Toothache during pregnancy

By trimester

Weeks 1–13

1st trimester

Morning sickness and general first-trimester caution can make people put off dental care, but urgent pain doesn't need to wait. Cleanings, fillings, and local anesthesia are appropriate now too, and CDC describes dental care as safe and important at any stage of pregnancy.

Weeks 14–27

2nd trimester

This is often the most comfortable window for a longer or more involved dental visit, mainly for positioning and energy reasons rather than a special safety rule. If a toothache has been nagging since the first trimester, this is a good time to finally get it looked at rather than waiting until after delivery.

Weeks 28–birth

3rd trimester

Reclining for a long dental appointment gets harder late in pregnancy, but urgent pain still needs urgent care. Ask about shorter sessions or extra positioning support, and keep in mind that pregnancy-related gum swelling can make an existing cavity or dental problem feel more intense than it otherwise would.

What does the evidence show for toothache?

• Dental care, including routine and emergency visits, is described by CDC as safe and important at any stage of pregnancy, so a painful tooth does not need to wait for a supposedly safer trimester before getting evaluated. 1
• About 60% to 75% of pregnant women have gingivitis, and hormonal changes during pregnancy can make gums more inflamed, red, and swollen, which can make an existing toothache or dental problem feel more pronounced. CDC also notes gum disease has been associated with preterm birth and low birth weight, though the exact mechanism remains unclear. 2
• A tooth abscess, a collection of pus from a bacterial infection, typically causes a persistent gnawing, sharp, shooting, or throbbing toothache, sometimes with gum swelling that can look like a pimple, fever, or a bitter taste, and MedlinePlus specifically calls swelling of the upper or lower jaw a very serious symptom. 3
• Acetaminophen is still considered by many health care providers and organizations to be the pain reliever of choice during pregnancy, with guidance to use it only as needed at the lowest effective dose, since recommended doses have not been shown to increase the chance of birth defects or miscarriage. 4
• The FDA recommends against using NSAIDs like ibuprofen after week 20 of pregnancy unless a healthcare provider specifically advises it, since later use has been linked to effects on fetal kidneys, lower amniotic fluid, and early closing of the fetal ductus arteriosus, so ibuprofen for dental pain should be a conversation with your provider rather than an automatic choice. 5
• One in four women of childbearing age has untreated cavities, and CDC notes that a mother with a lot of cavity-causing bacteria can pass that bacteria to her baby's mouth, which is part of why addressing a painful tooth during pregnancy also matters for the baby after birth. 2

Toothache during pregnancy: what to do

When should I call my provider about toothache?

Facial or jaw swelling, fever, difficulty swallowing or breathing, or pain that keeps getting worse despite acetaminophen are reasons to get same-day dental or medical care rather than wait for a routine appointment. MedlinePlus specifically calls swelling of the upper or lower jaw a very serious symptom of a spreading dental infection, so these signs deserve urgent evaluation rather than a wait-and-see approach. If you are ever unsure which side of the line you are on, make the call. Obstetric teams handle these check-ins as routine, not as overreacting.