Yes, you can take certain antibiotics while pregnant for a tooth infection, and in most cases, you should. Both the American College of Obstetricians and Gynecologists (ACOG) and the American Dental Association affirm that treating dental infections during pregnancy is safe and important. Leaving a tooth infection untreated actually poses a greater risk to your pregnancy than the antibiotics used to treat it.
Which Antibiotics Are Safe During Pregnancy
Penicillin-type antibiotics, including amoxicillin, are the go-to choice for dental infections in pregnant patients. These belong to a broader class called beta-lactams, which are generally considered safe throughout all trimesters. No new safety concerns have emerged in decades of use, and large population studies consistently show no meaningful increase in birth defects, miscarriage, or other pregnancy complications.
If you’re allergic to penicillin, clindamycin is a common alternative. Studies involving pregnant women have not found an increased chance of birth defects or low birth weight with clindamycin use. One study of 249 women actually found that clindamycin treatment reduced the chances of late miscarriage and preterm delivery.
There is one important class to avoid: tetracyclines, which include doxycycline. These antibiotics can cause cosmetic staining of a baby’s developing teeth if taken during the second or third trimester. There are also concerns about effects on fetal bone growth. Your dentist and OB should both be aware of this, but it’s worth confirming that any prescribed antibiotic is not in the tetracycline family.
Why Treating the Infection Matters
An untreated dental infection during pregnancy is not just a matter of pain. Bacteria from a tooth abscess can enter your bloodstream and trigger an inflammatory response that affects your entire body, including the placenta. Inflammatory chemicals produced in response to oral infections can, at high enough levels, cause the uterine membranes to rupture early, triggering premature labor.
The numbers are striking. Women with active periodontal disease have roughly twice the risk of preterm birth compared to women with healthy gums. In some populations, the risk is even higher. A study in Rwanda found that periodontitis elevated the chance of premature birth by six times, regardless of maternal age. When gum disease is combined with high blood pressure, the risk of premature birth and low birth weight can quadruple. Researchers estimate that 30% to 50% of premature and low birth weight cases can be traced back to infections, with periodontal disease among the most common culprits.
In rare but serious cases, a dental abscess can spread into the deep tissues of the neck and chest. A systematic review of severe dental infections during pregnancy found a 13% rate of fetal death and a 5.8% rate of maternal death when infections progressed to advanced stages like Ludwig’s angina (a dangerous infection of the floor of the mouth) or sepsis. These are extreme outcomes from infections that went untreated for far too long, but they underscore why dental infections should never be ignored during pregnancy.
Dental Procedures Are Also Safe
Many pregnant women worry not just about antibiotics but about the dental visit itself. ACOG’s guidance is clear: prevention, diagnosis, and treatment of dental conditions are safe during pregnancy. This includes dental X-rays (with abdominal and thyroid shielding), local anesthesia with lidocaine (with or without epinephrine), root canals, extractions, and fillings. All of these can be performed at any point during pregnancy.
Delaying treatment often makes things worse. A small cavity that could have been filled may progress to an abscess. An abscess that could have been drained may spread. If your dentist recommends a procedure to address the source of infection, the antibiotic alone may not be enough. Antibiotics control the bacteria, but the underlying problem, whether it’s a decayed tooth or an abscess, typically needs hands-on treatment to fully resolve.
Managing Pain Alongside Antibiotics
Acetaminophen (Tylenol) is the safest pain reliever during pregnancy and has no noteworthy limitations for use at any trimester. Ibuprofen (Advil, Motrin) and other anti-inflammatory painkillers should generally be avoided, particularly in the third trimester, when they can affect fetal heart development and reduce amniotic fluid.
If your pain is severe enough that acetaminophen isn’t cutting it, let both your dentist and your prenatal provider know. This usually signals that the infection needs more aggressive treatment, such as draining an abscess, rather than stronger pain medication.
What to Expect at Your Appointment
When you call your dentist, mention that you’re pregnant and describe your symptoms. If you have swelling, fever, or pain that wakes you up at night, ask to be seen urgently. Your dentist will likely coordinate with your OB or midwife, especially if you’re in a high-risk pregnancy.
A typical plan for a dental infection during pregnancy looks like this: you’ll be prescribed a course of antibiotics (most often amoxicillin), and your dentist will schedule a follow-up to address the source, whether that means a root canal, extraction, or deep cleaning. Finish the full course of antibiotics even if you start feeling better after a day or two. Stopping early lets resistant bacteria survive and the infection can return stronger.
Between appointments, rinsing with warm salt water several times a day can help reduce swelling and draw out some of the infection. Keeping up with brushing and flossing, even if your gums are sore, prevents additional bacteria from building up. Some dental providers also recommend chlorhexidine or fluoridated mouth rinses during pregnancy to keep oral bacteria in check.