Mar 10, 2011
The second part in a guest series on women and gum disease from Dr. Joseph R. Nemeth, DDS & Associates, a top periodontist in Southfield, Michigan.
Continuing our study of Women and gum disease leads to the question of how gum disease affects fertility and the implications of oral contraceptives on a woman’s oral health. The established link between gum disease and other systemic issues is especially important for women during different phases of life from puberty through menopause. How gum disease affects a woman’s fertility and how birth control affects a woman’s oral health are two very important areas of study. Let’s begin with fertility.
Fertility
Could something as simple as flossing your teeth help keep you fertile? Perhaps. “Several studies have indicated that a woman’s oral health may be related to her reproductive success,” says Susan Karabin, D.D.S., a spokesperson for the American Academy of Periodontology. In one study, women who needed fertility treatments had higher levels of gum bleeding and inflammation than those who conceived naturally, the Journal of Periodontology reports. “Brush and Floss every day and get a professional cleaning and exam every six months,” advises Karabin, who adds that not smoking and avoiding sugary foods and drinks are also key to keeping your teeth and gums healthy, possibly leading to better reproductive success.
Other studies have produced evidence that the presence of infection has led to failed embryo development and unsuccessful embryo implantation in in vitro fertilization patients. Since gum disease is a chronic bacterial infection, a patient’s periodontal status may very well lead to ineffective outcomes in some infertility treatments. Therefore, it can be concluded that before a woman proceeds with invasive reproductive procedures, it is incredibly important that she makes sure her oral health is in impeccable shape. Any gum disease should be treated before implantation procedures in order to ensure a more successful outcome.
Male infertility has also been linked to gum disease and poor oral health. The gum disease bacteria may very well be one of the many possible causes of male infertility. Studies have shown that men with high levels of gum disease bacteria have much lower levels of healthy sperm than men with healthy mouths - just one more thing to think about when deciding if now is the right time to begin trying to conceive.
Birth Control
If now is not the right time to have a baby, a woman must think about the possible oral implications of taking birth control pills.
A recent study found that women taking oral contraceptive pills had more gingival bleeding upon probing and deeper periodontal pockets than those who were not taking oral contraceptive pills. It is important for women to alert their dental practitioners about any medications they are taking, such as oral contraceptive pills, because it is possible that their oral health may be affected.
Women who use oral contraceptives may be susceptible to the same oral health conditions that affect pregnant women. They may experience red, bleeding and swollen gums. Women who use oral contraceptives should know that taking drugs sometimes used to help treat periodontal disease, such as antibiotics, may lessen the effect of an oral contraceptive.
Researchers at University of Buenos Aires in Argentina evaluated the effect of oral contraceptives (birth control pills) on periodontal health. The study specifically looked for the presence of specific bacterial and yeast species in 91 women. What they found may surprise you.
The study concluded that the use of birth control pills leads to increased inflammation of the gum tissue. This increased inflammation is probably due to an increase in the concentration of sex hormones in the gingival tissues of women who use newer formulations of oral contraceptives.
The study evaluated a group of 41 women who were taking oral contraceptives and measured them against a control group of 51 women who reported that they were not taking birth control pills.
The study found:
- More women who were taking birth control pills had moderate to severe periodontitis compared to those not taking oral contraceptives.
- The incidence of moderate to severe periodontitis was nearly twice as high for smokers taking oral contraceptives as smokers who were not on birth control pills.
- Those taking oral contraceptives more than three years also had a higher prevalence of moderate to severe periodontitis.
- While periodontal pathogens were identified in sub-gingival samples in all but 16 women; 11 of pathogen-free women were in the control group.
- Candida species were identified in 95 percent of those taking oral contraceptives and 78 percent of controls.
Clinical Implications: Women taking oral contraceptives and smoking are at greater risk of periodontal disease and should be advised to pay careful attention to their daily oral hygiene.
Stay tuned for Part 3 Coming soon!
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