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Flossing for Fertility

Pay Attention to Oral Health When You're Trying to Conceive

By Kelly Burgess

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"There seems to be a direct correlation between the rise in the levels of progesterone and estrogen and the level of gingival inflammation," says Dr. Haytac. "Gingiva is a target tissue for estrogen, since it contains specific high-affinity estrogen receptors."

The effect of a rise in levels of progesterone and estrogen and an increase in levels of gingival inflammation is not a new finding, says Dr. Haytac. Although it's not known why, elevated levels of these hormones during puberty and pregnancy and with the use of oral contraceptives have all been associated with periodontal issues. The concern is that these problems remain confined to these specific triggers and don't cause long-term oral health problems.

"Sometimes you can't avoid these problems," says Dr. Michael P. Rethman of Honolulu, Hawaii. "When you're on hormonal manipulation, your gums become hypersensitive, so in some cases, people even with terrific oral hygiene may experience some problems. This may occur even to a small degree during monthly cycles."

While these problems are usually of finite length, ongoing gingival inflammation can lead to a more severe condition, periodontitis, which can result in bone loss and tooth loss.

For women who are experiencing gingival inflammation, which may include sensitive or bleeding gums, Dr. Rethman, president of the American Academy of Periodontology, recommends stepping up oral hygiene, which can prevent more severe problems down the road. This should start with an evaluation by a dentit, perhaps even a periodontist. More frequent professional cleanings may help – even monthly cleanings if covered by insurance. At home, Dr. Rethman says to make sure and clean each tooth "360 degrees." In other words, it's necessary to brush and floss.

Although there have been no definitive studies showing the superiority of power toothbrushes over traditional toothbrushes, Dr. Rethman feels that the power toothbrushes do a better job of cleaning. He particularly recommends higher-end products, but says even the less expensive models are fine. He also notes that ads by Listerine that claim using Listerine is equal to flossing have merit, but says everyone should floss regardless of how great their mouthwash is.

The bottom line is that the problems caused by elevated hormone levels, assuming excellent dental hygiene is maintained, are generally short term and will resolve themselves when the hormone levels return to normal.

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