Why Is Oral Health Important for Fertility and Pregnancy?

Oral health (or dental health) isn’t just about teeth, gums, and the oral-facial system. What’s happening in your mouth often mirrors what’s happening in your whole body, making it a key indicator of overall wellness—and much more connected to other systems in the body than previously thought, thanks to emerging research. Read on to learn more about why oral health is important, including for fertility and pregnancy, along with tips on how to improve it.

Typically, oral health refers to the health of your teeth, mouth, tongue, and throat, and the things (like flossing and regular dental visits) that keep them healthy and functional. But it’s also related to overall physical and mental well-being.

The oral cavity marks the start of the respiratory and digestive tracts, is lined with a mucous membrane that is one of the body’s primary immune defences, and harbours microbes that can help prevent (or contribute to the onset of) disease.

Also known as the oral microbiome, your oral cavity is home to bacteria, viruses, fungi, and other microbes that can work to our advantage (much like a healthy microbiome in our gut). But just like the gut, the oral microbiome can get out of balance, and when it does, can contribute to issues like tooth decay, gum disease, and even systemic health concerns (known as the mouth-body connection).

Gum disease (and periodontitis, a severe form of gum disease) isn’t just about bad breath or loose teeth: it’s a chronic infection that can destroy the tooth and surrounding tissue, and even spill bacteria and inflammatory chemicals into your bloodstream. This can cause inflammation and infection, which can wreak havoc in your body. The most common causes of periodontitis are poor dental hygiene (creating favourable conditions for dental microbial biofilm formation), smoking, and chronic inflammation. Bottom line? Oral health hygiene is very important to help reduce the risk of systemic disease. 

There’s a strong relationship between these inflammatory chemicals and cardiovascular disease. Compared to older individuals, younger folks (age 45 and younger) with periodontitis are at a higher risk for cardiovascular disorders. Some studies show that treating severe gum disease can slow atherosclerosis (plaque buildup in the arteries), reducing the risk of cardiovascular disease. 

Studies show that those with type 2 diabetes who have a difficult time controlling their blood sugar have a 2 to 3 times greater risk of developing periodontitis (it’s now considered a complication of the disease). This is likely a result of gingival vascular lesions caused by elevated glucose levels. Meaning that type 2 diabetes can contribute to periodontitis.

Remember: the oral cavity marks the start of the respiratory system. Saliva and oral bacteria can be inhaled into the lower airway, especially in older adults or people with swallowing problems, seeding pneumonia and worsening chronic lung inflammation. Good mouth care (brushing, denture cleaning, professional care) reduces that risk in hospitals and care homes. 

Finally, don’t forget the basics: missing teeth and chronic mouth pain change how you eat, which can lower nutrient intake and shift diet quality (think fewer raw veggies, less protein). That affects immunity, energy, and healing. 

• Time to conception: It turns out that women with periodontal disease take an average of two extra months to become pregnant compared with women whose gums were healthy. The culprit is likely microbial imbalances in the uterus (yes—that’s linked to periodontitis, too) and microbes and toxic products (like lipopolysaccharides, components of bacterial cell walls that make bacteria more inflammatory) into the blood. The result? Activation of the immune system leading to more inflammation. Although more research in this area is needed, the initial data points to the connection between our oral health and fertility, and is something couples shouldn’t neglect when trying to conceive. 
  
  

• PCOS: Females with polycystic ovarian syndrome (the most common cause of infertility) were found to have worse periodontitis compared to those without PCOS. Since women with PCOS are at a higher risk for insulin resistance and type 2 diabetes, and inflammation is also at the root of this condition, the connection might not be a surprise. Since periodontitis can increase blood sugar and inflammation in the body, treating periodontitis and improving oral health should be a mainstay treatment to improve PCOS symptoms, too. 
  
  

• Endometriosis: Endometriosis is an estrogen-dependent gynecological condition rooted in immune and inflammatory dysfunction by which endometrial tissue is found outside of the uterine cavity. Endometriosis and periodontitis have been shown to work similarly in the body: both conditions contribute to chronic low-grade inflammation and impaired immune regulation. The stats show that those with endometriosis had a 57% greater risk of periodontitis. Those experiencing endometriosis and periodontitis were also found to have similar microbiome compositions, pointing to a concept called “microbial translocation” (AKA microbes travel from one region of the body to another). In fact, there’s a causal relationship between endometriosis in the pelvic peritoneal region and periodontitis. 

• Sperm health: The hormonal process of making sperm (aka spermatogenesis) and sperm themselves are highly susceptible to chronic inflammation, oxidative stressors, poor nutrition, and unhealthy lifestyle habits. So, an inflammatory condition like periodontal disease definitely impacts sperm parameters, too. There’s a significant association between periodontitis and decreased sperm motility, abnormal morphology, and increased DNA fragmentation–all critical for successful conception. 

• Probiotics: Probiotics help oral health by promoting beneficial bacteria that reduce cavity-causing pathogens, gum inflammation, and bad breath, while also supporting immune function.