SA, Weintraub JA, Featherstone JD, Ramos-Gomez FJ. Maternal oral bacterial levels predict early childhood caries development. J Dent Res. 2014;93(3):238-44.
  65. Wan AK, Seow WK, Walsh LJ, Bird P, Tudehope DL, Purdie DM. Association of Streptococcus mutans infection and oral developmental nodules in pre-dentate infants. J Dent Res. 2001;80(10):1945-8.

More In The Series

The Miscarriage Project

THE WHEN LIBRARY

Skin and Nail Changes After a Pregnancy Loss

After a pregnancy loss, there may still be changes in your skin and nails that take time to settle....
  • Education, Miscarriage Project
READ MORE

Breast Changes After a Pregnancy Loss

Breast changes are often one of the first signs of pregnancy. For many women, they’re also one of the last...
  • Education, Miscarriage Project
READ MORE

Feet and Ankles After a Pregnancy loss

During pregnancy, your feet and ankles carry more than just physical weight. Hormones shift, your balance changes, and tissues that...
  • Education, Miscarriage Project
READ MORE

Hormone Changes After Miscarriage

Hormonal changes affect almost every part of the body. After a pregnancy loss, those changes do not reverse instantly....
  • Education, Miscarriage Project
READ MORE

Fluid Retention After Miscarriage

There is very little research on what happens to fluid levels after pregnancy loss, but we do know from physiology...
  • Education, Miscarriage Project
READ MORE

Pelvic Health After a Pregnancy Loss

After a pregnancy loss, you might feel things in your body that no one warned you about. A tightness in...
  • Education, Miscarriage Project
READ MORE

Your First GP Visit After Miscarriage

Seeing your GP after a pregnancy loss can feel like a big step, especially if you’re not sure what to...
  • Education, Miscarriage Project
READ MORE

Medical Management After a Missed Pregnancy Loss

Medical management i.e. medication is usually offered when a pregnancy loss has been confirmed, but the pregnancy hasn’t completely passed...
  • Education, Miscarriage Project
READ MORE

Returning To Exercise After a Pregnancy Loss

There’s no one way to feel after pregnancy loss. For some women, movement helps them cope. For others, it can...
  • Education, Miscarriage Project
READ MORE

Trying Again After a Pregnancy loss

Trying again is a big question. But before you even think about what’s next, it helps to understand what’s happening...
  • Education, Miscarriage Project
READ MORE

Surgical Care After a Missed Pregnancy Loss

Surgical care may be offered when a pregnancy loss has been confirmed but hasn’t passed on its own....
  • Education, Miscarriage Project
READ MORE

Eating After a Pregnancy Loss

After a pregnancy loss, your body is still going through changes, even if others can't see them. You might notice...
  • Education, Miscarriage Project
READ MORE

Eye Changes After a Pregnancy Loss

Hormonal changes after a pregnancy loss can affect more than just your energy or cycle, they can also influence how...
  • Education, Miscarriage Project
READ MORE

Hair Changes After a Pregnancy Loss

Hair changes can happen after a pregnancy loss. For some women, hair that felt normal or fuller, starts to shed...
  • Education, Miscarriage Project
READ MORE

The Miscarriage Project

For too long miscarriage has been a taboo subject and women have been expected to just move on with their...
  • Education, Miscarriage, Miscarriage Project, Projects
READ MORE

Need Immediate Help?

If you or someone you know is struggling during the postnatal period, it’s crucial to remember that immediate help is available. Here are steps and resources you can turn to:

In Urgent Situations:

  • Hospital Emergency: Visit your nearest hospital emergency department.
  • Ambulance: Dial triple zero (000) for immediate medical assistance.

Support Services:

  • Beyond Blue: Offers guidance for depression and anxiety. Call 1300 224 636.
  • Lifeline: Provides critical support and suicide prevention. Contact 131 114.
  • Women’s Domestic Crisis Service: For domestic violence support, call 1800 015 188.
  • WIRE (Women’s Information and Referral Exchange): For information and support, dial 1300 134 130.
  • PANDA (Perinatal Anxiety & Depression Australia): For perinatal anxiety and depression support, call 1300 726 306.
  • Parent Line: For parent support, reach out to 132 289.
  • Sands: Offers support for miscarriage, stillbirth, and newborn death issues. Contact 1300 072 637.

Remember, you are not alone, and reaching out for help is a step toward healing. Your well-being is important, and support is just a phone call away.