Safe To Gargle With Hydrogen Peroxide While Pregnant?

Hand written by Dr David Chen, an actively practicing dentist and avid writer. #doctorswrite

We often hear about how pregnant women shouldn’t whiten their teeth and that it is better to wait until after giving birth to do so. The reason being that the whitening material could potentially be harmful to the unborn child. But did you know that one of the primary teeth whitening ingredients happens to be hydrogen peroxide?

Yes, that is the same hydrogen peroxide that you can purchase at your local pharmacy as an antiseptic. Although it does come in a much lower concentration when compared to professional teeth whitening products. Nonetheless, it contains the same exact ingredient.

It works wonderfully as an antiseptic for the skin but it can also be used as a mouthwash. Some people prefer to use it as a rinse over traditional products like Listerine.

hydrogen peroxide

Therein lies the problem. If you shouldn’t whiten your teeth with it while you’re pregnant, is it still safe to gargle with it? Indeed that is a very valid question, which we will attempt to answer. But just to let you know ahead of time, unfortunately there are a lot of mixed answers via various sources in regards to its use and safety during pregnancy.

What the manufacturers say

Most of the store branded hydrogen peroxides do not specifically mention the safety of hydrogen peroxide in regards to pregnant women. The labels all say that you may swish with it when it is mixed in equal portions with water. Just make sure that you DO NOT SWALLOW IT and spit it back out.

Sources and labels for various hydrogen peroxide products at a 3% concentration:

Basically, none of them mention anything regarding using it as a mouth rinse for pregnant women. They all explicitly say to not swallow the solution.

Exception

There is one exception and that is from this one specific brand of 3% hydrogen peroxide called care plus. The label explicitly says that hydrogen peroxide should not be used while pregnant or while breastfeeding.

Care plus hydrogen peroxide label

That is a departure from all of the other brands of the antiseptic solution that we’ve seen. In fact, we don’t really recognize the brand at all, at least here in the US. Nonetheless, it is still something to keep in mind.

High concentration of hydrogen peroxide

Most of the 3% solutions don’t mention anything about pregnancy except that one from care plus but the tone changes when the concentration increases. The labchem SDS for 30% hydrogen peroxide explicitly says to avoid contact while pregnant and also nursing!

That is incredibly interesting because it may imply that it may be relatively safe and not harmful at lower concentrations but once you increase it, it can be harmful. Although we don’t believe that high concentration is even available for purchase without a special license. Most of the drug store ones only sell 3-6% solutions of hydrogen peroxide. Perhaps there is a reason why they cap it at that percentage.

However, we must say that at 30% it isn’t even usable as a mouth rinse anymore. Even at 3%, the instructions tell you to dilute it down to half because you’re mixing a 1 to 1 solution with water. If you’re using 30% it is basically un-rinsable due to how much it will burn from the acidity.

The only conclusion we can come to is that it’s not meant for the general public use and it is reserved for other types of applications.

Pregnancy category

Despite what the labels may say about hydrogen peroxide, it is still useful to know what pregnancy risk category this drug falls under. According to PubChem, hydrogen peroxide is a category risk group C drug.

Pregnancy Risk Categories Chart

Basically what the category C means is that the risk cannot be ruled out because there has been no satisfactory studies done on pregnant women. There may have been animal studies done on it which DID demonstrate a risk to the fetus. Nonetheless, usage of it is still permissible if the benefits outweigh the risks.

Usually it is up to your doctor to determine whether or not the benefits outweigh the risk. We also want to point out that the medical community has moved away from these five categories but the new system is not as simple. Most people are still use to these 5 categories.

FDA guidance

Hydrogen peroxide is approved by the FDA as an over the counter product for human use as an oral wound healing agent. We do have to mention that the regulation does not specifically mention anything about pregnant women using the product.

Nonetheless, it is reassuring that it is at least not dangerous and forbidden to use. As a bonus, it is also generally recognized as safe when used as a bleaching agent as well. Are you happy to know that last part?

What the public health of england says

The toxicology department of the public health of England actually specifically says that there is no evidence to suggest that exposure to hydrogen peroxide can affect unborn children. Apparently exposure to it will result in rapid detoxification and only a minimal amount of it enters the blood.

We found another study in the NIH database, which essentially said the same thing. The hydrogen peroxide gets rapidly detoxified as soon as it enters the blood stream. However, what they were testing was skincare products on pregnant women. The hydrogen peroxide was used to bleach or whiten.

Nonetheless, that shouldn’t be too far off from using it as a mouth rinse since you’ll be spitting it back out anyway. The contact time for the rinsing solution will only be 1-2 minutes at most.

Based on these two reports and studies as well as the pharmacy labels of hydrogen peroxide, we would have to say that it is probably relatively safe to gargle with it for pregnant women. With that being said, there are still risks which we will explain below.

Hydrogen peroxide can be lethal if consumed

The only study which we found that showed harmful effects of consuming hydrogen peroxide was by the European Union Risk Assessment Report. Directly consuming this solution either in a high concentration or large quantity can potentially be lethal.

The first case they reported was of a 2 year old boy who ingested 4-6 oz of 35% hydrogen peroxide (HP). The boy became rapidly unresponsive and died four days later. This result is consistent with the labchem SDS which says to NOT swallow the 30% concentration solution.

The second case was of a 16 month old boy who was playing with a bottle of 3% hydrogen peroxide and consumed about 230g of it. He started foaming at the mouth and died 10 hours later. This concentration is the same as what you’d find in the drug stores. In other words, you should keep this drug away from children.

Basically what we can take away from this massive report is that it can be lethal if you directly drink the solution. However, as long as you practice jurisprudence you shouldn’t be drinking it because you’re only supposed to rinse with it and then spit it back out!

The Verdict – Is it safe to use hydrogen peroxide when you’re pregnant?

To summarize all of the studies that we’ve found above in regards to hydrogen peroxide and also its effect on pregnant women, we would have to say that it is most likely safe to gargle with it. It appears that the most harmful effect of using it is if you try to drink it.

However, since most pregnant women are adults and they know not to do that it shouldn’t be a problem. Everyone should be aware that you’re only supposed to gargle and swish it around before spitting it back out. You are not supposed to swallow it at all.

Even if you happen to swallow a little bit due to residue in your mouth, it should get metabolized fairly quickly. Studies have shown that there is very little harm in that.

So yes, it is safe to gargle with hydrogen peroxide while you’re pregnant but in our opinion it would be safer to NOT take that small risk at all. There are plenty of other great mouthwashes out there that do not have this somewhat ambiguous safety standard attached to it.

There are a lot of great mouthwashes that can be used as an alternative:

  • Listerine
  • Act mouthwash
  • Salt water rinse
  • Chlorhexidine
  • Coconut oil pulling
  • Essential oil rinses

We think it would be safer to use one of the alternatives while you’re pregnant. If you really like hydrogen peroxide, it doesn’t hurt to wait until after you give birth to use it again. After all using a mouthwash is still an adjunct to your normal oral hygiene routine. The bread and butter of keeping your mouth healthy is still just a plain toothbrush and floss.

If you need one last convincing, the American Dental Association (ADA) says that you should wait until you give birth before you whiten your teeth. You can extrapolate their implication because whitening products also contain hydrogen peroxide. Thus, the ADA is implying that you should probably hold off on the rinse until after the baby comes out!

Related content: In case you were curious, we’ve an article about whether you can whiten your teeth while you’re still nursing!

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