TUSHY-D: What Fertility Patients Need to Know About Oral Health with guest Dr. Katie Lee, DDS

I’m welcoming Dr. Katie Lee, a holistic and integrative functional dentist, to answer real-life questions about the surprising connection between oral health and fertility. In this interview, we cover practical advice, debunk myths, and provide actionable tips for optimizing both dental and reproductive health. Plus, we’re talking about how visiting a dentist is so important as part of your fertility journey that I’m considering adding a “D” (for dentist) to The TUSHY Method.  Welcome to “TUSHY-D!”

We dive into how the oral microbiome affects hormones, fertility, and pregnancy outcomes, including topics like gum inflammation, dental anxiety, and systemic inflammation markers. Dr. Katie also shares simple, evidence-based strategies couples can implement to protect their oral and reproductive health, plus the top products and tests she recommends for anyone planning a pregnancy.

I created The TUSHY Method as an easy way for fertility patients to remember the 5 tests they need to get a thorough diagnosis before beginning fertility treatment. It gives patients a clear path to getting a diagnosis, and it’s something you can share with your own provider to start a conversation, or ask more questions if you don’t understand your own diagnosis before beginning treatment.

After multiple conversations with holistic and integrative dentist Dr. Katie Lee, I’m excited to share an expanded version, which we’re calling “TUSHY-D” because your Dentist belongs on your fertility care team.

Here’s a quick overview of The TUSHY Method (and you can find more about it here.)

“T” in TUSHY stands for tubes (the fallopian tubes)
“U” in TUSHY stands for ultrasound of the uterus.
“S” in TUSHY stands for semen analysis.
“H” in TUSHY stands for hormone testing.
“Y” in TUSHY stands for your genetic profile.

Now we’re expanding it to TUSHY-D, because your Dentist belongs on your fertility care team.

D: Dentist (Oral Health & the Oral-Systemic Connection)

What it is:
A focused dental evaluation to reduce oral inflammation and infection, and assist in getting a diagnosis before and during TTC.

How your dentist can do this check:

• Comprehensive dental exam with periodontal screening (gingivitis/periodontitis)
• Identify and treat caries, cracked teeth, or root canal infections
• Discuss saliva/oral microbiome testing, which can be done with online tests and ordered through Dr. Lee
• Review habits: mouth breathing, snoring/sleep apnea, bruxism (grinding), reflux, oral hygiene routines
• Product check: toothpaste ingredients (SLS, fluoride, xylitol), floss, rinses, and timing of dental visits around fertility treatment

Why it matters:
Inflammation is inflammation. Chronic gum disease can add to systemic inflammatory load, which is the same theme we monitor in endometriosis and PCOS. Gum infections (yes, gingivitis is included here) can make it more difficult for a woman to conceive.

Two bacteria are especially important:

• Fusobacterium nucleatum (Fn) can cross the placenta and cause pregnancy complications.
• Porphyromonas gingivalis (Pg) is linked to difficulty conceiving.

Having chronic inflammation in the mouth is associated with endometriosis, PCOS, and pelvic inflammatory disease, conditions that are known causes of infertility because they can inhibit ovulation.

The oral microbiome also communicates with the gut microbiome. Disruptions in either can influence immune activation, insulin resistance, and hormonal stressors affecting ovulation, implantation, and pregnancy health.

Male factors matter too. Periodontal disease and other oral issues can impact sperm quality, quantity, and contribute to erectile dysfunction.

Timing & safety notes:

• Routine cleanings and necessary dental care are generally safe before TTC and during pregnancy.
• Modern X-rays use very low radiation; if needed, shielding and timing can be coordinated with your REI and dentist.
• Urgent infections should always be treated promptly, during fertility treatment or during pregnancy.

What to ask:

• Do I have any active gum inflammation or untreated decay?
• What’s my personalized plan to reduce oral inflammation in the next 4–8 weeks?
• Which products and habits best support a healthy oral microbiome while TTC?

Why TUSHY-D Helps (Especially for Endometriosis & PCOS)

Emerging research shows that two key oral bacteria: Fusobacterium nucleatum and Porphyromonas gingivalis may contribute to infertility through their effects on inflammation and hormone balance.

• Endometriosis: Research has found that Fusobacterium nucleatum (FN) bacteria, often present in the mouth, may play a role in the progression of endometriosis. Because endometriosis is a whole-body inflammatory condition, addressing oral inflammation could help lower overall inflammatory load and better support implantation.
• PCOS: The interplay of Fusobacterium nucleatum, Porphyromonas gingivalis, and periodontal disease with hormonal imbalance, insulin resistance, and systemic inflammation suggests that improving oral microbiome health may directly support ovulation and egg quality.
• Unexplained infertility: Sometimes the issue isn’t truly “unexplained,” it’s simply “unchecked.” Including the “D” in TUSHY-D closes a common blind spot and ensures oral health isn’t overlooked as a contributing factor.

These findings underscore a powerful concept: inflammation is inflammation. Managing oral pathogens like F. nucleatum and P. gingivalis through dental care, oral microbiome balance, and systemic support can help lower inflammatory burden and support reproductive health.

How to Use TUSHY-D With Your Care Team

• Run the checklist: Make sure each letter has been addressed for both partners.
• Triage & treat: Fix what’s fixable now (like a cavity or gingivitis).
• Personalize: Your plan should match your diagnosis, timeline, and values.
• Coordinate: Ask your dentist and fertility doctor to communicate so your care is seamless.

In our YouTube episode, Dr. Katie Lee and I apply TUSHY-D to your real questions, like X-ray safety near retrieval, canker sores and inflammation, toothpaste choices, lipstick and oral health, pillowcases and the microbiome (yes, really!), PCOS + gum inflammation, unexplained infertility and gum disease, dental anxiety before IVF, teeth grinding and stress, and much more.

If you’re TTC, consider this your nudge to add the “D.” Your mouth is part of your fertility story, and with the right plan, it can be a supportive one.

In this episode, we cover:

• Daily habits and oral care tips that support fertility and overall reproductive health
• Safety of dental procedures, X-rays, and managing dental anxiety before IVF
• How oral microbiome imbalances, gum inflammation, and systemic inflammation affect hormones and fertility
• Partner oral health, PCOS, and other conditions that influence conception
• Recommended natural oral care products, testing options, and actionable strategies for preconception planning

Resources:

Book a time to do an oral microbiome test with Dr. Katie Lee

Follow Dr. Katie Lee on Instagram

Find Dr. Katie Lee’s website here

Join The IVF Class

Find Dr. Aimee’s Fertility Essentials & Supplements

Products recommended by Dr. Lee

Wellnesse: Healthy toothpaste, floss, tongue scraper and oral probiotics to replenish the oral microbiome

Daily Dental Cares: Protektin lozenges and water additive, pHossident lozenges and toothpaste tablets

Protektin lozenges are great for reducing bacteria that cause gum disease. Can also be inserted vaginally in the case of a BV infection.

Protektin water additive are great for fixing the (leaky) gut, reducing inflammation in the female reproductive system caused by oral bacteria including PCOS and endometriosis.

pHossident lozenges and toothpaste tablets are the “best product on the market for preventing tooth decay.”