Toothache while pregnant: what's safe and when to see a dentist

What’s probably going on

Pregnancy doesn’t cause toothaches by itself, but it changes your mouth in ways that make some problems more likely. The usual causes, most common first:

• Sore, swollen gums (pregnancy gingivitis). Higher hormone levels change how your gums react to plaque. Gums can get puffy and tender and bleed a little when you brush or floss. It can feel like a tooth ache, especially around one tooth. See gum pain around one tooth.
• A cavity. Snacking more often can give decay more chances, and acid from morning sickness can damage enamel. A cavity that reaches the nerve can start to throb. See throbbing tooth pain.
• Sensitive teeth from acid. Morning sickness raises the acid level in your mouth, which can damage enamel. Worn enamel can make teeth twinge with cold. See tooth sensitive to cold.
• An infection (abscess). An old cavity or crack can infect the root, with deep throbbing pain and sometimes swelling. See tooth abscess.
• A “pregnancy tumor.” Despite the name, it isn’t cancer. It’s an overgrowth of gum tissue, usually in the second trimester, that usually goes away after the baby is born. Show it to your dentist.

Gum disease left alone can get worse. The ADA notes that gingivitis can lead to more serious gum disease, so your dentist will suggest ways to treat it.

Is it safe to see a dentist while pregnant?

Yes. The American Dental Association and the American College of Obstetricians and Gynecologists both encourage dental care during pregnancy. The ADA encourages check-ups and needed treatment at every stage of pregnancy. The ADA and ACOG agree that urgent care, such as a root canal, an extraction or a filling, can be done safely while pregnant.

Waiting has its own risk. The ADA and ACOG point out that delaying treatment can lead to more complex problems. If you have a high-risk pregnancy, your dentist or OB may suggest timing some care differently.

• X-rays. Dental X-rays are considered safe at any stage of pregnancy. The ADA considers them safe at any stage and says abdominal or thyroid shields are no longer recommended. If you have questions, ask your dentist.
• Numbing shots. Local anesthetics such as lidocaine, including the kinds with epinephrine, may be used during pregnancy.
• Tell the office up front. Say you’re pregnant, how far along you are and your due date when you book, and list any medicines your OB has you on.

What to do tonight

1. Rinse with warm water. Warm salt water is fine too.
2. Floss gently around the tooth. Something stuck under the gum is a common cause, and removing it can ease the pain.
3. Cold pack on the cheek. About 20 minutes at a time. Never use heat on a swollen face.
4. Sleep with your head raised. An extra pillow may ease the pressure.
5. Call your OB, or ask a pharmacist, before taking a pain reliever. Acetaminophen is the usual over-the-counter option in pregnancy; take it only as the label directs and as your doctor advises. In September 2025 the FDA started a label change about a possible link between acetaminophen in pregnancy and autism and ADHD. The FDA also said a cause-and-effect link has not been established, that some studies disagree, and that acetaminophen remains reasonable in some situations. Ask your OB how this applies to you.
6. Call a dentist in the morning. See what to do for a toothache right now and how to sleep with a toothache for more.

What not to do

• Don’t take ibuprofen, naproxen or aspirin from 20 weeks on unless your doctor tells you to. The FDA warns these NSAIDs can cause rare but serious kidney problems in the baby, leading to low amniotic fluid. Many over-the-counter products contain them, so check labels or ask a pharmacist. (Low-dose aspirin your doctor prescribed is a separate case; don’t stop it without asking.)
• Don’t put aspirin or any pill on the tooth or gum. It burns the tissue.
• Don’t take leftover antibiotics. Only a dentist or doctor should decide whether you need them, and which ones are right in pregnancy.
• Don’t use numbing gels, herbal oils or other remedies without asking your OB or pharmacist first.
• Don’t wait until after the baby. Relief isn’t a cure, and infections can spread.

How a dentist fixes it, and what it costs

The fix is usually the same as it would be if you weren’t pregnant.

• Gingivitis usually gets a professional cleaning, sometimes more often during pregnancy.
• A cavity gets a filling.
• An infected nerve gets a root canal or, sometimes, an extraction. See root canal cost.

The price depends on the treatment, the tooth, where you live and your coverage, so ask for a written estimate before work starts. If you have Medicaid, ask your plan whether it covers dental care during pregnancy. Without insurance, a dental savings plan can lower the price at participating dentists. It’s a discount plan, not insurance.

How to keep it from coming back

• Brush twice a day with a fluoride toothpaste, paying extra attention to the gumline.
• Clean between your teeth once a day.
• After vomiting, don’t brush right away. Rinse with a teaspoon of baking soda in a cup of water to wash away the acid.
• Keep sweet snacks to mealtimes when you can.
• Keep your regular cleanings. Your dentist may suggest more frequent cleanings while you’re pregnant.

Healthy habits now help your baby too; baby teeth start forming between the third and sixth month of pregnancy. For brush picks, see the best electric toothbrush.