Periodontitis and Infertility: An Evidence-Based Review

Periodontal diseases are initiated by a pathogenic biofilm, in a susceptible host, affecting the tooth periodontium. Its possible association with many biologic systems has been studied. In this evidence based review, a comprehensive literature search was carried out to assess if there is an association between periodontal diseases and female infertility. An extensive search was conducted in PubMed and Cochrane Library. Epidemiological studies, experimental studies, inquiries or editorials on the theme periodontitis and infertility published until May 2016 were included. The initial search retrieved 47 papers, from which six were selected due to inclusion criteria. The epidemiological study with the highest level of evidence concluded that periodontal disease might be a factor that increases the time to conception, on average, in two months more, which is as negative as obesity. The authors stated that all patients before attempting to conceive could be oriented to have a dental checkup, as they are currently advised to smoking discontinuation, weight loss, and folate supplementation. The experimental studies pointed out that the infertility problem is a secondary outcome in rodents challenged with periodontitis. The possible biological explanation is that periodontitis causes a systemic inflammation, which could: a) prevent ovulation; b) prevent implantation of the embryo or does not sustain its implantation. It is known that oral health incorporation into general health agenda is crucial for optimal health and general wellbeing. Therefore, women trying to conceive should be in the best possible health, which will be achievable through an effective multidisciplinary teamwork.