Hyperemesis gravidarum and oral health: A scoping review

BACKGROUND: Hyperemesis gravidarum (HG) is a severe form of nausea and vomiting in pregnancy (NVP), associated with dehydration, nutritional deficiencies, and systemic complications. Although recurrent vomiting, altered dietary patterns, and medication effects might plausibly affect oral health, this relationship has not been comprehensively synthesized. OBJECTIVE: The objective of this scoping review is to systematically map the existing evidence on the association between HG and oral health. ELIGIBILITY CRITERIA: Primary studies of any design examining oral health in individuals with HG or severe nausea and vomiting in pregnancy (meeting HG-level severity criteria) were included. Editorials, commentaries, studies of mild or moderate nausea and vomiting in pregnancy (NVP), and studies without oral health findings were excluded. SOURCES OF EVIDENCE: Seven electronic databases (PubMed/MEDLINE, Embase, CINAHL, Scopus, Web of Science, OVID Medline, and the Cochrane Library) were searched in October 2025. Additional sources included gray literature from HG-focused organizations (e.g., HER Foundation and Pregnancy Sickness Support) and reference lists of included studies. CHARTING METHODS: Screening was conducted independently by two reviewers following reviewer calibration, using Covidence software for reference management and deduplication. Full texts were assessed independently by two reviewers, with disagreements resolved through discussion or third-reviewer adjudication. A pre-piloted data charting form was used to extract study characteristics, oral health assessment methods, and key findings related to HG. Data were synthesized narratively and reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. RESULTS: The search identified 2697 records, with 1752 remaining after deduplication. Of 38 full-text articles screened, 10 studies met the inclusion criteria. Study designs included cross-sectional (n = 3), case reports (n = 3), case-control (n = 2), and retrospective cohort studies (n = 2). Across all studies, a total of 8630 participants were represented (range 1-7765; median 34.5). Periodontal status was clinically assessed in one study, which found significantly worse periodontal indices in HG compared with controls, and one additional study reported higher self-reported gum disease in individuals with HG. Dental cavities were self-reported in one study, showing higher pre- and post-pregnancy prevalence among those with HG. Three studies described hypersalivation consistent with ptyalism gravidarum, frequently co-occurring with HG, while salivary biomarkers were assessed in two studies. One study reported enamel hypoplasia in children born to mothers with severe HG. Self-reported oral hygiene difficulties were described in six studies, and one study noted higher levels of self-reported temporomandibular joint disorder in HG participants. CONCLUSION: This scoping review identifies a substantial gap in evidence linking HG with oral health conditions. Available studies suggest challenges in maintaining oral hygiene practices, alongside frequent gastric acid exposure, which might heighten risk for oral complications, but robust clinical data are lacking. Further research and interdisciplinary attention are needed to clarify and address these associations.