Common Causes of Sore Gums in Early Pregnancy

Pregnancy is a beautiful journey. Your body is growing a human being inside of it, with you at the center of the experience. While the journey comes with many wonderful moments, it also comes with its own set of challenges.

Besides your belly and limbs swelling up, you may also notice that your gums look swollen and tender, and sometimes they bleed after brushing or flossing. This usually happens early on in the pregnancy.

Irritated, swollen, and bleeding gums are part of the pregnancy. It is a mild type of gum disease known as pregnancy gingivitis. It is the direct result of your hormones going haywire.

Research shows that gingival inflammation prevalence ranges from 30-100% during pregnancy, with studies documenting 89% in Ghana, 86.2% in Thailand, and 47% in Brazil. This widespread condition is primarily driven by hormonal changes that dramatically affect periodontal tissues.

The Timeline of Sore Gums

Sore gums are sometimes considered to be an early sign of pregnancy. They occur during the first trimester and upgrade to a bleeding stage by the second and third trimesters.

Studies show that oral lesions were seen in 44.2% of pregnant women overall, with distribution varying by trimester: 27.5% in the first, 52.5% in both second and third trimesters. Inflammation peaks in the third trimester when gingival enlargement becomes the most commonly observed oral lesion.

However, if you were already battling gum disease prior to the pregnancy, the pregnancy gingivitis can appear to be more severe than usual.

What Causes Pregnancy Gingivitis?

There are several reasons why your toothbrush comes away with a tint of pink during pregnancy or why chewing hard food invokes discomfort. If you have been diagnosed with pregnancy gingivitis, these are the culprits behind it.

There Is Hormonal Activity Afoot

Your body goes through enormous changes during pregnancy, one of which includes getting flooded with peak levels of pregnancy hormones (mainly progesterone). These hormones are responsible for the rush of blood flow to your mucous membranes.

Recent research published in 2024 demonstrates that elevated levels of estrogen (p = 0.001) and progesterone (p = 0.003) were significantly linked to the severity of stomatognathic changes during pregnancy. Hormonal fluctuations accounted for approximately 45% of variance in gingival inflammation and dental caries severity.

The increase in blood flow causes your gum tissue to swell. They become sore and more prone to bleeding. Higher levels of estrogen and progesterone lead to greater vascular permeability and capillary dilation within gingival tissues, which makes them more prone to inflammation. This inflammation is simply your body's reaction to your pregnancy.

Additionally, progesterone can suppress local immune defense by reducing the effectiveness of neutrophils and macrophages against bacterial plaque, encouraging bacterial accumulation and gingival inflammation. Estrogen receptor-beta (ER-β) is the predominant receptor in periodontal tissues, and pregnancy hormones modulate subgingival microbiota, particularly affecting Porphyromonas gingivalis and Prevotella intermedia.

Those Odd Cravings You Have Been Having

Your taste buds change during pregnancy. You crave the unhealthiest and sometimes the oddest types of food. With the increased attraction towards acidic food and all kinds of sugary treats, the risk of plaque buildup rises.

Your consumption of unhealthy pregnancy cravings creates a friendly environment for plaque and bacteria to set up shop. This leads to angry, swollen gums.

Your Mouth Is Drier Than Usual

Saliva production takes a little time off for some pregnant folks, courtesy of the hormones. With lesser than usual saliva production, bits of food tend to stick around for longer in the mouth. This invites plaque to build up and irritate the gums.

Your Saliva Has Changed

Pregnancy brings about changes to the pH level of your saliva. It has been observed that the saliva of pregnant women is more acidic than that of non-pregnant women. This increases the risk of enamel wear-down and caries.

Research shows that salivary pH progressively decreased from the control group to the third trimester group, indicating increasingly acidic conditions as pregnancy advanced. Low salivary pH provides an acidogenic environment for growth of aciduric bacteria leading to dental caries, which further lowers salivary pH creating a vicious cycle.

You Are the Unfortunate Victim of Morning Sickness

Morning sickness affects 70% of pregnancies in the early stages. It is an exhausting combination of nausea and vomiting.

The strong and repeated upheaval of the stomach acid has a detrimental effect on the teeth. The gastric acids present in the emesis erode the enamel on the inner surface of the teeth, most commonly the front teeth. The constant contact with acid weakens them, and irritation sets in. They also become more prone to decay.

Research emphasizes that after vomiting, pregnant women should rinse their mouths with water and wait at least an hour before brushing their teeth to prevent additional enamel damage. The effects of tooth erosion such as marked tooth sensitivity may last beyond the duration of the pregnancy.

The Saga of Your Pernickety Senses and Toothpaste

Pregnancy heightens all your senses. Your start to show aversion towards certain tastes and smells. Some women find it quite difficult to bear the taste and smell of their toothpaste. This makes them reluctant to follow their usual brushing routine.

Oral hygiene habits showed statistical significance (p = 0.02) in research, with poor brushing and flossing practices correlating with increased inflammation and caries. A dip in the frequency of dental hygiene makes your mouth a playground for harmful bacteria. They thrive in an unclean environment and give rise to dental problems.

What Are the Treatment Options for Pregnancy Gingivitis?

Since so much is going on in your body during pregnancy, it can be quite easy to neglect proper treatment of sore and bleeding gums. While it is usually a mild inflammation, it can develop into a severe case of gum disease down the road.

However, there is no reason to panic. Pregnancy gingivitis can be fought off with the right treatment. Research shows that good oral hygiene can partially neutralize hormonal effects on gingival tissues.

Maintain Oral Hygiene

Invest in a quality soft-bristled toothbrush. It will soothe your aching gums and prevent unnecessary bleeding. If your current toothpaste is making you gag, select a toothpaste flavor that will not make you heave.

Armed with a soft toothbrush and the right toothpaste, brush your teeth twice a day using the proper technique. Hurrying through your brushing routine will only cause more harm than good. Be gentle and make sure that you tackle the plaque in the far recesses of your mouth.

Certain antigingivitis toothpaste may also help provide you relief from your symptoms. Discuss it with your dentist before you begin its use.

Keep Up the Flossing

Maintain a steady routine of flossing at least once a day. It will help you get rid of all the nasty leftover gunk from between and around your teeth. Good flossing reduces the chances of bacteria attacking your teeth and prevents plaque formation.

Scrub Your Tongue

A commonly neglected part during oral hygiene is the tongue. It is a breeding ground for harmful bacteria and requires the same amount of cleaning care as your teeth. Make sure to include a good tongue scrub into your oral hygiene routine.

Say No to Alcohol-Based Mouthwash

If you are suffering from morning sickness, your first instinct after a vomiting session is to wash out your mouth with a minty fresh mouthwash. However, if you are using an alcohol-based rinse, it is doing more harm than good.

Alcohol-based mouthwashes eliminate both the good and bad bacteria in the mouth. This proves detrimental to dental health.

You can also pick up an antigingivitis mouthwash with your dentist's recommendation.

Say Yes to Vitamins

Maintaining good health is vital during pregnancy for both you and the baby. Remember to take your prescribed vitamins regularly. They will give a boost in maintaining strong, healthy teeth in addition to the rest of your body.

Say No to Sugar, Yes to Healthy Eating

It is hard to deny your pregnancy cravings. However, you should curb your intake of sugary treats and acidic food for the sake of healthy teeth and gums.

Replace sugar with a healthy crunch of fruits. An apple a day keep the doctor away. It is true to a certain extent. While you may not want to munch on an apple every day, consider it a good substitute for processed sugar treats. The snackable fruit helps cleanse your teeth and freshens up your breath.

Similarly, fruits and vegetables rich in vitamin C promote gum health. So, lean towards incorporating them into your daily diet.

Salt Rinse for Calm Gums

This is a popular home remedy for reducing gum inflammation. Stir one teaspoon of sea salt into one glass of warm water and use it as a rinse. It helps soothe sore gums.

Simply swirl the concoction around in your mouth for 15 seconds. Do it twice a day only. Overuse of it is detrimental to dental health. Make sure that you do not swallow any of it.

While it does not treat pregnancy gingivitis, it will give you some relief from its symptoms. However, make sure you consult a professional before you apply the remedy.

Get an Appointment

Do not skip out on your dentist appointments, especially during pregnancy. Regular dentist checkups are part of promoting good dental health. Make sure that you maintain your regular visits to ensure excellent oral health.

What Is That Lump?

Sometimes, pregnant women will also notice lesions or small lumps in the oral cavity. They are called pyogenic granulomas. These raised bumps may bleed and are commonly known as pregnancy tumors.

Despite the scary name, pyogenic granulomas are benign and not a cause for major concern. Pyogenic granuloma is a non-neoplastic inflammatory reactive hyperplasia caused by factors such as hormonal imbalance. They develop due to the massive changes in hormonal activity during pregnancy, typically occurring during the second and third months of pregnancy. While they are most commonly found on the gums, they can also form on other parts of the body.

Medication and treatment options depend upon the size of the granuloma. However, in cases of pregnancy, most pyogenic granulomas appearing during pregnancy subside after delivery. If the lesion is large or bleeding, treatment during pregnancy is recommended in the second trimester.

Pregnancy Gingivitis and the Baby

In its mild state, sore gums have no effect on your baby, and with proper care, pregnancy gingivitis can be stopped from progressing to a more concerning state of periodontal or gum disease. Moreover, your oral ecosystem should return to its normal state postpartum, with inflammation resolving without permanent attachment loss.

However, certain studies have shown that in women with a pre-existing case of gum disease prior to the pregnancy, this mild inflammation can result in complications with the baby.

A 2025 bibliometric analysis examined 932 publications from 2000-2023, revealing that research confirms women with periodontitis face significantly elevated risks for adverse outcomes. Statistically significant values were obtained regarding the risk of preterm birth in pregnant women with periodontitis (RR = 1.67, 95% confidence interval), and low birth weight (RR = 2.53, 95% CI).

A severe case of gum disease such as periodontitis can increase the risk of low birth weight, preterm labor, and preeclampsia. Poor dental health during pregnancy has been linked to negative pregnancy outcomes, making routine dental care and preventive measures essential components of prenatal health management.

Final Thoughts

In all cases, it is vital that you practice good oral hygiene for the sake of your health and the health of the unborn baby. Pregnancy gingivitis or not, a regular oral hygiene routine and proper technique can save you a lot of unnecessary grief down the road.

Your gums should return to their normal non-sore state after the miracle of birth. Unlike the scary stories you may have heard, pregnancy will not cause your teeth to fall out. If you want a clean bill of oral health, follow a healthy diet and do not skip out on your checkups.

Research shows that most changes in oral tissues during pregnancy can be avoided with good oral hygiene, and that good oral hygiene can partially neutralize hormonal effects on gingival tissues. Maintaining proper dental care throughout pregnancy protects both maternal and fetal health.