Episode 590

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This is the Fertility Friday podcast, episode number 590.
We’re about to dive into an interview that is going to completely change the way
that you think about your mouth and your oral health and the potential link between
oral health and fertility. For the first time on the podcast, we are exploring this
topic of oral health and fertility. I am sharing my interview with Dr. Katie Lee,
a functional dentist and author, and we go into some really interesting territory.
Dr. Lee shares her incredible compelling story of what drew her into dentistry in
the first place. And she also talks about some very practical strategies that she
implores in her dental clinic, namely regularly testing the mouth for various strains
of bacteria, some strains that are actually known to have negative impacts on male
and female infertility. And so I feel like with this interview, we’re getting a
totally different perspective of our mouth as the window into our microbiome because
it’s all connected. And so if we have certain bacterial infections in the mouth,
they actually are able to then go through our bloodstream and cause problems in
other areas. So you may be brushing a little bit more intently and flossing more
frequently after today’s episode. So before we jump in, let me tell you a little
bit more about Dr. Katie Lee. She is a dentist author and founder of the Collective
Health Society and Integrated Dental and Medical Center in Aurora, Colorado, focused
on oral systematic health. She also leads the Collective Education Society training
clinicians in this emerging field. A former partner in over 80 dental practices, Dr.
Lee is the author of Save by the Mouth and serves as a clinical advisor to several
dental technology companies. Her passion for dentistry began after a traumatic ATV
accident as a teenager, which she shares more about in today’s interview, which
shaped her understanding of how oral health impacts the entire body. So without
further ado, let’s go ahead and jump into today’s episode with Dr. Katie Lee.
And I’m really excited to be here today with Dr. Katie Lee. Welcome to the show.
Thank you for having me. I’m really excited to chat with you. Yeah, me too. I was
saying to you before we hit record that we’ve never talked about oral health and
fertility on the show. So I’m really excited to delve into the connection. But
before we do, I would love for you to share a little bit about your background and
what prompted you into the field of oral health. But furthermore, How did you sort
out this connection between oral health and fertility? Yeah. It’s kind of a long
story. I’ll try and shorten it as much as I can. I really started getting informed
about oral health affecting systemic health from an accident that I had when I was
14. I was on a four -wheeler with no helmet and ran into a telephone pole head
first, going 35 miles an hour. It’s a miracle that I survived, but I broke every
bone in my face from my eyebrows down and lost a bunch of teeth and was in a
coma for about five days. And they wired my jaw shut that night in the hospital,
just trying to stabilize everything. And of course, losing teeth, breaking teeth,
everything else, they just wired them shut, they didn’t fix them. And over the next
eight weeks, I survived off of ice cream, boxed mashed potatoes, not even the real
stuff, boxed mashed potatoes, jello pudding, and I lost lost a ton of weight, had a
ton of oral infection, obviously, because my teeth were rotting. And so my liver
enzymes started spiking and my kidneys started shutting down and I became emaciated
and severely malnourished. And so I learned at a very young age just how important
your oral health is to systemic health. And when they took off my wires, I was
really excited to get to eat my first meal and they took my wires off and I
couldn’t open my mouth at all, my jaw completely fused shut. So it took four years
and nine reconstructive surgeries, where I was completely locked, couldn’t open to fit
a toothbrush in. And I admit, I was missing a couple of front teeth. So I had to
wear like little retainers with teeth on them, which was mortifying, you know, in
high school, ’cause half the time I’d go to school and forget to put my teeth in,
which was really embarrassing. And so there’s a big emotional component that went
along with that, a big mental health component that went along with that. And back
then in the nineties, you weren’t really talking about this stuff, right? It was
just toughen up, like toughen up Buttercup. And so it really impacted my life in a
profound way. And when I got my teeth fixed finally, four years later, senior year
of high school, I just remember the immediate impact it had on me having my smile
back and being able to chew food and eat in a social environment with other girls.
And so I said, you know, I got to go into dentistry. I got to help other people
’cause this is really important. And so that got me into dentistry, but then I
started paying attention and noticing that most of my patients that had oral disease
also had a lot of systemic conditions. And I kept seeing these correlations with
heart disease, with diabetes, and I would try and work with their healthcare
providers and their healthcare providers were like, you don’t know what you’re talking
about, you’re a dentist, stay in your lane. So that really got me going down this
path of let’s learn more, let’s try and see if there is a connection. And so I
read a couple of some great books, started educating myself, and I started
integrating salivary testing in my practice. And one of the very first patients I
had was a woman, but she came in with her husband, they were in their 20s, no
health issues, they were trying to get pregnant, and we’re having all these
difficulties. And so they went to their OBGYN, and they said, well, nothing is wrong
with you, but maybe you should go see your dentist, which to this day, that is the
only time I’ve ever been referred a patient by an OBGYN thinking that their oral
health could be impacting their fertility. And I’ve been working really hard to
change that. It really hasn’t changed that much. So wait, I did the saliva test and
they didn’t know I was doing saliva tests. They just called up a new random
dentist. And it turns out she had two bacteria in particular that are directly
implicated in fertility. I also tested her husband because obviously it takes two to
make a baby. So we’re swapping spit and he had it two and I treated both of them
and they were pregnant within three months. Nothing else changed with them. And so
that got me thinking, there’s more to this. And then I had my own fertility journey
where I was a patient of traditional medicine for six years and just saw how myopic
the treatment really is for women, right? We don’t even look at men except for we
take one sperm sample and then that’s really it. And then we only look at their
reproductive system and we don’t take into account other things that could be
contributing to it. So really just kind of made this my mission to do oral systemic
health in general, but specific focus on fertility ’cause I think women deserve
better and more. – Oh my goodness, there was so much in what you said.
I was welling up a little bit when you shared your story, because that is just, I
can’t imagine. You’ve probably shared it many times, you know, at this point, but
that is just unimaginable. I don’t know if we’re around the same age range, but I
just, I was, you know, born in ’82. – Yeah, ’84. – Okay, so we’re in the same age
range. Because I, and when you said you were riding with that helmet, I’m like,
man, she’s got to be an ’80s baby. – Yeah. – ‘Cause this was, that was the ’80s.
The reason that we have helmets today is because of the ’80s. And I just remember
when they started really pushing helmets and, but there was this, this image that
they just kept putting on all the billboards to try to get everybody to make, to
wear helmets. And it was of a child who had fallen off his bike and obviously he
had to get like, he broke his head open and they had to get that. And so when
you were describing your story, I was like, oh my gosh, like that was you. Like
you were one of the people who had to go through this horrible, horrible thing So
that, and then that changed everything for us now. And now we put helmets on our
kids to like walk from one side of the bed to the other. – I know, right? In
fact, now, or that day when I got hurt, it was July 5th, 1998, there were two
other four -wheeler accidents ’cause I grew up in the country. So there were two
four -wheeler accidents. One, someone got ran over by a four -wheeler and broke tons
of bones. And then the other and broke their neck and died and had to be
airlifted. And so there are three, four wheeler accidents that night, no one wearing
helmets. So yeah, it was pretty awful what I had to go through. And it was all
head and facial trauma. You know, I broke my wrist, I had surgery on my wrist to
repair that, but everything else was fine. It’s a miracle that I’m alive, it’s a
miracle that I am not in a wheelchair, and it’s a miracle that I still have some
of my brain left, you know? – Well, and it was such a profound experience for you
and how long it took you to recover. And so it was really inspiring just to hear
you talk about. I mean, I take a lot of things for granted, you know, how you try
not to, but when you said that, you know, when I finally got my teeth fixed and I
was able to just enjoy a meal and chew food and smile. And I’m thinking like, I
have never thought about that being. It’s never occurred to me.
So I, that just is an incredible reason that you went into dentistry and just had
to comment on that. Cause that was really, wow. Yeah. Food is, is so communal,
right? And I am high school girls are mean. Yeah. Mean.
So I would eat in the bathroom, you know, sometimes I go and eat in the bathroom.
Sometimes I would eat a lot of times I eat in the principal’s office. The
secretaries were always really nice to me, but there was no way I could take my
teeth out of the and stable. Like, are you kidding me? Yeah, it’s pretty hard going
in your formative years and your development years going through high school, having
that kind of trauma. But it led me down a great path. So I’m, I am thankful for
it at the end of the day. And then when you were talking about the early stages
of what they were feeding you, and obviously that just made a whole lot worse with
your teeth, right? There’s a lot of interesting, so I’ve been a been a follower of
the Westinay Price Foundation, and they have a lot of interesting things to say
about the connection between oral health, dental health, and overall diet and things
like that, which is just so interesting. So at the end of the day, it really feels
like you are called to do this work. I’m so impressed that you know who Westinay
Price is. That you just went to the top of my hero list there. I love that. Yeah.
It’s super important for our airway and how we develop and how our skeletons
develop. And, and yeah, being back in the 80s and 90s, like we were raised on like
Lucky Charms, right? So, and Wonder Bread with margarine, and then we put sugar on
it. So we definitely were not eating the way that we were supposed to. And then it
just exacerbated all my issues. It’s amazing that we survived the 80s. I mean, I
feel like the younger generation, no, no offense, right? But it feels like the
younger generation, like, I don’t know, you guys, it’s a different experience, well,
I got to say. – Yeah, yeah, for sure. – Okay, well, so let’s get into the
connection because again, I’m still unpacking your story from the beginning, but when
you shared about, I mean, that’s even interesting that the OB suggested, like, do
you know why they said to go to the dentist? Like, was there, did they have rotten
teeth or something? Like, was there an avert? – So, when looking at them, looking in
their mouth, you could tell it was a parent that they had gum infection for sure.
And that’s where we see a lot of the issues going on between oral health and
fertility is airway health and oral microbiome. And it was a parent just from
looking in their mouth that they had gum infection. I don’t think they had
immigrated to the country and I don’t think they’d really ever gone to a dentist
before. But that doesn’t mean that they have specific type of bacteria that impact
fertility, because there’s over for different types of species in the mouth. So it
really just depends on if you have a couple really specific strains that impact
fertility. And like I said, they had no idea who I was. They had no idea that I
was doing salivary testing. It just happened to be fate that they walked into my
office and I had just started doing the test. Well, so talk to us a little bit
more about that because that’s really fascinating. And interesting that you have
adopted that as kind of one of the standard things that you do. So maybe share
with us a little bit about what you’ve uncovered over the years just by doing
salivary testing as part of your practice. Yeah, I would say the biggest thing that
it’s shown me two things. One is that a lot of people have issues and most of the
time they don’t have symptoms. So a lot of people say, oh, I don’t go to the
dentist because nothing hurts or nothing’s bleeding or I go to the dentist all the
time and they tell me everything is great. And I say, well, if they don’t do a
test, how do they know, right? It’s just like if you go to your PCP for a
physical, if they don’t take your blood pressure, if they don’t take blood work,
they have no idea if your blood sugar is high or if you’re high blood, you know,
if you have high blood pressure or high cholesterol, you can’t tell just by looking
at somebody. And in dentistry, historically, we’ve never really had tests or used
tests to show us what’s going on beneath the surface. It’s always just been even
our judgment of what we see. It’s like you go to one dentist, they say one thing,
you go to another dentist, they could say something completely different. I hear
those stories all the time of one dentist that I had 12 cavities and the other
said I had none, right? Well, that’s ’cause there aren’t, and most people don’t use
tests. So without tests, you don’t actually know. And then you’re relying on the
person’s judgment and their experience to make a diagnosis. So we’re guessing at that
point. And so bringing in salivary testing is really important. So a couple of
things, one is most people have an issue and they don’t know it. And the other
thing is it’s really good at educating patients as to what is there and why
treatment is needed. Because again, I think there’s this distrust between the
population and dentists because the opinions are so all over the place that people
naturally are like, you know, how do I trust you? How do I know that what you’re
saying is true, and so this kind of you can’t ignore results, right? So that’s what
I found really profound with saliva testing. Yeah, no, that’s really interesting. And
one of the things that I talk about with our practitioners is, you know, so my
background, of course, is fertility. We’re in a cycle charting. And so one of the
main things that we do in our practice these days is to teach women’s health
practitioners to actually use the menstrual cycle as a vital sign. And so one of
the things that’s interesting about that approach is that you can look at the cycle
and see a lot of implications. You can see a lot of implications about hormones and
things like that, but often it’s the testing. So the cycle can then inform the
tests that you are doing instead of just doing a barrage. You can be a little bit
more precise, but then it’s the testing and the results that prompt the client to
get into action ’cause now they have that data to say, okay, there’s really a
problem. You could talk about something all day, but then when they get the test
that that nutrient is low or that the sperm count is off, all of a sudden now
we’ve got some motivation to take some action. – Yeah, definitely. And I find that
in dentistry all the time. Unless you can test, it’s kind of hard to motivate.
People are motivated by like pain, right? So if they have pain, they’re motivated,
but the problem with microbiome issues is oftentimes there’s no pain. Sometimes people
have bleeding gum, sometimes they’ll have bad breath, but oftentimes there are no
symptoms. And so it’s really hard to motivate someone who seemingly thinks they’re
fine, that has no symptoms that they need to act. And so yes, you’re totally right.
The test results get people to move.
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ahead and jump back into today’s episode.
So question for you, you gave the example of this client of yours and they were
trying to conceive and they both have this bacteria. So talk to us about that
connection. How could a bacteria in your mouth have any effect on your ability to
have a baby? Yeah. So the important thing to note is that the mouth is really the
entry point to the body, the major, largest entry point to the body. And it’s the
second largest microbiome that we have second to the gut. And so there’s this huge
amount of bacteria that’s there and less than 1 % of our total oral microbiome are
bad pathogens. But what happens because of diet, stress, environment, the people
around us, what have you, the microbiome can shift and become out of balance just
like in your gut. And What ends up happening is when the body senses that something
is awry in the mouth, it releases the body’s white blood cells to go attack
whatever shouldn’t be there. The white blood cells are really large cells. They can’t
fit through all the tissues to get to the source of infection. The white blood
cells release an enzyme called MMP8. This enzyme is a collagenase enzyme,
which just means that it’s a scissor and it goes through and it cuts through all
the tissues to allow the cells to get to the source of infection. It breaks down
any collagen in the body. So if someone has leaky gut, they also have leaky gums.
If they are suffering from arthritis, they’re going to have gum issues. And so what
happens is the gum tissue starts to break down. Our gums are supposed to be like
our skin in the sense that it’s a physical barrier. So it keeps the environment out
and keeps what’s in our body in. The gums are supposed to be the same thing,
except the gums are actually penetrated by our teeth. So they’re already kind of
weakened because our teeth are coming out. But the gums then form these tight
junctions around the teeth to kind of wall everything off. That collagenase enzyme
will go in and break down that gum tissue that’s right there. So then what happens
is the gums are no longer sealed to the teeth. Now the bad bacteria that are in
the mouth love to burrow into that gum tissue, and the gum tissue is where the
blood supply is. That’s why gums bleed. So once the bacteria hit the bloodstream,
they can circulate and go anywhere in the body. And one of the main places that
oral bacteria love to go are the female and male reproductive systems. And there’s a
couple of bacteria in particular that really, really do a lot of harm. Okay, that
is mind blowing. So let me just try to backtrack to make sure I understood what
you just said. So because In my mind, one of the questions that I have for you is
like, is it the chicken or the egg? Like, is it that I have this issue with my
gut and then it’s manifesting in my mouth? Or is it that I have,
because what you described is like, is that a product of bad oral hygiene that the
gums have gotten to that stage and then it’s allowing the penetration of the
bacteria to where it hasn’t been? Or is that a product of the bad gut health?
Maybe explain it a little bit more so that I can understand where is it coming
from? Love to. I just got done talking with the patient about this that is having
gut issues. So the gut microbiome critically important, right? But we got to take a
step back and think how did the microbiome get to the gut? We’re swallowing over a
trillion bacteria a day. Most of that bacteria are going to get eradicated in the
stomach and small intestine. The one that we’re really concerned with are the ones
that get to the bloodstream and get to the gut that way because it can really
bypass our protective mechanism organs like small intestine stomach. So we’re not
really concerned about what we swallow, although we are more concerned about the bad
pathogens in the bloodstream. There’s about a 45 to 50 percent overlap between the
oral microbiome and the gut microbiome. I have definitely seen it go both ways where
someone has gut issues that then first show in the mouth. In fact, before we really
knew a whole lot about this oral system and health connection, which is crazy to
think about it. Your mouth is the opening to your digestive system, so it’s crazy
that we never really thought of it this way. Most of gut issues show up first in
the mouth, so we’ll see people with Crohn’s and IBS actually have certain sores and
present certain ways in the office, in the dental office, and say, “Oh, I think you
have IBS or Crohn’s, go see your doctor,” so that’s been going on for decades. We
always say the mouth is really a mirror to the body. So sometimes I’ll see it that
they have something in their gut that then works its way back up to the mouth. But
I also see it the other way where sometimes it starts to the mouth and it goes to
the gut. And fortunately, I don’t really get to patients early enough to be able to
detect where it’s coming from first. Although I did have a family member that was
like the epitome of health. And I write about this in my book. I mean, she gets
up every day at five to work out. She didn’t even have plastic in her house, all
glass, everything. It makes all of her own food, nothing processed, or he doesn’t
drink alcohol. She’s just the epitome of health and never had a cavity. I would
never really save a whole lot of time for her at my office because I knew her
cleanings were going to be super quick. Then one day she came in and I started
doing her cleaning, and I was like, “Oh my gosh, what is going on with you?
Something is not okay.” She was bleeding like a pig, tons of inflammation. And I
said, “Have you been sick lately? Do you have any gut issues?” And she said, “I’m
so glad you brought this up because I have not been feeling well for months. And
I’ve gone to GI doctors, my primary care, they’ve done a colonoscopy, they’ve done
an upper GI, they ran blood work, they say everything is fine. I ran my test and
I’m like, “Everything is not fine.” So we treated her and then I sent her to her.
She actually found a functional medicine doctor and she ended up having SIBO. So in
that case, specific case, I think she had SIBO in the gut first and it translated
to the mouth because just knowing her personally, her mouth was always healthy. So
it’s hard to tell if it’s chicken or egg, but I do know you have to treat both.
You can’t have a healthy gut without a healthy mouth. Oh, that’s so fascinating. And
so what you said about if there’s the leaky gut issue, if you have this enzyme
that’s kind of penetrating through and essentially weakening that barrier that you
would naturally have in your mouth, you could have these harmful bacteria essentially
getting into the bloodstream from the mouth and then targeting different areas of the
body and that could be contributing. Also fascinating that you can just pick up on,
I didn’t know that in the dentist office they could pick up on certain gut issues
just by looking at your mouth. So I feel like this is very, very interesting
information. So One of the questions I have then is what do we do about this? I
mean, in the case of your family friend, she was flossing, right?
It sounds like she was on top of it. >> Very healthy. >> This was a different
thing.
Is inflammation of the gums called gingivitis? Is that what it’s called? >> So
gingivitis just means that the gums are inflamed, periodont, and that is reversible,
meaning we can treat it and the gums will shrink back. Peridontitis is where you
have inflammation of the gums, but you’ve also lost bone. So now the bone is dying
around the teeth. That we say is irreversible because we can’t get the gum tissue
or the bone to grow back. Either way, the bacteria are the same and the process is
the same. It’s just the timeframe in which you caught it. So if you caught it
early enough, the patient will just have gingivitis and you can reverse that. But
the bacteria are still getting into the bloodstream and damaging the body. So it
doesn’t matter if the bone is there. I mean, it does matter for us, but I mean,
the disease process and the systemic implications of that are the same. Well, and
so, I mean, obviously, there’s different things going on. So if you’re brushing and
flossing and doing the things you’re supposed to do. So tell us what the impact is
of that It’s someone who is brushing and flossing but has a deeper issue that is
then manifesting because it sounds like you could be doing the brushing and flossing,
but if you have an issue, it could still be presenting. Absolutely. Thoroughly
confused. Absolutely. Yes. And that’s actually the patients I see at my new office
is I’m a good patient. I brush, I floss, I’m doing all the things that I’m
supposed to be doing, I go to my dentist every six months and I still have all
these issues. And So a lot of other things can impact it. So diet is a big one,
high sugar carbohydrate, diets will affect it, food sensitivities will affect it,
airway health is so critical to our overall health. So oftentimes our patients have
airway issues and don’t know it, environment, maybe they’re low on some nutrients or
vitamins, that can do it, and stress, sleep and stress are big ones. Another big
one is alcohol, Unfortunately, you know, everyone, me included, loved my glass of
wine a few nights a week, but it’s not good for oral microbiome. It wipes out all
the good bacteria and leaves only the bad, so that destroys our microbiome. Well,
and you’ve mentioned airway issues a couple of times. Could you briefly just give us
a rundown on what that means? Sure. So airway, what I’m talking about is a couple
of things. One is nasal breathing. People absolutely need to breathe through the
nose. Our nose has all these turbinates with trillions, fun trillions of cilia,
which are a little
This is instead of being flat at the bottom of our face, start to peek, and then
we don’t have enough volume, and so it just perpetuates this mouth breathing. When
you breathe through your mouth, you get less oxygen into the body. You get more
inflammatory pollutants, so it’ll cause a lot of lung issues, a lot of systemic
inflammation, dries out the mouth, causes saliva in our mouth to become acidic.
We reduce our nitric oxide, which is a vasodilator that we need, so there’s all
kinds of issues with breathing through the mouth. But then that can go even further
into someone developing airway disordered breathing or sleep apnea. So as we age,
we lose collagen, we lose our muscle tenacity, and as women, we lose our bone mass.
And so we have less structure for our muscles and skin to attach to.
So when we go to sleep at night, everything collapses and our airway collapse. You
combine that with Winston Price and what he is saying is that our jaws have
actually shrunk over time, which they have, because of our modern day diets. And so
there’s not enough room for our tongue. Our sinuses aren’t developing properly. We’re
not breathing correctly. And so people will develop sleep apnea. And about 80 % of
people who have sleep apnea are undiagnosed. And that is critical for fertility,
critical for oral health, critical for heart health and brain health. So we know
that patients who are having fertility issues, I’m always going to run a sleep apnea
test on them, because if they are not breathing, and you know when you get
pregnant, you can’t, you start snoring anyway, right? You’re gaining weight, you’re
getting big, you can’t sleep comfortably. And what ends up happening, if you’re not
oxygenating your blood, you need oxygen and blood getting to that fetal artery to
help that baby develop. So we see a lot of preterm births and low birth weight
babies and people who have airway issues. Oh my goodness. I just didn’t realize
there were so many ways that our oral health was connected to, but it makes perfect
sense. It’s one of those things where as soon as you talk about it, it’s like,
well, yeah, that actually makes a lot of sense, but just haven’t necessarily thought
about it. I do have a question before I go into some of the fertility specific
questions, which is about root canals. So because I think that, I mean,
I’ve read a lot of things that would suggest that they’re problematic because, so I
feel like there’s probably two different camps and I’m curious what your thoughts are
on it that, and I haven’t had one, but my understanding, so correct me, ’cause I
don’t know what I’m talking about ’cause this is not my field. My understanding of
a root canal is that, you know, you’re drilling through the tooth when you have an
issue with your tooth and they kind of, they leave it in there, but they like
drill it so they essentially kill the tooth and then it’s dead. And there’s people
who would say that having a root canal tooth in there can cause a lot of problems
for people because it’s like essentially a dead tooth that is, yeah. So what are
you, but I don’t know if it’s controversial or not, but dentists are still doing
it. Yeah, it’s very controversial. Yeah, you know, it’s kind of, it’s a hard
question to answer. And what I always try and do with my patients is just give
them as much information as possible and let them decide. So our teeth are organs,
which is crazy to think about. They have a blood supply and they have a nervous
system and they’re connected to the body’s circulatory system and they’re connected to
the body’s nervous system. That’s why teeth hurt, right? And so when they become
infected by a cavity and you get pain and the nerve and the blood supply gets
infected, that’s not good for our bodies either. We don’t want our bodies fighting
any sort of infection anywhere. And so then the question becomes, okay, well, what
do we do about it? Do we take the tooth out and replace it with a foreign body
such as an implant? Because we don’t know necessarily how that person’s going to
respond to an implant. Most people, 95 out of 100 respond just fine to an implant,
but it is a foreign body that you are implanting and you can do metal or you can
do zirconia. Some people say ceramic implants are better, and the researchers coming
on that in the past, they have not been better. In fact, they fail after five
years, which the immune process that happens for a failing implant is very
significant on what that does to the body. So they are getting better, but they’re
not perfect, which by the way, I have three implants, so they do work. But the
problem with implants is implants aren’t teeth, And so they’re not connected to the
circulatory system and they’re not connected to the nervous system. So they’re much
less able to fight off bad bacteria than our teeth are. Because our teeth are
organs and they have that blood supply in that nervous system, you know, if they
get attacked by cavity -causing bacteria or periodontal -causing bacteria, they can kind
of fight it off because of all the blood supply around it. Implants don’t have
that. They’re inert. They’re stuck in the bone. So implants get disease easier. They
have more damage around them faster. So the amount of bacteria that it takes to
cause damage around the tooth is a lot higher than what we see with implants. And
even if we do go treat a diseased implant, they respond less to treatment. So
you’re not really solving a lot by taking into that and getting an implant. Now on
the flip side, do you get a root canal? The problem with root canals is because
they can be done biologically and pretty healthy, but the problem is that now we’ve
killed off the tooth and we’ve left a dead tooth there. Now the tooth doesn’t have
an immune system either, so it’s more prone to decay, it’s more prone to gum
disease, but the bigger issue is because that nerve is gone, if the root canal is
not done properly and it’s not monitored, they can develop an abscess around the
root of that tooth and that abscess can go unchecked for years because the patient
has no symptoms. I actually had a situation like that when I was undergoing
fertility treatment or getting ready to start. So I wanna make sure I had no
infection. So I took an X -ray and it turns out I had an abscess on a root and I
had no idea. So if you leave that infection there unchecked for a long time and no
one finds it, that does significant damage to the body. So I try and let patients
make their own decision on that. If they choose do a root canal, we want to do it
safely. We want to do it with a specialist that has microscopes and advanced imaging
to make sure we get everything cleaned out. And then we monitor it twice a year to
make sure it’s not developing new infection. If they want to take the tooth out and
do an implant, that’s great too, as long as they know that we have to take even
better care of an implant than we would the teeth. But I would personally like to
try and avoid the cavities going to the nerve in the first place, so we don’t have
to make that choice. Mm -hmm. Well, thank you for taking us through that.
It’s all very confusing because there’s a lot of different information. And there’s a
lot of people that are very passionate about both camps and they share a lot of
information. So I appreciate your balanced perspective on that. But at the end of
the day, it doesn’t sound like there’s a clear answer. And then one last question
on the front. The prevention, right? Obviously, yes. Yeah, prevention. And the other
thing you don’t want to do is take the tooth out and leave leave it. If you take
out your first molar, your chewing capacity reduces by 45%. You take out your second
molar reduces by 55%. That creates way more issues for TMJ, airway digestion,
systemic inflammation. A lot of people say just take my tooth out and leave it.
That’s probably by far the worst thing you could do. That was going to be my
question, actually. A lot of patients will just say, say, “Well, I don’t want either
option.” Just take it out. I’m like, “I would really advise against that, for sure.”
It’s so fascinating. Now, everyone needs to go and make an appointment with their
business. I wanted to ask you about, because I know one of the things that we
talked about before we started recording was the interesting connection between the
oral microbiome and certain conditions, like whether it’s endometriosis or PCOS, or
bacterial vaginosis. So I’d love to dig into that a little bit as well. Yeah. So
the same bacteria that are causing infertility issues are the ones that are going to
be contributing to these issues. So there was a study that was done in 2023, I
believe. There was 155 women that they looked at to see if the oral bacteria,
fuzobacterium nucleatum, was contributing and /or causing endometriosis. And what they
found is that in 64 % of those women, they had oral FN present in their
endometriosis lesions versus they sampled women that had healthy endometriums and only
7 % of them had oral FN. So, pretty significant finding showing that FN does at
least contribute to or find a way into endometriosis lesion. So, and I actually,
that was my experience I had in my practice. I had a patient come in, young woman,
had no systemic symptoms that she knew about. We did her exam and my hygienist was
like, “Doc, something’s wrong with this patient.” She is bleeding. I don’t see any
buildup on her teeth because typically the more buildup someone has, the more they’ll
bleed. She looks squeaky clean and she said that she had always bled since her
teenage years. We tested her. Her FN was off the her MMP. It was off the charts.
We treated her. She came back three months later and she was better, but it wasn’t
great. And so I sent her to her PCP and to an endocrinologist and they started
digging and they found she had systemic endometriosis. She had lesions in her lungs,
had no idea. And so she was treated successfully and was in remission. So anyone
that has any kind of female issues, even if they’re not trying to get pregnant,
definitely come and get a saliva test just to make sure that they’re okay. PCOS,
very similar. FN and PG contribute to PCOS. We know that PCOS has implications with
insulin sensitivity. When we have insulin sensitivity, we’ll have a lot of systemic
inflammation, and the oral bacteria can cause that systemic inflammation and can
contribute to insulin sensitivity issues. And then what was the other one? You said
PCOS – >> Bacterial vaginosis. >> Yes. So there’s a microbiome down there too, right?
So we got to make sure that everything is in balance. So there’s a couple of
supplements that I, or lozenges rather, that I recommend some patients to have when
they have oral microbiome issues. And what we know is that they insert one of those
lozenges actually vaginally. Oftentimes it clears up their bacterial vaginosis. So it’s
all microbiome stuff that we got to balance.
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That’s fertilityfriday .com /realfood.
So then what do you recommend? So I suppose this is like the natural question.
Now that we’re scared off of it, all this back to you. I know. I don’t like to
scare people because there’s so many solutions. That’s the thing. Yes. I mean, but
at the end of the day, it’s good to know because, I mean, I for one, don’t
necessarily spend a lot of time thinking about my oral health. I mean, I definitely
do my best to be on top of it. I’d be like one of those people that you’ve
mentioned, like I floss every day. I actually do. And I make my kids floss every
day at low. I and I escape a couple of days here and there. And so you feel like
you’re doing what you need to be doing, but what are your general recommendations
for us to maintain good oral health? – Yes. So first thing is I would get a saliva
test ’cause you gotta know what’s there. Oftentimes people have issues and they have
no idea. So figure out what’s there because the bacteria, half of the bacteria don’t
respond to regular cleaning. So a lot of people say, my gums bleed, but they’ve
always bled. Well, that’s probably ’cause they have certain bacteria that don’t
respond to cleaning. So they’re getting the wrong treatment. So get tested first, get
that fixed. And then after that, things that you can do at home, I love patients
to be on an oral probiotic. Oral probiotics are different than gut probiotics. So
the bacteria in the, we need the oral probiotic to dissolve in the mouth. So the
bacteria stay in the mouth. If you’re swallowing a probiotic, that’s helping your
gut, but doing nothing for your mouth. So you need to be on an oral probiotic. You
also need to be on these two losanges that I love from daily dental cares. One is
sposident, which is great for preventing cavities. And the other one is protectant,
which is great for preventing gum disease. There’s also a water additive of that
that you can drink to help your gut. And then you can insert that one vaginally
for bacterial vaginosis. I tell everyone that they must brush twice a day with an
electric toothbrush and they must floss. So in between, floss twice a day. In
between our teeth, we have our gum tissue. Our gum tissue is where our blood supply
is. And in between the teeth is the only place that the toothbrush does not hit.
So I tell people, if you’re only brushing, you’re hitting three out of the five
surfaces and you’re missing the two most important ones that are directly next to
your bloodstream. So must floss every time you brush. So if you brush twice, floss
twice. And then tongue scraping is really important. Our tongue has its own
microbiome. Granted, it’s different from everywhere else, but that’s really critically
important in preventing like bad breath and things like that. And then get an airway
health test to make sure that your airway is good. ‘Cause like I said, 80 % of
people are undiagnosed for airway. Then when we talk about supplements and diet, so
the oral microbiome loves plant -based foods in terms of the thing that can really
support your oral microbiome is prebiotics. So if you don’t want to be on a plant
-based diet, just make sure you’re getting tons of prebiotics, so lots of fiber. And
then our teeth actually love more animal -based stuff. So if you want super strong
teeth, you need to make sure you’re getting vitamin A is critically important,
vitamin K2 and D3 is really important, and magnesium. Everyone is so depleted on
magnesium. They should be taking a magnesium supplement. So those are kind of my
tools that I arm patients with when they come to see me.
As you were mentioning those, all of those strategies, so thank you for that. Now,
I have to contemplate flossing twice a day. I only floss once a day. Most people
do. I did for up until like eight years ago when I really got down this path. But
if you think about it, your gums, the Pointy papillas, those are in between your
teeth. That’s the only place that your toothbrush doesn’t hit, and that’s where your
blood supply is, so you have to clean that. – Mm -hmm. Well, so there’s this really
interesting book that I often share with our practitioners called Cure Tooth Decay. I
think it’s by Peter Nagel. There’s that. – Oh, I don’t read it, but I’m going to.
– It’s along the lines of the Westinay Price philosophy, and the concept basically is
when someone has a cavity in the early stages to potentially reverse it through
diet. So, you know, liver to the vitamin A, cod liver oil, and then reducing the
consumption of the processed foods and all of that good stuff. So I feel like it’s,
I’m not saying that I think it’s a really important resource. And I suppose one of
the ways that I have seen dental health reflect overall health would be,
so from just from my perspective, again, not my field, if I have an intake with a
client and I noticed that they’ve had like six root canals. That’s a pretty good
sign that they are potentially undernourished. Certainly haven’t been eating in the
way that the author of cured tooth decay would indicate, right? The high nutrient
dense foods that actually actively kind of worked against the development of cavities.
I’m not sure if you have a comment on that, but that came to mind because that
would, you took it to another level with the connection between oral health and
fertility, but I feel like I’ve seen it in that way just that or people who have
like tons and tons and tons of cavities. To me, that’s a sign of certainly like
just like what you explained in your own personal experience of being fed. What did
you say? I scream and jello? Yeah. And it led you to have just like not like it.
The rest of my life. Like I’m still dealing. Yeah, I’m still dealing with it. First
off, I want to just commend you for thinking, even connecting those two and thinking
about it. Because most people don’t pay attention to it. Like I said, I’m so
impressed that you know who Weston A Price is. I think that’s miraculous. And you’re
absolutely right. If you look in someone’s mouth, and they have tons of root canals,
tons of fillings, tons of cavities, you know something is wrong. Like that’s not
healthy. And oftentimes, they are undernourished. Oftentimes, they are eating a ton of
processed foods and /or sugars. And we know that processed foods and sugars spike our
immune system, right? It causes a ton of inflammation, and we know inflammation is
not good when you’re trying to have a baby. And so there’s a lot of work that can
be done with diet alone, which is why in my office, I have a certified nutrition
specialist. So everyone that sees me sees her because I can fix your teeth and fix
your microbiome, but if you’re not eating sustainably, all my work three months,
we’re just going to be doing this again. So nutrition is critically important and
you need both, right? You need plant -based stuff for microbiome and you need animal
stuff for teeth. The other important thing that I, and I, this top of mind because
I just saw a patient with this, is if someone has a lot of root canals, it can
also mean, and if they have a lot of abscesses on their root canals, that tells me
that their immune system is shut because they should be able to ward off infection.
And so if they have a root canal and the root canals just keep getting infected,
which I do see this in a lot of patients, they just keep getting recurrent
infections around root canals. I know they have no immune system, which tells me
that cortisol is probably through the roof, adrenals are fatigued. It also probably
tells me they probably have infection and inflammation going on other places. And so
we just now have to go on a hunt and try and find where all this stuff is coming
from, because the body should be able to heal itself to some degree. If they have
fillings on all their teeth and recurrent abscesses, I know they have no immune
system. Well, so one other comment that I want to make, and then I have another
question, of course, is that, so one of the things that’s really interesting about
Weston A Price’s work, so for anyone who isn’t familiar, because I’m sure there’s
people who I haven’t necessarily heard of his work, but he was a dentist in the
30s and 40s. If you get his book, I’m trying to remember the name of his book.
Is it nutrition and physical degeneration, I think it’s called? – Something like that.
It’s like a manual, it looks like. – But it was like, he wrote this book before
the social conventions that we have now. So he traveled the world and as a dentist,
it seems like he had this one question, which is like, how could people be living
in these industrialized societies with access to all of this money and all of these,
you know, all of the things, but have horrible teeth, like rotting out because this
was before we had proper dentistry. So when people had bad teeth, they would just
walk around with that teeth. Like nowadays, you wouldn’t even be able to tell
because you can fix it, right? And but he would go into these just places, whether
it was the Swiss Alps or whether it was African places where there’s, they’re not
yet in the modernized world. People who aren’t even brushing their teeth, who have
no cavities and perfect jawline structure and stuff like that. So that’s just to
give a little bit of context for anyone who hasn’t heard of it, why we keep
bringing it up. But I think one of the things that really stood out to me many
years ago, when I first discovered this information was that when I was a kid, they
taught you to brush your teeth. And I had the idea that it was like the sugar
would be on your teeth or something and causing the cavity on your teeth. But I
feel like when you talk about this concept of nutrition and what you’re actually
eating and how that could almost make you immune to cavities, then it kind of
challenges the idea that it’s just like you’re just brushing the stuff off your
teeth. If these people can never brush their teeth, but because of their diet, they
don’t get – Yeah, so a couple of points there. One is cavities are caused by a
couple of specific strains of bacteria. So if you have these strains strep mutants
and strep sanguinis, I can never say this one, sanguinis, if they’re at a balance,
right? If they’re high and your good microbes can’t keep them down, then you’re more
prone to getting tooth decay. So I will test patients in my practice that say, I
always get I want to know, is this a bacterial issue? Is this a diet issue or is
this like the mineral makeup of your teeth issue, which very often that’s not the
case. A lot of people say it’s genetic. You know, I got it from my mom. That’s
usually not the case. It’s more of a bacterial issue. So I will test for those
types of bacteria. So you have to have the bacteria, then you have to have food
for them. Those bacteria love sugar and processed carbohydrates. So what happens is
it’s not the sugar that cause the cavities, the bacteria love that sugar. So they’ll
eat the sugar and then they excrete or poop out acid on your teeth.
It’s the acid then that’s dissolving the teeth and causing cavities. The other thing
is that every time we eat, the acidity level in our mouth rises. So the pH in our
mouth goes down because that’s the way that the body can start digestion. So we
secrete salivary amylase, which is an enzyme that starts to break down carbohydrates.
So the more often you eat, the more times you’re pushing the pH in your mouth
acidic. So the more times you are triggering this whole cavitation process to occur.
This is one thing that I grew up making a horrible mistake because I always
thought, you know, to be thin and fit, eat several small meals throughout the day.
So I would munch all day long on stuff, Oftentimes pretzels, right? So low fat, low
carbohydrates. Those are like the worst things you can eat for oral health. So what
you really want to do, stay away from processed carbs, stay away from sugar. Make
sure you don’t have those two types of bacteria. But if you just stay away from
sugar, stay away from processed carbs and don’t eat that often, you’ll be fine. So
oftentimes nutrition counseling for my patients and just say, you know, we really
need to get you not eating as often. I’d rather you eat bigger meals less often.
Now, if they’re diabetic or, you know, type 1 diabetes or something, we have to do
something different. But, and the two supplements that I was recommending before the
faucet and protectant, what they do is they actually make the mouth a ketogenic
environment. And when the mouth is ketogenic, the bad pathogens can’t survive on a
ketogenic environment because they love sugar. So they die off and then our good
pathogens flourish because they like proteins. So it’s So it’s like a hack, if you
will, of making your mouth sugar -free is by having those supplements. >> That’s so
interesting. Thank you for breaking down how cavities are formed. I feel like I’m in
school again. I’m putting so much today. >> I can tell you’re such a good student.
You get the information very, very quickly and you know so much already, which is
great. >> Well, so one very practical question for you because it sounds like we
would all have the most amazing experience if we came into your office, but I
Imagine that every dentist is not necessarily as versed in this. So tell us about
the state of dentistry and how do our listeners who are now concerned about their
oral health, how do we find a dentist that is in line with this where, like, is
it a standard thing? Can we ask for a salivary test from any dentist or do we
need to be looking for a holistic dentist? How does this work? So, you know, it’s
tough because there really isn’t a whole lot of people that practice this way,
unfortunately, I’m trying to change that, obviously. So a couple of options that
people can do. Yes, certainly look for a functional or biological dentist. You can
go to the IAOMT website and search for biological functional dentist near you.
However, they may just be biological or functional in that they remove amalgam
fillings, right? A certain way to make sure it doesn’t get in your system. Maybe
they place ceramic implants, or maybe they do ceramic fillings. The range of what a
biological functional dentist is greatly varies, so it’s not necessarily that they do
saliva tests. WorldDNA .com is a great resource. It’s a type of saliva test that’s
out there. They actually have a directory. If you type in your zip code, they can
be able to tell you what dentists in your area do a saliva test. Now, there’s many
other tests on the market that are just is great. I don’t think that the other
ones have a directory like that. So yes, try and look up a functional biological
dentist, try and look up to see if they do saliva testing, but call ahead and just
ask. And you’ll probably have to call several people before you find someone that
will do it. But it’s critically important to get this kind of testing done. I do
remote telehealth testing for people. So I can always, if they contact me, I can
ship them a test, go over results, and then help them get a care plan with a
local dentist, that way we can get them treated. And then in terms of state of
dentistry, I would say the information about oral systemic health is getting out
there, which is really exciting. The American Dental Association is finally
acknowledging that the mouth is connected to the rest of the body. And so they
actually have a meeting coming up this summer talking about oral systemic health. So
more and more people are getting aware of it.
You know, it’s hard because a lot of the stuff isn’t covered by insurance, right,
by dental or medical in terms of the testing. Fortunately, it’s inexpensive to get
the test done, which is great, but I think it’s going to be a long time before
people can get up there and get educated. And if somebody is struggling with
fertility challenges they’re trying to conceive or they have certain menstrual
challenges, are those themselves a flag for oral health or would you say that
there’s a few specific things like you mentioned the bleeding thing many times today.
So it seems like that would be definitely a sign. If is it just bleeding with a
brushing and flossing and that kind of thing where it’s constantly bleeding, but are
there any other just things that come to mind that, that we should be aware of?
Yeah. So I always tell people if you’re thinking of trying to start a family, if
you’re trying to start a family and you’re having difficulty, or if you have
endometriosis or PCOS, like you need to get a saliva test because it’s just another
place to look under the hood, right? To see what’s going on. Signs and symptoms
would be bad breath, sensitive teeth, bleeding gums, frequent cavities. That’s another
big one. And then for airway health, it’s going to be anyone who breathes through
their mouth. If you wake up at night frequently to go to the bathroom, anyone who
clenches and grinds should have an airway test. if they’re suffering from acid
reflex, if they’re on two or more high blood pressure medications, and this is
irrespective if they snore or not. A lot of people say, “Oh, I don’t have apnea. I
don’t snore.” Snoring is like, sure, it can be a sign, but I see a lot of
patients who have apnea that don’t snore. All right. Well, so many, just so much
information. This has been wonderful. I just info dumped on you guys. Hey, that’s
why we’re here. Well, so let us – So a little bit more about your practice. So
tell us again where you are physically. I know you also mentioned that you do
telehealth work with clients. Tell us, you know, give us your website, your socials,
all the things, and then also what you had in your book. And so everything, but
also if there’s anything interesting on the horizon for you as well. – Yeah, so I
did write a book called “Save by the Mouth.” They can get it on Amazon or from my
website. I was really shocked about, I didn’t think anyone would read it. It’s all
about oral systemic health, but I tried to write it in a fun, cheeky way. So I
talk about patients in my practice and them having a certain systemic disease and
what we did to treat it from an oral perspective and how their symptoms resolved.
So say by the mouth, it’s a great easy read for people. They can get it from
Amazon or my website. My website is katyleedds .com, so ddsdentistentasurgeon .com.
They can also book their telehealth saliva test with me too. So I coach, consult
and do saliva testing for people all over the world actually. So I patients all
over the place that I can treat. And what we do is we’ll do the saliva test,
we’ll figure out what’s going on, and then I’ll get a holistic care plan together
for the patient and work with their current dentist or help them find a new
provider if we need to that can render that treatment. And then I just opened up
my brand new practice some month ago. It’s called the Collective Health Society. It’s
been a two year in process kind of project, fully integrated dental and medical
center. So it’s me, I have a medical director, I have a certified nutrition
specialist who does cellular health testing, hormone imbalances, toxins, parasites,
nutrient deficiencies, she’s amazing. We do myofunctional therapy, we do airway, and I
have an IV clinic also here. So that opened up and then I have a training and
education center called Collective Education Society where I’m trying to educate
providers all around the country on this topic. – Well, that is amazing. I am
excited to just sit back and watch you change the face of dentistry. This is going
to be very enjoyable, I think, for me to watch. – Thank you, thank you, thank you.
Oh yes, and follow me on Instagram. So Katie Lee, DDS on Instagram. – Awesome,
Awesome. Well, thank you so much for being on the show today and sharing your
wisdom. I feel like you’ve blown a lot of minds and you’ve reminded us how
important it is to focus on our oral health. So I’m really excited to share this
interview. Thank you so much for having me. Thank you for listening. If you enjoyed
today’s show, please share it with a friend. You’ll find the show notes page at
fertilityfriday .com /590. I hope that you enjoyed today’s episode as much as I did.
I had so many takeaways from this episode. I think the biggest takeaway I had was
the connection between oral health and fertility. Certainly very eye -opening to think
about all the bacteria that could be building in your mouth. And not only that, it
doesn’t stay in the mouth. It can have then full access to your bloodstream and go
into various different parts of the body and cause all kinds of problems. So that
is certainly eye -opening. Really emphasized how important it is to pay attention to
our oral health. So a great reminder for any of you who don’t floss, if that’s a
thing, it’s a great time to start. I’ve fortunately been flossing for decades now,
but only once a day. And now I’ve learned that that is not enough. So I’ll keep
you posted on if I’m able to incorporate the twice a day for brushing. Full
disclosure, since this episode was initially recorded, I have not started flossing
twice a day, but certainly have been very consistent with my once a day flossing
and twice a day minimum brushing. And there are times when I might floss an
additional time if I’ve eaten something, but it’s usually that if I’ve eaten
something and I could feel stuff in my teeth, then I might get an extra floss in
there. But with that said, I mean, there’s so much to think about. And one of the
other points that stood out to me from today’s interview was the potential link
between explain fertility and these hidden infections that can start in the mouth and
then cause these different problems. So her recommendation for if somebody has
experienced unexplained infertility, even to be thinking about their oral health and
potentially having their saliva tested for certain strains of bacteria, I mean, that
is just not something that typically comes to mind. So a really great reminder on
the complexity of our bodies and how our body is a system that is connected. And
even our oral health can play a role in overall health, again, because of this
potential for our mouths to harbor unfavorable bacteria and other critters.
So if this episode resonated with you and you can think about somebody who would
benefit from hearing it, then please do share. The share link is fertilityfriday .com
/590. If you have been listening to this podcast for a while, loving it,
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taken the chance to review the episode and to share it because that is one of the
most powerful ways that this podcast has continued to reach new people and people
have continued to find it over the years. So with that said, I hope you have a
wonderful weekend, whatever you’re tuning into the show. And of course, as always,
until next time, be well and happy charting. If you’re loving the podcast and you’re
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