The importance of maintaining a sound oral hygiene is often underestimated by women but new research has shown that presence of gum disease can by an average of two months extend the time that it takes for a woman to become pregnant. Researchers have for the first time been able to clearly demonstrate the significant impact of poor oral health on the time to pregnancy in women who are trying to conceive.
Speaking at the annual meeting of the European Society of Human Reproduction and Embryology, Professor Roger Hart informed that the ill effects of poor oral health on pregnancy are of the same degree as the effects of obesity. He is the Professor of Reproductive Medicine at the University of Western Australia (Perth, Australia) and Medical Director of Fertility Specialists of Western Australia.
Periodontal disease is a chronic inflammatory disease that affects the periodontium, i.e., the tissues that surround and support the teeth. Periodontitis involves progressive loss of the alveolar bone around the teeth, resulting in the formation of periodontal pockets. If left untreated, it can lead to the loosening and subsequent loss of teeth. Periodontitis is caused by microorganisms that adhere to and grow on the tooth’s surfaces, along with an overly aggressive immune response against these microorganisms.
The inflammation of the gums results in tissue destruction that can find its way into the blood circulation. Due to this, most forms of gum disease in earlier studies have been shown to play a significant role in heart disease, type 2 diabetes, respiratory and kidney disease, and problems in pregnancy such as miscarriage and premature birth. It is believed that about 10% of the general population suffer from gum disease which can easily be prevented by brushing teeth regularly and the use of dental floss.
Prof Hart said:
“Until now, there have been no published studies that investigate whether gum disease can affect a woman’s chance of conceiving, so this is the first report to suggest that gum disease might be one of several factors that could be modified to improve the chances of a pregnancy.”
Pregnancy planning and pregnancy outcome was analysed by scientists for 3,416 women out of a total of 3,737 who participated in the SMILE study, a study conducted in Western Australia.
They found that women with gum disease took an average of just over seven months to become pregnant – two months longer than the average of five months that it took women without gum disease to conceive.
The study also revealed that non-Caucasian women who had gum disease were at the highest risk of later conception and were more likely to take over a year to become pregnant compared to those without gum disease. Non-Caucasian women with gum disease faced an increased risk of 13.9% for later conception compared to only 6.2% for women who were free from gum disease. Caucasian women who had gum disease also took longer to conceive than those who were disease-free; however the difference was not statistically significant.
Out of the 1,956 women for whom data related to time of conception was available, it was found that 146 women had impaired fertility as they took more than 12 months to conceive. These women were usually older, non-Caucasian, smokers with a BMI of over 25 kg/m2.
Information on time to conception was available for 1,956 women, and of, these, 146 women took longer than 12 months to conceive – an indicator of impaired fertility. They were more likely to be older, non-Caucasian, to smoke and to have a body mass index over 25 kg/m2. Out of the 3,416 women for whom pregnancy planning and pregnancy outcomes were analysed, 1014 (26%) were found to have some form of gum disease.
Prof Hart explained:
“Our data suggest that the presence of periodontal disease is a modifiable risk factor, which can increase a woman’s time to conception, particularly for non-Caucasians. It exerts a negative influence on fertility that is of the same order of magnitude as obesity. This study also confirms other, known negative influences upon time to conception for a woman; these include being over 35 years of age, being overweight or obese, and being a smoker. There was no correlation between the time it took to become pregnant and the socio-economic status of the woman.”
“All women about to plan for a family should be encouraged to see their general practitioner to ensure that they are as healthy as possible before trying to conceive and so that they can be given appropriate lifestyle advice with respect to weight loss, diet and assistance with stopping smoking and drinking, plus the commencement of folic acid supplements. Additionally, it now appears that all women should also be encouraged to see their dentist to have any gum disease treated before trying to conceive. It is easily treated, usually involving no more than four dental visits.”
“The SMILE study was one of the three largest randomised controlled trials performed in Western Australia. It showed conclusively that although treatment of periodontal disease does not prevent pre-term birth in any ethnic group, the treatment itself does not have any harmful effect on the mother or foetus during pregnancy*.”
The higher impact of gum disease on time to conceive in non-Caucasian females was attributed by Prof Hart to the higher degree of inflammatory response to the disease that was seen in this population.
* Published in Obstetrics and Gynecology, vol. 114, no. 6, December 2009
Source: European Society of Human Reproduction and Embryology
Written by Barry Windsor