Toothache During Pregnancy: Safe Relief and When to Get Help

Dental care is safe at any point in pregnancy, including X-rays, numbing shots, fillings, root canals and extractions, and putting off needed treatment can be riskier than getting it. For pain, acetaminophen is usually the preferred option; avoid ibuprofen and other NSAIDs from 20 weeks unless your doctor advises otherwise. See a dentist promptly for a toothache, and go to the ER for facial swelling with fever.

Many people assume they should wait until after the baby arrives to deal with a toothache. The American Dental Association (ADA) and the American College of Obstetricians and Gynecologists (ACOG) both say the opposite: urgent dental problems should be treated during pregnancy, because an untreated infection can become more serious.

Why teeth and gums can hurt more during pregnancy

• Pregnancy gingivitis: hormonal changes make gums more sensitive, swollen and likely to bleed. It's very common, especially in the second trimester.
• Morning sickness: stomach acid from vomiting can wear enamel and make teeth sensitive.
• Cravings and frequent snacking can raise the risk of cavities.
• A pregnancy "tumor" (pyogenic granuloma): a harmless red lump on the gum that sometimes bleeds. It usually shrinks after delivery but should be checked.

An existing cavity or cracked tooth can also flare up during pregnancy, the same as at any other time.

Is dental treatment safe while pregnant?

Yes. According to the ADA, preventive, diagnostic and restorative dental treatment is safe throughout pregnancy, including:

• Dental X-rays, with standard shielding
• Local anesthesia, including numbing shots with epinephrine such as lidocaine
• Fillings, root canals and extractions when needed

Many dentists schedule non-urgent work for the second trimester, when sitting in the chair is most comfortable. But a painful or infected tooth shouldn't wait for a particular trimester. Tell your dentist you're pregnant and how far along you are.

What can I take for tooth pain while pregnant?

If a tooth is infected, you may need an antibiotic. Dentists routinely prescribe antibiotics that are considered safe in pregnancy, so tell them you're pregnant.

When a toothache in pregnancy needs urgent care

Go to the ER if you have facial swelling that's spreading, a fever, or trouble breathing, swallowing or opening your mouth. An infection that spreads is more dangerous during pregnancy and needs treatment right away. See when dental swelling is dangerous.

See a dentist the same day for:

• Throbbing or constant pain, or pain that keeps you awake
• A bump or pimple on the gum near a tooth
• Swelling limited to the gum or one side of the face, without fever
• A broken tooth or a lost filling or crown

Book a regular visit for bleeding gums, mild sensitivity, or a routine checkup. Regular dental care during pregnancy is recommended.

Protecting your teeth during pregnancy

• After vomiting, rinse with water or a mix of 1 teaspoon of baking soda in a cup of water. Wait before brushing, since acid softens enamel.
• Brush twice a day with fluoride toothpaste and floss daily, even if your gums bleed a little.
• Limit sugary snacks and drinks, especially between meals.
• Keep your regular dental visits. Pregnancy is not a reason to skip them.

How a virtual dentist can help

If you're pregnant with a toothache, especially at night, on a weekend, or when getting to an office is hard, a licensed dentist can see you over video. They can:

• Work out what's likely causing the pain and how urgent it is
• Recommend pregnancy-appropriate pain relief
• Prescribe a pregnancy-safe antibiotic if there are signs of infection, sent to your pharmacy
• Tell you whether you need in-person treatment and how soon

Teledentistry.com connects you with a dentist licensed in your state, 24/7. Visits are $60 without insurance and covered by many dental plans. Tell the dentist you're pregnant and how many weeks along you are. Talk to a dentist now.