How your oral health can influence fertility, pregnancy and childbirth

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You might be planning for or experiencing your journey to parenthood, but did you know this is a time when your oral health is of utmost importance?

Oral health is an important component of general health and wellbeing, with several well established links between our mouths and the rest of our bodies, but research now indicates that the maternal oral microbiome (balance of bacteria and microbes in the mouth) is transmitted to the baby during pregnancy. The pathway by which pregnancy elicits these changes is unclear, but it is likely attributed to alterations in the overall immune state that occurs during pregnancy and is possibly due to increased levels of hormones progesterone and oestrogen, which can also exacerbate existing gingivitis known as ‘pregnancy gingivitis’.

This explains the many observations of maternal periodontal disease (imbalance of bacteria that drive gum disease) being correlated to increased risks of pregnancy complications such as preterm birth, preeclampsia and delivery of a small-for-gestational age infant. The similarity between placental and oral microbiota suggests that bacteria pass from the oral cavity to the placenta. This clarifies why women with gum disease are at increased risk of pregnancy complications and mothers-to-be with an increased cariogenic microbiome (imbalance of bacteria that drive dental decay) can predispose their baby to the development of dental decay.

The importance of expectant mothers nurturing their oral microbiome does not stop at the foetal stage. A newborn baby’s oral microbiome is shaped from the moment of delivery. Early colonisation differs between vaginally delivered and C-section babies, with the infant oral microbiome resembling that of the mother’s gut and vagina with increased bacterial diversity in those delivered vaginally over babies born by C-section. One study suggests that C-section delivered babies colonise a dental decay causing species of bacteria (Streptococcus Mutans) almost a year earlier that vaginally delivered infants. 

Not only does the mode of delivery shape the infant oral microbiome, but in the subsequent hours, the baby’s mouth will be exposed to a large number of microorganisms by contact with the outside world through breathing, breastfeeding, parents and medical staff. In 24hrs, the establishment of the ‘pioneer’ species in the baby’s oral cavity has already begun. Breastfed infants demonstrate higher diversity of oral bacterial species and potentially more health-associated species than formula-fed infants. Breastmilk has also shown to inhibit growth and attachment of certain decay-causing bacteria, such as S. Mutans.

Often mothers do not have a choice when it comes to mode of delivery or method of feeding, so much of this is out of our control. Reassuringly, we still have the power as parents to shape a healthy oral microbiome in our children as they grow, by taking into account factors such as introduction of solid foods, practising good oral hygiene habits, teaching positive lifestyle choices and leading by example of eating a healthy, balanced diet.

These positive choices and good habits will serve our oral health throughout our lifetime and, as emerging research suggests, improve our fertility with regard to length of time to conception in women and sperm quality in men. One study showed that women with periodontal disease took longer to conceive especially those from ethnic minorities. A plausible explanation is that the spread of bacterial toxins in the blood circulation that results from gum disease can activate the immune system and thus hinder reproductive function. Men with excessive and untreated cavities or periodontal disease have been shown to display a lower sperm count, poor sperm motility and abnormal sperm morphology. In addition, men who experience erectile dysfunction are more likely to have gum disease. 

So with all this in mind, how can parents-to-be and those planning to be reduce their risk of dental disease?

Oral hygiene measures. Mechanical removal of the bacterial load through meticulous tooth brushing, interdental cleaning and tongue scraping. Brush at least twice a day using a fluoride toothpaste.

Nutrition. A diet rich in plant-based foods with a large variety of fresh fruits and vegetables and low in refined carbohydrates will help support the oral microbiome. Be mindful of your ‘free sugar’ intake and consume a diet rich in omega-3 fatty acids (oily fish). Take a vitamin D supplement, which is essential for mother-to-be as well as for the dental health of the developing foetus. 

Eat more fermented and cultured foods on a regular basis to introduce probiotics (good bacteria) to your mouth and gut. One study has found that certain orally administered probiotic strains can help reduce the occurrence of both plaque and bleeding gums after 8 weeks. 

Lifestyle. Reducing stress levels through mindful exercise, yoga or meditation. Ensuring plenty of sleep and keeping well hydrated. 

Visit your dentist regularly. To check for any existing disease in the mouth and help resolve any problems.

If you would like to learn more about how to “Optimise Your Oral Health’, get in touch with Dr Maria Papavergos for a bespoke online consultation: maria@thelifestyledentist.co.uk

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