Could Microbial Imbalance in Your Mouth Be Affecting Your Chances of Conception?

What is the oral microbiome?

The oral microbiome refers to the community of microorganisms that reside in the mouth, including bacteria, viruses, fungi, and other microbes. These microorganisms play an important role in maintaining oral health, and an imbalance in the oral microbiome can lead to various dental and medical problems. Like in all areas of the microbiome that we live with (skin, gut, vaginal), it needs to be in balance. Click here to read our recent post on the connection between fertility and the gut microbiome.  The oral microbiome is influenced by factors such as diet, oral hygiene practices and products, genetics, and environmental factors. 

How does the oral microbiome affect fertility?

The exact mechanisms by which an imbalanced oral microbiome affects fertility are still not fully understood, but research suggests that it may be related to systemic inflammation and changes in hormone levels.

An imbalanced oral microbiome can lead to periodontal disease, a condition characterized by chronic inflammation and infection of the gums and other tissues that support the teeth. Periodontal disease has been associated with several adverse health outcomes, including an increased risk of cardiovascular disease, diabetes, and preterm birth. It may also interfere with the process of ovulation, which is clearly critical for fertility.

Inflammation and immune activity in the body are internal stressors.  When the body is busy fighting an infection it has fewer resources to give to fertility.  If survival from an infection is a perceived threat, reproduction is one of the first systems to be affected.  The delicate balance of hormones is thrown off, and the body focuses on the threat instead.  

Periodontitis is also linked with preterm birth, preeclampsia, and low birth weight in infants.  With these links well studied, it also begs the question: why wait to heal your oral health?  Do it before you conceive!

Several studies have suggested that an imbalanced oral microbiome can affect fertility in both men and women. Here are some examples:

1. A study published in the Journal of Periodontology in 2009 found that women with periodontal disease were more likely to take longer to conceive than those without the condition. The study followed 3,737 pregnant women and found that those with periodontal disease took an average of 7 months to conceive, compared to 5 months for those without the disease.  They concluded: “Low-grade systemic inflammation associated with periodontal disease may have a local effect within the endometrium.”
2. A study published in the Journal of Reproductive Medicine in 2011 found that men with periodontal disease had lower sperm counts and motility compared to those without the condition. The study followed 56 men and found that those with periodontal disease had significantly lower sperm counts and motility than those without the disease.
3. A study published in the Journal of Assisted Reproduction and Genetics in 2016 found that women undergoing in vitro fertilization (IVF) who had periodontal disease had lower pregnancy rates and higher rates of miscarriage compared to those without the condition. The study followed 256 women undergoing IVF and found that those with periodontal disease had a pregnancy rate of 33%, compared to 56% for those without the disease.

An imbalanced oral microbiome may affect fertility in several ways:

1. Inflammation: An imbalanced oral microbiome can lead to chronic inflammation in the gums and other tissues in the mouth. This inflammation can spread to other parts of the body, leading to systemic inflammation that can negatively impact fertility health.
2. Hormonal imbalances: An imbalanced oral microbiome can affect hormone levels in the body, which can interfere with ovulation and other reproductive functions. 
3. Immune system dysfunction: An imbalanced oral microbiome can cause immune system dysfunction, which can affect the body's ability to fight off infections and other health problems. This can also negatively impact fertility.
4. Spread of harmful bacteria: An imbalanced oral microbiome can allow harmful bacteria to thrive and spread to other parts of the body, such as the reproductive system. These imbalances can be asymptomatic yet still cause fertility to be compromised. 

How to improve your oral health to support fertility: 

1. Brush and floss regularly: Brush your teeth at least twice a day, preferably after meals, and floss daily to remove plaque and prevent the buildup of harmful bacteria.  The products you choose for this matter!  Unfortunately, many oral care products come along with unwanted chemicals.  Floss can contain PFAS to help it glide between your teeth: but these chemicals are known endocrine disrupters.  One company we love for dental care products is Primal Life.  Check them out here and see what you think! 
2. Eat a healthy diet: A diet that is rich in fruits, vegetables, whole grains, and lean protein can help promote a healthy oral microbiome.  Sugar imbalances in the body can lead to insulin resistance which is linked with several fertility complications such as PCOS.  Do your oral health and your reproductive health a favor and work towards balanced blood sugar. Click here. 
3. Avoid sugary and acidic foods and drinks: Besides the connection to insulin resistance and overall health, sugary and acidic foods and drinks directly increase the risk of tooth decay and gum disease.
4. Quit smoking: Smoking can increase the risk of periodontal disease and other oral health problems, which can affect fertility.
5. Get regular dental checkups: Regular dental checkups can help detect and treat any oral health problems before they become more serious.
6. Avoid products that contain Triclosan and alcohol: they kill everything in your mouth, including the good bugs.  This leads to more imbalance in the microbiome.  If you need to change your oral microbiome, killing everything isn’t the way to go.  Working with a holistic practitioner will help you identify specific ways to work with your body and set you up for great oral health and fertility.

Maintaining proper dental hygiene and getting treatment for periodontal disease may help build a healthy mouth microbiota and lower the risk of reproductive issues, before, during, and after pregnancy. When you are trying to conceive the basic advice to maintain a healthy lifestyle that includes a good diet, frequent exercise, and stress management all apply. Maintaining excellent dental health and seeking treatment for periodontal disease may be helpful for both men and women in improving fertility. By following the tips and maintaining good oral hygiene practices, you can help promote a healthy oral microbiome and improve your overall reproductive health.