Hygienists understand how important it is for patients to make the connection between their oral and systemic health. Those “other” health conditions can sometimes be a touchy subject ‒ reproductive health, for example. These conditions include everything from the ability to get pregnant to whether they have erectile dysfunction (ED).
More than likely, a dental hygienist is not going to ask a male patient if he’s suffering from symptoms of ED or inquire about how long a woman has been trying to conceive. How should dental patients be informed that oral hygiene practices could inhibit reproductive wellness?
By being inclusive with your patient education and making it part of the entire discussion.
“Gum Disease is Linked to…”
When we discuss active inflammation and periodontal disease with patients, take advantage of the opportunity to list off the systemic health effects as well. That way, there are no assumptions, uncomfortable questions, and everything is handled in a professional manner.
For example, during your periodontal probing or cleaning, you might say, “One of the reasons why we want to help you get this periodontal infection under control is because of the strong link between gum disease and other health conditions. The more research there is, the more we see that gum disease is directly influencing everything from stroke and diabetes to pneumonia and infertility.”1,2,3
You just opened the door for a professional, health-related conversation without anything getting too awkward. Let’s speculate, though, that you catch them off guard. “Infertility?!” they ask.
That’s your cue to continue the conversation. “Yes, isn’t that crazy?! We’ve seen all sorts of studies come out over the past few years. Now we know that active gum disease is linked to things like preeclampsia, stillbirths, erectile dysfunction, and even delayed conception times. But the good news is that we have also seen that eliminating oral infections helps to reduce those risks or even improve the symptoms within as little as a few months after dental treatment. It turns out infections inside of our mouths can really strain our immune system.”4,5
You kept it simple. You kept it factual. The patient can now pursue additional information if they want to. Chances are, they’ll probably look online once they get home that evening.
How Periodontitis Affects Reproductive Health
Oral bacteria are known to spread through infected periodontal pockets into our bloodstream. From there, these pathogens strain our immune system and increase inflammation levels throughout the body (not just the mouth.) That’s why it has been found in places like the placenta and umbilical cords in women who are pregnant and have active periodontal disease. Women who are struggling to conceive may want to consider an improved oral hygiene routine as part of their prenatal care.6 Even when undergoing in vitro fertilization (IVF), the presence of periodontal infection can interfere with overall success rates for the couple trying to conceive.3
When inflammatory responses occur, men tend to struggle with more than just symptoms of ED. They also prove to be at a higher risk of having a lower sperm count compared to men without periodontitis, which, in turn, affects a couple’s ability to conceive and their projected conception timeframe.7 Men who suffer from either of these conditions will want to consider whether or not existing periodontal infections play a role in their co-existing medical symptoms. Undergoing periodontal therapy and adjusting their preventative care routine could improve their response to other reproductive treatments.
Thankfully, there is good news for men and women alike. Effective periodontal therapy does help to reduce overall inflammation and lessen the bacterial strain on our immune systems, which directly improves numerous medical conditions, including those related to reproductive health.
Why it Matters
Whether you share this information with your patients, your friends, or even on your practice’s website is up to you. You will be, however, changing a life without even realizing it. Reproductive health is a taboo subject that most of us don’t want to talk about (but everyone wants to know). By feeding our patients small bits of factual information during their visits, they can take what’s applicable to them and choose to discuss it further if they’re open to it.
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- Hashemipour, M.A., Afshar, A.J., Borna, R., et al. Gingivitis and Periodontitis as a Risk Factor for Stroke: A Case-control Study in the Iranian Population. Dental Research Journal (Isfahan). 2013; 10(5). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3858735/
- Moghadam, S.A., Shirazaiy, M., Risbaf, S. The Associations between Periodontitis and Respiratory Disease. J Nepal Health Res Counc. 2017; 15(35): 1-6. Retrieved from https://www.researchgate.net/publication/319100530_The_Associations_between_Periodontitis_and_Respiratory_Disease
- Khanna, S.S., Dhaimade, P.A., Malhotra, S. Oral Health Status and Fertility Treatment Including IVF. J Obstet Gynaecol India. 2017 Dec; 67(6): 400-404. Retrieved from https://pubmed.ncbi.nlm.nih.gov/29162952/
- Han, Y.W., Fardini, Y., Chen, C., et al. Term Stillbirth Caused by Oral Fusobacterium nucleatum. Obstetrics and Gynecology. 2010; 115(2 Pt 2): 442-445. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3004155/
- Kellesarian, S.V., Kellesarian, T.V., Ros Malignaggi, V., et al. Association between Periodontal Disease and Erectile Dysfunction: A Systematic Review. American Journal of Men’s Health. 2018; 12(2): 338-346. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5818109/
- Martelli, M.L., Brandi, M.L., Martelli, M., et al. Periodontal Disease and Women’s Health. Current Medical Research and Opinion. 2017; 33(6): 1005-1015. Retrieved from https://pubmed.ncbi.nlm.nih.gov/28277873/
- Tao, D.Y., Zhu, J.L., Xie, C.Y., et al. Relationship between Periodontal Disease and Male Infertility: A Case-control Study. Oral diseases. 2021; 27(3): 624-631. Retrieved from https://pubmed.ncbi.nlm.nih.gov/32702140/