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Teeth (Dental Health, Cavities & Gum Disease)

Cavities and gum disease are among the most common health problems there are, and most of the time they are preventable with fluoride, daily cleaning, less sugar and regular dental visits. A swollen face with trouble breathing or swallowing, or a knocked-out tooth, needs care right away.

Go to the emergency room or call 911 if a toothache or sore gums come with any of these:

Call a dentist the same day (or go to urgent care if you can’t reach one) if:

  • A tooth has been knocked out. The NHS says to ask for an emergency dentist appointment, even if you can’t find the tooth, and to get to a dentist as soon as possible. Hold the tooth by the crown (the white part), not the root; if it is dirty, rinse it gently in milk, saline or saliva; and try to put it back in its socket. If you can’t, keep it in milk or saliva. Never put a baby tooth back in, because it could damage the tooth growing underneath (NHS (opens in a new tab)).
  • You have a swollen face or jaw, a fever, or an intense toothache. That can mean a dental abscess, a pocket of pus from infection, which needs urgent treatment by a dentist and will not go away on its own (NHS (opens in a new tab)).
  • Bleeding won’t stop. After a tooth is removed, press on the area with a clean cloth for at least 10 minutes; bleeding that does not stop, or pain and swelling that are severe or getting worse, need an urgent dentist appointment (NHS (opens in a new tab)).
  • Toothache lasts more than 2 days, doesn’t ease with painkillers, or comes with pain when you bite, red gums or a bad taste in your mouth (NHS (opens in a new tab)).
  • A tooth is chipped, cracked or broken. That is usually not serious and a dentist should be able to treat it; if a piece broke off, keep it in milk or saliva and bring it along (NHS (opens in a new tab)).

Two common problems: cavities and gum disease

Most dental trouble comes from one source. Bacteria in the mouth join with food to form a soft, sticky film called plaque. They use the sugars and starches in what you eat and drink to make acids, and those acids attack the minerals in your tooth’s hard outer layer, the enamel (MedlinePlus (opens in a new tab)). Plaque that isn’t removed can harden into tartar, which only a dentist or dental hygienist can remove (NIDCR (opens in a new tab)).

Cavities (tooth decay)

Your teeth lose and regain minerals all day long. Fluoride and saliva help enamel repair itself. A white spot is an early sign, and NIDCR says decay can be stopped or reversed at that stage; once enough minerals are lost, the enamel breaks down and forms a cavity, a hole in the tooth (NIDCR (opens in a new tab)), which a dentist has to repair with a filling (MedlinePlus (opens in a new tab)). Early decay usually causes no symptoms. Later it can cause a toothache, sensitivity to sweets, heat or cold, and staining, and if the tooth becomes infected, an abscess with pain, facial swelling and fever (NIDCR (opens in a new tab)). CDC notes that cavities keep growing unless stopped, so waiting for pain limits your options (CDC (opens in a new tab)).

Gum disease

Gum disease is an infection that inflames the tissues holding your teeth in place. It starts as gingivitis: red, swollen gums that bleed easily, which you can usually reverse with daily brushing and flossing and regular cleanings. Left alone it can become periodontitis, in which the gums pull away and form infected pockets, and the bone and tissue supporting the teeth are destroyed (MedlinePlus (opens in a new tab)). Other signs are loose or sensitive teeth, pain when chewing and persistent bad breath (NIDCR (opens in a new tab)). CDC adds that it can become serious before you notice symptoms (CDC (opens in a new tab)). NIDCR names tobacco use as the most significant risk factor; others include older age, diabetes and genetics (NIDCR (opens in a new tab)). See our Smoking guide and Diabetes guide.

How common is it?

Very. CDC reports that almost all U.S. adults 20 or older have had a cavity in their permanent teeth (CDC (opens in a new tab)), and about half of children 6 to 9 have had at least one cavity (CDC (opens in a new tab)). About 4 in 10 U.S. adults 30 or older had periodontitis of some level in a 2009–2014 survey, and about 60% of adults 65 and older (CDC (opens in a new tab)). Cavities and gum disease are the leading causes of tooth loss (CDC (opens in a new tab)). The encouraging part: CDC calls both gum disease and tooth loss largely preventable (CDC (opens in a new tab); CDC (opens in a new tab)).

When a toothache is something else

Besides decay, the NHS lists a dental abscess, a cracked tooth, a loose or broken filling, an infection around a wisdom tooth, braces problems, gum disease, teeth grinding and sensitive teeth (NHS (opens in a new tab)). Pain in the jaw joint or chewing muscles can be a temporomandibular disorder; see our TMJ guide. For sores inside the mouth, see our Canker Sores guide.

Side by side

Six approaches compared

For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.

Teeth (Dental Health, Cavities & Gum Disease): six approaches compared
ApproachWhat it involves Estimated costWhat to expect
Conventional medicine (AMA) Regular dental check-ups and cleanings, fluoride, sealants for children, fillings for cavities, deep cleaning for gum disease, root canals or extractions for badly damaged teeth, and urgent treatment for infection. Routine cleaning about $80–$200; filling about $100–$450 per tooth; deep cleaning about $185–$444 per quadrant; root canal about $1,000–$1,500 plus a crown. Medicare covers most dental care only in special cases. Dental care is the only approach that removes decay, tartar and infection. Fluoride and sealants have good evidence for preventing cavities, and treating gum disease improves it.
Chiropractic Chiropractic care focuses on the spine and joints. It has no role in treating cavities, gum disease or dental infection. Not applicable for tooth problems. For general chiropractic visits: about $90–$200 for a first visit and $55–$100 for follow-ups. We found little research on chiropractic care for tooth or gum problems. Dental problems need a dentist. A chiropractor may help with related neck or jaw-muscle complaints — see the TMJ guide.
Acupuncture Fine needles used as a complement for dental pain or anxiety. Acupuncture cannot repair a cavity, clear an abscess or treat gum disease. About $125–$230 for a first visit and $90–$185 for follow-ups; community clinics about $50–$90. A 2023 review found lower pain after dental procedures with acupuncture compared with sham acupuncture, but called the research limited. Evidence for dental anxiety is thin.
Herbal medicine Clove oil for toothache, oil pulling and herbal mouthwashes are the best-known home remedies. They may soothe or add a little to daily care but do not replace fluoride, cleaning or a dentist. Cost estimate being researched. Reviews of oil pulling report possible benefit for gum health, but the evidence is very low certainty. Clove oil is used for toothache; swallowing a lot of it can harm the liver.
Massage therapy Massage can help with stress and tense jaw, face and neck muscles. It does not treat cavities or gum disease. At one national chain, about $125–$160 for a 60-minute massage for non-members and $65–$90 for members; memberships about $70–$90 a month. We found little research on massage for dental problems. It may help you relax before a visit or ease clenching-related muscle tension.
MBHA Wellness Coach Habit coaching: a brushing and cleaning-between-teeth routine, smarter snacking and drinks, quitting tobacco, managing dry mouth, handling dental fear, and keeping dental appointments. MBHA coaching cost estimate being researched. Daily habits are what decide how often you need a dentist’s drill. Coaching supports those habits alongside — never instead of — dental care.

Approach 1 of 6

Conventional medicine (AMA)

Conventional care means a dentist (and often a dental hygienist), and it is the only approach here that can remove decay, tartar and infection. NIDCR’s advice for keeping teeth for a lifetime: brush twice a day with fluoride toothpaste, clean between your teeth, limit sugary foods and drinks, avoid tobacco, and get regular check-ups and professional cleanings (NIDCR (opens in a new tab)). CDC suggests at least one visit a year (CDC (opens in a new tab)). The NHS says people at higher risk of gum disease, such as those who are pregnant or have type 2 diabetes, should see a dentist and hygienist regularly (NHS (opens in a new tab)).

1. Prevention in the dental chair

If you are at high risk of decay (for example, because medicines give you a dry mouth), a dentist may give a fluoride varnish or foam, or recommend a gel or rinse for home (NIDCR (opens in a new tab)). Sealants are covered in the children’s section below.

2. Treating cavities

Early decay can be reversed with fluoride before a hole forms (NIDCR (opens in a new tab)). For a typical cavity, the dentist removes the decayed tissue and fills the space, with tooth-colored (composite) or silver-colored (amalgam) material; badly broken-down teeth can get crowns. Fillings and crowns generally do not last a lifetime and may need replacing (NIDCR (opens in a new tab)). If infection or damage reaches the pulp, the soft center of the tooth, you might need a root canal. In the most severe cases the tooth is pulled, and a bridge or implant may be suggested, because otherwise the neighboring teeth can drift and change your bite (MedlinePlus (opens in a new tab)).

3. Treating gum disease

The main goal is to control the infection. NIDCR says early gum disease can often be reversed by daily brushing and flossing, while periodontitis needs a dentist or hygienist, who may do “scaling and root planing” (a deep cleaning), prescribe a rinse, or in advanced cases operate. Daily care at home and quitting tobacco matter to the result (NIDCR (opens in a new tab)). CDC adds that severe cases may be referred to a periodontist, a gum specialist (CDC (opens in a new tab)).

4. Infection and abscess

A dentist treats an abscess by draining the pus; depending on the cause you may need a root canal or the tooth may be removed, and you might get antibiotics (NHS (opens in a new tab)). Don’t assume pills alone will fix it. A 2024 Cochrane review found only three small trials (134 people): where the tooth was also being treated, adding antibiotics made little or no difference to pain or swelling in the trials that looked, and no trials tested antibiotics without a dental procedure (Cochrane review, 2024 (opens in a new tab)). Your dentist or doctor decides whether you need one. Until you are seen, the NHS suggests over-the-counter pain relief (children under 16 should not take aspirin), soft foods, a soft toothbrush, and avoiding very hot or cold food and drink (NHS (opens in a new tab)), plus a pain-relieving mouth gel and, for adults, a salt-water rinse (NHS (opens in a new tab)). We don’t list doses; a pharmacist can advise. CDC notes that decay reaching the tooth’s nerve can cause an infection that may spread through the body, which it calls rare but potentially fatal (CDC (opens in a new tab)).

What it costs

These are self-pay ranges from The Pricer; your bill depends on your dentist, location and insurance.

Original Medicare covers dental care only in a few situations; see “Paying for dental care” below. Ask for a written estimate before treatment.

Find a medical doctor in our directory

Approach 2 of 6

Chiropractic

Chiropractic care often involves spinal manipulation, a controlled thrust to a joint of the spine (NCCIH (opens in a new tab)). Cavities, gum disease and dental infections are problems of the teeth and gums, and spinal manipulation does not treat them. When we searched the research database PubMed for chiropractic studies of teeth, gums and toothache, we found little research to review, and nothing showing chiropractic care treating decay, gum disease or a dental infection.

A chiropractor may help with a nearby problem. If your jaw, neck or head hurts from clenching or a jaw-joint disorder rather than a tooth, see our TMJ guide and Neck guide. Please don’t delay seeing a dentist for a toothache, swollen face or bleeding gums: a dental abscess will not go away on its own (NHS (opens in a new tab)).

What it costs

For general chiropractic care (not dental treatment), about $90–$200 for a first visit and $55–$100 for follow-ups (The Pricer (opens in a new tab)).

Find a chiropractor in our directory

Approach 3 of 6

Acupuncture

Acupuncture cannot fill a cavity, drain an abscess or clean tartar from below the gum line. In dentistry the question is whether it eases pain or anxiety around treatment, not whether it treats the disease.

  • Pain after dental procedures. A 2023 systematic review found 23 publications on acupuncture for acute dental pain. In 11 randomized trials (668 people) of pain after dental procedures, people who got acupuncture had lower pain scores than those who got sham acupuncture; the authors said the results were limited by weaknesses in the studies (systematic review, 2023 (opens in a new tab)). NCCIH reports that a 2016 evaluation of 11 studies of pain after surgery (not specifically dental) found less pain and less opioid use the day after the operation (NCCIH (opens in a new tab)).
  • Anxiety and gagging. We found little research on needle acupuncture for dental anxiety. A 2023 review of four small studies of laser stimulation of acupuncture points in children reported positive results for gag reflex, pain before an injection and sleep bruxism, and asked for better-designed studies (systematic review, 2023 (opens in a new tab)).

Safety and cost

NCCIH says relatively few complications have been reported, but they have come from non-sterile needles and improper treatment (NCCIH (opens in a new tab)). Sessions run about $125–$230 for a first visit and $90–$185 for follow-ups; community clinics about $50–$90. Medicare Part B covers acupuncture only for qualifying chronic low-back pain (The Pricer (opens in a new tab)).

Find an acupuncturist in our directory

Approach 4 of 6

Herbal medicine

People have used plants for sore teeth and gums for a very long time. None of these replaces brushing with fluoride toothpaste, cleaning between your teeth or seeing a dentist.

Clove oil for toothache

Eugenol, also called clove oil, is an aromatic oil used as a food flavoring and as an herbal oil applied to the tooth area for toothache. A U.S. government liver-safety resource says that therapeutic amounts have not been linked to liver injury, but swallowing high amounts, as in an overdose, can cause severe liver injury (LiverTox (opens in a new tab)). A 2025 systematic review of 21 studies of plant-based products for dental pain concluded the evidence supports pain relief from several, including clove oil, and called for standardized products and larger trials (systematic review, 2025 (opens in a new tab)). A numbed tooth is still a sick tooth: the NHS says to see a dentist if toothache lasts more than two days (NHS (opens in a new tab)). Keep clove oil away from children.

Oil pulling

Oil pulling means swishing a cooking oil such as sesame or coconut oil in the mouth. A 2016 review found only five small trials (160 people) and concluded the limited evidence suggests it may help mouth hygiene over the short periods studied (systematic review, 2016 (opens in a new tab)). A 2024 review of 25 trials (1,184 people) found a probable benefit for gum health, but chlorhexidine (a prescription antiseptic rinse) was better at reducing plaque, and the overall evidence was very low certainty (systematic review, 2024 (opens in a new tab)). Nothing we read suggests oil pulling should replace fluoride toothpaste, cleaning between teeth or dental visits.

Talk to your doctor or pharmacist before trying a supplement or concentrated plant oil. Supplements may interact with your medicines, and the FDA does not review them for safety before they are sold (NCCIH (opens in a new tab)). We don’t list doses here. Our Medication Safety guide has more.

What it costs

Cost estimate being researched.

Approach 5 of 6

Massage therapy

Massage can’t treat a cavity or gum disease. Two things are worth knowing.

  • Stress and anxiety. Fear of the dentist keeps some people from care. We found little research on massage for dental anxiety. A large 2021 review of non-drug ways to reduce anxiety before medical or dental procedures included massage among many approaches studied, alongside music, education and relaxation (systematic review, 2021 (opens in a new tab)). Telling your dentist you are nervous is still the most useful step.
  • Clenching and jaw muscles. If you wake with a sore jaw, our TMJ guide reviews the research on massaging those muscles.

NCCIH says the risk of harm from massage appears low, though there are rare reports of serious side effects, some with vigorous deep-tissue massage (NCCIH (opens in a new tab)).

What it costs

At one national chain, franchise price lists show about $125–$160 for a 60-minute massage for non-members and $65–$90 for members, whose memberships run about $70–$90 a month (The Pricer (opens in a new tab)). Tips are extra.

Find a massage therapist in our directory

Approach 6 of 6

MBHA Wellness Coach

Dentists treat the damage; daily habits decide how much there is. An MBHA Wellness Coach can help you build the routines below, alongside your dentist and doctor, never instead.

A cleaning routine you will actually do

NIDCR’s list is a good template: brush twice a day with fluoride toothpaste, clean between your teeth regularly, visit the dentist for check-ups and cleanings, and eat a balanced diet (NIDCR (opens in a new tab)). A coach can help you attach the routine to an existing habit and set a reminder for your next cleaning.

Smarter snacking and drinks

NIDCR advises limiting sugary and starchy foods and drinks and limiting snacking (NIDCR (opens in a new tab)). A coach can help you plan water-first drinking, move sweets to mealtimes and read labels.

Tobacco, dry mouth and diabetes

Tobacco is the biggest gum-disease risk factor NIDCR lists (NIDCR (opens in a new tab)); a coach can help you build a quit plan (see our Smoking guide). If you take medicines that dry your mouth or have diabetes, a coach can help you keep a medicine list for the dentist and keep up the self-care steps below.

Dental fear and keeping appointments

Fear and cost are big reasons people put off care, and an untreated cavity only grows (CDC (opens in a new tab)). A coach can help you rehearse what to tell your dentist, write down questions and look into low-cost clinics. MBHA coaching cost estimate being researched.

Another approach

Brushing, flossing and daily care

The point of daily cleaning is to remove plaque before it hardens or makes acid. NIDCR notes that even teeth with fillings can decay, because plaque can build up under a chipped filling, and exposed roots where gums have pulled back can decay too (NIDCR (opens in a new tab)).

Brushing

NIDCR’s tips: use fluoride toothpaste, angle the bristles toward the gum line, brush gently in small circles rather than scrubbing, brush every side of every tooth and your tongue, and replace the brush when the bristles are worn (NIDCR (opens in a new tab)). The NHS suggests brushing for about two minutes, last thing at night and at one other time, then spitting out the toothpaste and not rinsing, since rinsing washes away the fluoride (NHS (opens in a new tab)). It also says electric or manual doesn’t matter if you clean every surface. A Cochrane review of 56 trials found powered brushes reduced plaque and gum inflammation somewhat more, while saying the clinical importance is unclear (Cochrane review, 2014 (opens in a new tab)).

Cleaning between teeth

NIDCR recommends cleaning between your teeth once a day with floss, a pick, small interdental brushes or a water flosser, and suggests a floss holder or water flosser if arthritis makes floss hard to hold (NIDCR (opens in a new tab)). The NHS says interdental brushes can replace floss, especially if there are gaps, and advises against wooden toothpicks, which can damage the gums (NHS (opens in a new tab)). Be aware of the research limits: a Cochrane review of 35 trials found that floss or interdental brushes on top of brushing may reduce gum inflammation or plaque more than brushing alone, and that interdental brushes may beat floss, but the evidence was low to very low certainty, the studies were short, and the effects may not be clinically important (Cochrane review, 2019 (opens in a new tab)). It remains standard advice, and a good habit.

Mouthwash

The NHS says a fluoride mouthwash can help prevent decay, but not to use it right after brushing, which would wash away the fluoride left on your teeth; use it at another time, such as after lunch (NHS (opens in a new tab)).

Another approach

Fluoride: what the public-health agencies say

Fluoride is a mineral found naturally in soil, water and rocks. NIDCR says it has been shown to prevent cavities by strengthening enamel and replacing lost minerals, and that people of all ages benefit. You can get it from toothpaste, mouth rinse, tap water in communities that adjust fluoride levels, and varnish or gel applied by a dental professional (NIDCR (opens in a new tab)). We don’t give amounts here; your dentist and product labels do.

Toothpaste and varnish

A Cochrane review of 96 studies supports the benefit of fluoride toothpaste for preventing cavities compared with non-fluoride toothpaste, and notes that the choice of strength for young children should be balanced against the risk of fluorosis, white marks on teeth from too much fluoride while they form (Cochrane review, 2019 (opens in a new tab)). Another Cochrane review of 22 trials (12,455 children) found professionally applied fluoride varnish substantially reduced decay in baby and permanent teeth, with moderate-quality evidence (Cochrane review, 2013 (opens in a new tab)).

Community water fluoridation

CDC says drinking fluoridated water reduces cavities by about 25% in children and adults, and that state and local governments decide whether to fluoridate (CDC (opens in a new tab)). A 2024 Cochrane review is more cautious. Its 157 studies were all non-randomized; in contemporary studies, starting fluoridation may lead to a slightly greater reduction in decay in baby teeth, with smaller effects than older studies and low-certainty evidence. It found no eligible studies of caries in adults, and found fluoridated water associated with dental fluorosis, with very low-certainty evidence on other possible harms (Cochrane review, 2024 (opens in a new tab)). So U.S. agencies call fluoridation a cornerstone of cavity prevention, while the most rigorous review says the modern evidence is weaker than the older studies suggested. Your dentist or doctor can help with questions. NIDCR notes that fluoride in your water depends on the source, and many bottled waters lack the recommended amount; your water utility can tell you your level (NIDCR (opens in a new tab)).

Toothpaste for babies and toddlers

Advice differs by country. NIDCR says not to use fluoride toothpaste for children younger than 2 unless a dentist or doctor advises it (NIDCR (opens in a new tab)), and CDC says to consult first (CDC (opens in a new tab)). In the UK, the NHS tells parents to start with a smear of fluoride toothpaste as soon as the first tooth appears (NHS (opens in a new tab)). Ask your child’s dentist or doctor.

Another approach

Food, drink and your teeth

Decay needs sugar and starch to feed on. NIDCR and MedlinePlus tell people to limit sugary and starchy foods and drinks (NIDCR (opens in a new tab); MedlinePlus (opens in a new tab)), and CDC recommends avoiding added sugar as much as possible (CDC (opens in a new tab)). A review done to inform World Health Organization guidance found that nearly all studies in children and adults reported at least one positive link between sugar and cavities, with moderate-quality evidence of less decay when free sugars were under 10% of energy intake (systematic review, 2014 (opens in a new tab)).

Babies and toddlers who drink from bottles are at risk, especially if given juice or bottles at bedtime, which exposes their teeth to sugar for long periods (MedlinePlus (opens in a new tab)).

Sugar-free gum and xylitol. NIDCR says some sugarless gums and candies contain xylitol and may help prevent cavities (NIDCR (opens in a new tab)). A Cochrane review of 10 studies found only low-quality evidence that fluoride toothpaste containing xylitol may beat plain fluoride toothpaste in children, and insufficient evidence for other xylitol products (Cochrane review, 2015 (opens in a new tab)). Treat xylitol as a possible extra, not a substitute for fluoride and cleaning.

Another approach

Dry mouth

Saliva washes away food particles and contains minerals that fight decay, so too little raises the risk of cavities and mouth infections. NIDCR says dry mouth is not a normal part of aging and is worth checking with your dentist or doctor (NIDCR (opens in a new tab)). Causes include side effects of hundreds of medicines, diseases such as Sjögren’s disease, HIV/AIDS and diabetes, head and neck radiation, chemotherapy and nerve damage (NIDCR (opens in a new tab)). The NHS adds dehydration, breathing through the mouth at night and anxiety, and warns not to stop a prescribed medicine without medical advice (NHS (opens in a new tab)). See our Sjögren’s guide.

What helps: sipping water, sugarless gum or candy, avoiding tobacco, alcohol and too much caffeine, a bedroom humidifier, and a dentist or doctor changing medicines or prescribing a saliva substitute (NIDCR (opens in a new tab)). The NHS suggests asking a pharmacist about gels, sprays or lozenges and brushing twice a day (NHS (opens in a new tab)).

Another approach

Children’s teeth and sealants

Cavities start early. NIDCR describes “early childhood caries,” or baby bottle tooth decay, as severe decay that starts in the front teeth and extends to the back (NIDCR (opens in a new tab)). CDC says cavities in children can cause problems with eating, speaking, playing and learning (CDC (opens in a new tab)), and advises brushing twice a day once teeth come in and a first dental visit by the first birthday (CDC (opens in a new tab)). The NHS says parents should brush young children’s teeth and supervise until about age 7 (NHS (opens in a new tab)). See our Children guide.

Dental sealants

Sealants are thin plastic coatings painted onto the chewing surfaces of back teeth, where grooves trap food and germs. NIDCR says children should get them on permanent molars as soon as they come in (first molars around age 6, second molars around age 12); it is painless and can be done in a dental office, community clinic or school program; some medical insurance (including Medicaid) and almost all dental insurance pay for it (NIDCR (opens in a new tab)). CDC says sealants on back teeth prevent 80% of cavities for 2 years and about half for up to 4 years (CDC (opens in a new tab)). A 2017 Cochrane review of 38 trials (7,924 children) found moderate-quality evidence that resin-based sealants prevented decay in the first permanent molars of children 5 to 10, with limited information on side effects (Cochrane review, 2017 (opens in a new tab)).

Another approach

Your mouth and the rest of your body

A few links come up often. An association does not prove cause, and treating the gums doesn’t always change the other condition.

Diabetes

People with diabetes have a higher chance of gum disease, dry mouth and thrush, and gum disease can make blood sugar harder to control (NIDCR (opens in a new tab)). A 2022 Cochrane review of 35 trials (3,249 people, mostly type 2) found moderate-certainty evidence that treating periodontitis with a deep cleaning lowered HbA1c, a long-term blood sugar measure, by about 0.4 percentage points at 3 to 4 months (Cochrane review, 2022 (opens in a new tab)). See our Diabetes guide.

Heart disease

A 2024 umbrella review of 41 reviews found all reported an association between gum disease and cardiovascular disease, with the authors urging caution (umbrella review, 2024 (opens in a new tab)). Whether treating the gums prevents heart disease is unknown: a 2022 Cochrane review found only two high-risk-of-bias trials and could not draw conclusions (Cochrane review, 2022 (opens in a new tab)). See our Heart guide.

Pregnancy

Hormonal changes can cause swollen, bleeding gums in pregnancy, so good oral hygiene matters, and NIDCR suggests a dental check-up if you plan to become pregnant (NIDCR (opens in a new tab)). A 2010 BMJ meta-analysis of 11 trials (6,558 women) found the higher-quality trials showed no significant effect of gum treatment on preterm birth, and a 2025 review likewise found benefits only in lower-quality studies (BMJ meta-analysis, 2010 (opens in a new tab); systematic review, 2025 (opens in a new tab)). Dental exams during pregnancy are still reasonable for your own oral health. See our Pregnancy guide.

Another approach

Grinding and clenching

Bruxism is grinding or clenching the teeth, awake or asleep. NIDCR says many cases are mild, but severe bruxism can damage teeth and cause jaw pain and headache; helps include reminders to keep your teeth apart, stress management, a mouth guard and dental repair (NIDCR (opens in a new tab)). Night guards run about $15–$100 at retail, $150–$200 from a mail-order lab and $300–$700 or more through a dentist (The Pricer (opens in a new tab)). Our TMJ guide covers the evidence.

Another approach

Paying for dental care

  • Medicare. In most cases original Medicare doesn’t cover routine cleanings, fillings, extractions, dentures or implants. It may cover dental services that are directly related to certain covered medical treatments, such as an exam and treatment before a heart valve replacement or organ transplant, or before and during dialysis for end-stage kidney disease, plus some services when you are admitted to a hospital for them. You pay all costs for non-covered services (Medicare.gov (opens in a new tab)).
  • Dental and dental hygiene schools. NIDCR recommends contacting a dental school in your state; student clinics, supervised by licensed dentists, often charge reduced fees (NIDCR (opens in a new tab)).
  • Community health centers charge what you can afford based on income (NIDCR (opens in a new tab)).
  • Medicaid and CHIP. States must provide dental benefits for children on Medicaid but choose whether to cover adults, and most cover only limited adult services; CHIP covers dental services for children up to age 19 (NIDCR (opens in a new tab)).
  • Local help. Your health department, 2-1-1 and United Way may know of free or reduced-cost programs. NIDCR warns that ads or messages claiming it provides dental implants or financial help are likely fraudulent (NIDCR (opens in a new tab)).

Member stories

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Sources

This page is for education only and is not medical advice. Costs are typical U.S. ranges and estimates; yours will depend on your provider, location and insurance. Talk with your doctor before starting, stopping or combining any treatment. In an emergency, call 911. See our disclaimer.

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