The Connection Between Periodontal Disease and Infertility

What is infertility? 

In general, infertility is defined as not being able to get pregnant (conceive) after one year (or longer) of unprotected sex. In the United States, about 1 in 5 (19%) married women aged 15 to 49 with no prior births in the United States are unable to get pregnant after 1 year of trying. 1 in 4 (26%) women in this group have difficulty getting pregnant or carrying a pregnancy to term. And while often thought of as a woman’s struggle, infertility can affect both men and women. 

What is periodontal disease? 

Periodontal disease, also known as gum disease, is caused by bacteria in the mouth that infect and inflame the tissues surrounding the teeth. These bacteria eat away at the alveolar bone that serves as the tooth’s foundation. If left untreated, this bacteria can enter the bloodstream, travel to other areas of the body, and increase the risk of over 57 other systemic health issues. More and more we hear of the connection between oral health and heart disease, oral health and diabetes, oral health and sleep apnea, etc. However, one correlation that is not discussed quite as frequently is the connection between periodontal disease and infertility.

What is the connection between periodontal disease and infertility?

Studies have found that improving your oral health is a relatively easy change you can make to your daily routine that can help your overall chances of conceiving. Of the hundreds of species of bacteria in your mouth, there are several known high-risk pathogens, five of which are the most critical and highest risk for infection, inflammation, oral cavity damage, and systemic consequences. These five high-risk bacteria are Aa (Aggregatibacter actinomycetemcomitans), Pg (Porphyromonas gingivalis), Td (Treponema denticola), Tf (Tannerella forsythia), Fn (Fusobacterium nucleate animalis), Pi (Prevotella intermedia), Cr (Campylobacter rectus), Ec (Eikenella corrodens) and Cs (Capnocytophaga sputigena) and have been proven to not only affect your oral health but also have a direct and significant impact on fertility, pregnancy, and the developing child.

One recent study in particular, looked at 256 healthy non-pregnant women who had stopped taking birth control in hopes of getting pregnant. Researchers tracked all of the women for one year to see if they were successful in conceiving. They discovered that the bacteria Porphyromonas gingivalis (Pg), which is associated with periodontal disease, appeared more frequently in the saliva of the women who did not conceive compared to those who did. In fact, the women with Porphyromonas gingivalis in their saliva had a threefold risk of not conceiving compared to the other women. 

In addition to hindering fertility, these 5 bacteria can also cause a 7 fold increase in health risks to your child during pregnancy, increased risk of preterm delivery, impaired brain development, low birth weight, fetal infection, and in more serious cases, stillbirth. 

How can I find out if I have any of these risk bacteria in my mouth? 

There is now a saliva test readily available to dental patients called HR5. This test is simple, affordable, and highly accurate. With just 1mL of saliva, the exact levels of each of the 5 high-risk pathogens present in your mouth can be detected. Knowing these specifics enable your dentist and dental hygienist to personalize your recommended treatment to your individual needs. The test results will indicate what mouth rinses and cleaning (bacterial disruption) methods will be most effective based on the bacteria that are present and the pattern in which they present themselves. Antibiotics as well as oral probiotics are also found to be beneficial in treating certain bacteria. By decreasing these harmful bacteria your risk of further systemic health conditions, including infertility and pregnancy complications, can also be decreased. 

Is your mouth putting your fertility or your pregnancy at risk?

For all pregnant women and their partners, for anyone planning or working towards pregnancy, and even for new mothers with young families, the first step in prevention is screening. Ask your dental healthcare provider about HR5 salivary testing and find out if your mouth is putting your pregnancy at risk. 

Resources

Dr. Steven Lin.2023. Why Bad Teeth Cause Infertility in Some Cases. https://www.drstevenlin.com/bad-teeth-cause-infertility/

CDC: Centers for Disease Control and Prevention. 2023, April 26.Infertility. https://www.cdc.gov/reproductivehealth/infertility/index.htm

Direct Diagnostics, LLC. 2023. HR5 High Risk Pathogen Test Saving Teeth. Saving Lives.https://www.directdiagnostics.com/hr5