# Why Do Teeth Get Worse During Pregnancy and How to Prevent It Pregnancy is a period of significan
Pregnancy is a unique period full of changes for every woman – and not just the visible ones. While a growing belly and fatigue are topics discussed openly, dental health during pregnancy is often overlooked. Yet this is precisely the period when surprisingly significant changes occur in the mouth, which can have long-term consequences if not given sufficient attention. The deterioration of dental health during pregnancy is neither a myth nor a coincidence – it is a well-documented physiological phenomenon driven by several interconnected causes.
Many expectant mothers have encountered what their grandmothers expressed in an old folk saying: "A tooth for every child." Although modern medicine has refined and qualified this notion, there is a kernel of truth in it. Pregnancy genuinely creates conditions in which teeth and gums are significantly more vulnerable than usual – and understanding why this happens is the first step toward protecting one's smile for life.
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What happens in the body and why teeth suffer
Hormones play a key role. During pregnancy, levels of estrogen and progesterone rise to values the body never otherwise experiences, and these hormones affect virtually every system in the organism – including the oral cavity. Elevated progesterone levels cause the gums to become more sensitive to bacterial plaque, reacting to it more strongly than normal and becoming more prone to inflammation. The result is so-called pregnancy gingivitis, an inflammation of the gums that affects an estimated 70% of pregnant women according to various estimates. It manifests as bleeding when brushing teeth, swelling and sensitivity of the gums, and possibly redness. Many women explain these symptoms by thinking they are brushing too vigorously – in reality, however, this is a hormonally conditioned response of the organism.
Hormonal changes are just one piece of the puzzle. Pregnancy also brings changes in saliva composition, which has a fundamental impact on dental health. Saliva plays the role of natural protection in the oral cavity – it neutralises acids, helps remineralise enamel, and rinses bacteria from teeth. During pregnancy, its composition changes: in some women, saliva becomes more acidic, reducing its protective function and making tooth enamel more susceptible to damage. In others, excessive salivation occurs, which, while not harmful in itself, tends to be an unpleasant side effect of the first trimester.
One of the most common problems of the first trimester cannot be overlooked – morning sickness and vomiting. Stomach acid that enters the oral cavity during vomiting is highly aggressive toward tooth enamel. Repeated contact with acid literally dissolves the enamel, and if a woman immediately reaches for her toothbrush after vomiting, she paradoxically worsens the situation – she spreads the acid across the teeth and mechanically damages the softened enamel. The correct approach is to rinse the mouth with water or a baking soda solution and wait at least half an hour before brushing.
Changes in diet and eating habits also play a role. Pregnant women often crave sweets, eat more frequently and in smaller portions to alleviate nausea – and it is precisely this frequent food intake, especially sweet snacks, that creates an environment in the mouth that directly favours cavity-causing bacteria. Bacteria process sugars and produce acids that attack the enamel. The more frequently one eats, the less time teeth have for natural remineralisation.
There is also a widespread but mistaken assumption that the body "draws" calcium directly from the mother's teeth for the benefit of the developing foetus. In reality, teeth serve as a calcium reserve only to a very limited extent – unlike bones. The foetus draws calcium primarily from the mother's bone mass and from diet. However, if calcium intake from food is insufficient, this can indirectly affect overall oral health and the body's ability to maintain strong enamel.
Pregnancy gingivitis and its possible consequences
The gum inflammation that develops during pregnancy is not merely a cosmetic problem or a temporary inconvenience. If left untreated, it can progress to a more serious form of disease – periodontitis, an inflammation of the deeper tissues supporting the teeth. Periodontitis during pregnancy is associated with a higher risk of premature birth and low birth weight in newborns, as suggested by the results of numerous scientific studies, including work published in the specialist journal Journal of Clinical Periodontology. Although the precise causal relationship is still the subject of research, the very fact that gum health can influence the course of pregnancy is sufficient reason to take dental care during this period very seriously.
But why do so many women underestimate dental problems during pregnancy or postpone visiting the dentist? Part of the answer lies in fear – of X-ray radiation, local anaesthesia, and medications. These concerns are understandable but largely unnecessary. Dental treatment during pregnancy is not only safe but actively recommended, particularly in the second trimester, when the risk to the foetus is lowest and the woman no longer feels as tired and nauseous as in the first trimester. A dental X-ray with a protective apron delivers a minimal dose of radiation, and modern local anaesthetics are considered safe for pregnant women. The Czech Dental Chamber and international organisations such as the American Dental Association alike recommend regular dental check-ups throughout the entire duration of pregnancy.
Consider a specific situation: a thirty-year-old woman in her fourth month of pregnancy notices that her gums bleed when she brushes her teeth. Because she is afraid of the dentist and tells herself she will deal with it after giving birth, she postpones the visit. Meanwhile, the gingivitis deepens, plaque accumulates, and tartar builds up that cannot be removed by home cleaning. After giving birth, exhausted from caring for a newborn, she does not visit the dentist until a year later – and discovers she has early-stage periodontitis and two teeth with cavities. Yet a single preventive check-up in the second trimester and professional tartar removal would have prevented the entire situation.
How to protect teeth during pregnancy
Dental care during pregnancy does not require any radical changes to one's routine – rather, it calls for conscious adherence to and possible refinement of what should be second nature for everyone. The foundation remains thorough tooth brushing twice a day with a soft toothbrush and fluoride toothpaste, ideally supplemented with interdental brushes or dental floss. Fluoride helps strengthen enamel and increases its resistance to acids – and precisely during pregnancy, when enamel is more vulnerable, its role is all the more important.
Diet also plays a significant role. Adequate intake of calcium, vitamin D, and vitamin C supports the health of teeth and gums and contributes to the overall resilience of the organism. Calcium is found in dairy products, leafy vegetables, almonds, and tofu; vitamin D is found in oily fish and eggs, and – in favourable weather – is synthesised in the skin through sun exposure. Vitamin C is essential for the synthesis of collagen, which forms the basis of healthy gums, and its deficiency manifests precisely as increased gum bleeding. Limiting sweet and acidic foods, or consuming them as part of a main meal rather than as a snack, significantly reduces the risk of tooth decay.
As dental researcher Philippe Hujoel once noted: "Oral health is not isolated from the health of the rest of the body – it is an integral part of it." This thought holds doubly true during pregnancy, when the body is one interconnected system in which every part affects the whole.
The ideal time for a dental check-up is before conception – as part of so-called preconception care. If this is not possible, then as soon as possible after the pregnancy is confirmed, so that the dentist has the opportunity to treat any problems within the safe window of the second trimester. Preventive check-ups and professional cleaning are covered by health insurance during pregnancy, so financial barriers should not be a reason for delay.
Caring for the oral cavity during pregnancy is an investment not only in the mother's health, but also in the child's. Research suggests that cavity-causing bacteria can be transmitted from mother to child – for example, by licking a dummy or tasting baby food with a spoon that the child then receives. The better the mother's oral health, the lower the risk that the newborn will be colonised by cariogenic bacteria from the outset. A mother's healthy smile is thus, in a certain sense, the first gift she can prepare for her child even before birth.
Pregnancy brings countless new concerns and priorities into a woman's life. Teeth may not seem to belong among them at first glance – but as is clear from the above, this is precisely the period when they deserve exceptional attention. The hormonal upheaval, altered oral environment, nausea, and modified diet create a combination that, without conscious care, can leave lasting marks. Fortunately, relatively little is needed: regular brushing, a balanced diet, limiting sugar, and one or two visits to the dentist throughout the entire pregnancy. That is a price that is certainly worth paying.
