Ep 147: The Link Between Dental Health and Fertility with Dr Katie Lee
Fertility Forward Episode 147:
In today's episode, we're thrilled to welcome Dr. Katie Lee, a multifaceted professional hailing from Aurora, Colorado. Dr. Lee is a dentist, speaker, author, and coach. She also consults for health technology companies and provides implant education for general dentists. Dr. Lee's passion for dentistry and empowering fellow practitioners stems from her firsthand experiences, particularly in understanding the link between oral health and systemic well-being. Her recent book, Saved by the Mouth, underscores the significance of oral health for both patients and clinicians. We use today’s conversation to delve into the surprising connection between oral health and fertility, the physiological factors involved, and what Dr. Lee’s research reveals about this important topic. Our conversation delves into the impacts of oral health on fertility, how you should approach oral health as a pregnant person, and why taking a trip to the dentist can make such a huge difference. To learn more about this field of study and Dr. Lee’s important discoveries, be sure to tune in to this thought-provoking conversation!
Rena: Hi everyone. We are Rina and Dara and welcome to Fertility Forward. We are part of the wellness team at RMA of New York, a fertility clinic affiliated with Mount Sinai Hospital in New York City. Our Fertility Forward Podcast brings together advice from medical professionals, mental health specialists, wellness experts, and patients because knowledge is power and you are your own best advocate.
Dara: Today we have a really interesting woman on our podcast, Dr. Katie Lee, who is a dentist, speaker, author, and coach who lives in Aurora, Colorado, where it's snowing a lot today. Dr. Lee graduated from University of Illinois at Chicago in 2010 and was an owner partner in over 80 DSO supported dental practices throughout the US and served as clinical partner overseeing five states. Currently, she consults for health technology companies and provides implant education for general dentists. Dr. Lee has two passions in her profession, dentistry itself and making other dentists successful. Her passion about the oral systemic health link comes from her own personal experience. Recently Dr. Lee authored a book entitled, Saved by the Mouth, to educate patients and clinicians on the importance of oral health. Dr. Lee has won many accolades including Top 40 Under 40 Dentists in America and International Women of the Year in Dentistry. She's been featured on Local Fox and NBC news stations discussing the importance of oral health. Wow. Dr. Lee, we are really happy to, to have you on today to discuss, which I am shocked that there's a link between oral health and fertility. So thanks for being on.
Dr. Lee: Thanks for having me. And, and many people are shocked by this connection and so I'm happy to talk about it.
Rena: Yeah, so as we were sort of all chatting before the podcast, we were saying neither of us had had thought about that at all, and, and when this was pitched to us as a guest, it was sort of so eye-opening. I really had never thought about this. And so I'm so fascinated to share your research and your own experience with our patients. So let's dive right in and tell us how did you even sort of discover this link and?
Dr. Lee: Yeah, yeah. So my journey into, and I'll keep this part of the story short, my journey into oral systemic health came from my own experience. So when I was 14 years old, I crashed into a telephone pole headfirst without a helmet on a four wheeler. Now being a mom, I'm like, how did my poor parents? And so I broke every bone in my face from my eyebrows down. I was in a coma for several days and I had my jaw wired shut immediately. And so I, I had lost several teeth, broke several other teeth, as you can imagine, and the doctors just decided to wire my teeth shut or wire my jaw shut that night and they were shut for about two months, eight weeks.
Dara: Wow.
Dr. Lee: And during that time, oh my God, I survived off of ice cream and Hershey's syrup, boxed potatoes, pudding, and jello. Like the worst things you could possibly do, especially if your teeth are all broken down. So immediately…
Dara: No, I'm actually, I'm thinking of like, oh my gosh, your parents probably felt sick and they probably wanted to give you whatever you wanted and also to make sure you had, and weight wise, I'm sure losing that many, losing 10 pounds, they probably just wanted to give you anything to help you keep on weight!
Dr. Lee: Well, and they were trying to just like keep me happy, right? It's like whatever, you might just have it. And so very quickly, obviously my teeth began to get infected and and decay. And so I started having a lot of dental pain that wreaked havoc on my body. And then just not being able to eat my liver enzyme spiked, my kidneys started shutting down and I became, like, super emaciated. And so I learned at a very young age just how important your oral health is to your overall health and wellness. And then just being, you know, a teenage girl in high school, not having front teeth to smile and having to wear false teeth, you know, it really does a lot to your social interaction and your mental health. And so that's how I decided I wanted to be a dentist and really focus on the whole body, not just the mouth. And then my journey into fertility came twofold. One is I was having difficulty conceiving. So I was an IVF patient for six years and did six rounds of IVF. And so I started looking into, okay, well how does the mouth affect the overall body? And the research is, I would say, the research about oral health, fertility health connection came about like way before we started knowing about heart disease, Alzheimer's, dementia, diabetes, things like that. But it never was focused on, because as you guys know, women's health is an underfunded, under talked about thing here in America, unfortunately. And so I started studying this and while I was a patient undergoing all this IVF treatment, not one practitioner asked me about my dental health or even looked in my mouth, which was really shocking to me. And so I started doing saliva testing 'cause I wanted to see what my own bacteria levels were. So I started looking into different companies for saliva testing and started incorporating it into my practice. And I actually had a couple that came to me. They were a young couple in their twenties. She was having a really hard time getting pregnant and their OBGYN said, maybe you should go see your dentist. And she found me by chance. She, I wasn't advertising that I was doing this testing and she came in and I said, well, I have this saliva test, we should test you and your husband. And sure enough, she was off the charts. Both of them were off the charts for the bacteria that adversely affect fertility. We got them all cleaned up, we did a post-test to make sure that their levels went down. Then they got pregnant a couple months later. Now, again, that's, like anecdotal, right? Like, was it the dental treatment that did it or not? You know, I can't for certain say that. All I know is she ended up pregnant, but we know unequivocally that she was healthier, she was gonna have a better pregnancy and better pregnancy outcomes by the fact that we treated her oral health. So that's kind of how I got into this.
Dara: I'm impressed that the OBGYN sent them which like, that's to be, I'm, I'm shocked because I, to be honest with you, it's, I've never heard is that a common.
Dr. Lee: I've never heard that. And that was in 2014. And since then, I've never had another OB GYN send their patients to me for that. In fact, it's always the opposite. Patients are told to not go to their dentist while they're pregnant. Which, if you think about it, clearly they knew that there was some association between oral health and pregnancy if they told people to avoid the dentist. Right? But we never actually looked at can your oral health positively impact or positively or negatively impact pregnancy? We just tell pregnant women don't go to the dentist, which is the absolute worst thing you wanna do. Right?
Dara: Well, is it, is that a myth?
Rena: Or anyway, right, to not send pregnant women to the dentist? Like what is that process?
Dr. Lee: Yeah, I, I think a lot of it is there is no, or there wasn't any research showing if dentistry was safe or not back in the day. But there's studies, you know, even as early as ‘96 saying that dentistry was safe during pregnancy. But it's kind of just like women's health is such an underfunded, understudied part of science in America, unfortunately. And the lawsuits are so high, if something, if you do something while someone's pregnant and they lose the baby that's opening the door for a lawsuit. So I think they just wanna avoid it altogether.
Dara: And also I think what you wrote, which was interesting, is that especially women who are having fertility struggles or even women who are not and get pregnant, anything that won't stress people out and sometimes the dentist can be somewhat of a stressful experience. So even that notion of like, okay, we don't wanna overstress you, you don't need to go to the dentist. But yeah, that's not a good thing.
Dr. Lee: Yeah. We know your mouth decreases your chances If you have an unhealthy mouth or an unhealthy microbiome, we know that decreases your chance of getting pregnant. We know that it affects your pregnancy by shortening your gestation. You have a increased risk of early birth or a low birth rate baby, which having a preterm birth baby is responsible for 75 to 80% of all mortality newborns in the US. So this is a big deal. But then we also know that having a poor oral health for moms really negatively affects their outcomes and their health after pregnancy. You know, it can lead to preeclampsia. Increased risk for c-section, increases risk for gestational diabetes. And so not only does it affect the baby, but it also affects the mom down the road.
Dara: I was shocked to hear how it could affect gestational diabetes. That was interesting. That was one of my favorite parts of your chapter. I was like, wow. Like, and there's not a lot of research to show, which is, is what you said. Like there there's, people aren't researching it.
Dr. Lee: It's really hard, you know, 'cause it's hard to get like a control, right? So if, if you have two pregnant women and you intentionally make one have periodontal disease by telling them not to brush their teeth, the effects of that which we know could be very deadly or very harmful versus a control. Like, there's a lot of ethical issues with that. So it's just really understudied, unfortunately.
Rena: So how would you know, I know probably now our listeners, they're trying, gonna wanna run out and figure out, oh my god is my, is my oral health healthy? How do I know? What should I do? Is there any sort of test? What do you, now should you be freaking out if you have just had a cavity or a root canal or sort of what's the guide for you have a healthy oral hygiene, I guess?
Dr. Lee: Yeah, so the, the biggest thing is that I always say you never wanna see pink in the sink. Which that's like a funny cheeky saying in dentistry. So if you're brushing your flossing and you see pink in the sink, that's not a good thing. I always tell people, if you're trying to get pregnant or if you are pregnant, go see your dentist and have them look at your gums. It might be a little challenging to find a dentist if you already are pregnant that will see you because of the scare tactics of lawsuits and everything. But there's been so many studies out there showing that periodontal treatment during pregnancy decreases financial, the patient's finances by like $2,400. If they get perio treatment during pregnancy, it decreases the risk of adverse pregnancy outcomes by 77%. So you need to get treated, but you need to have the dentist actually go in and measure your gums, measure the pockets around your teeth and see how much your gums are bleeding. Now obviously your gums are gonna bleed more 'cause you're pregnant and all the hormones are causing inflammation and bleeding. But what you can really do to really ensure is you have to test the microbiome because if you're not testing, you don't know what's causing the bleeding gums or the infection. It could just be swollen bleeding gums from pregnancy, or it could be a combination of swollen bleeding gums from pregnancy and bacteria. And so there's three main bacteria that affect pregnancy, either trying to conceive while you're pregnant or the health of the mom out afterwards. But if you don't test, you don't know if you have those bacteria. And just doing your standard prophylactic cleaning or deep cleaning, unfortunately doesn't get rid of these specific pathogens. So you have..
Dara: So I know in your book I saw FN is one of the bacteria, PG is another one. What's the third one?
Dr. Lee: You are such a great student, the fact that you knew that I only put two in there. So PG and FN are the main ones that everybody talks about. There's the most research behind those. But there's another bacteria that's part of the red complex of gram-negative anaerobes called Tannerella forsythia that's coming out that's really being associated with adverse pregnancy outcomes as well. And it's just not as popular as the other two.
Dara: So would you suggest…
Rena: If you have those, how would you then get rid of them?
Dr. Lee: Yeah, so that's great question. First thing is, is you know, test, right? If you go to the physician, they test you for everything and then based on your blood work, they decide what treatments to give you. Well now in dentistry, we have these tests too, these saliva tests. So once you find out that you have them, depending on how you present clinically, you know the depth of the gum pockets and all this other stuff, typically what we do is we start by just doing a deep cleaning called scaling and root cleaning. The difference, there's two types of cleanings we do in dentistry. One is we do a prophylactic cleaning, which cleans above the gum line. That is for healthy patients that have no gum issues. If you have gum issues, so gum infection, this bacteria specifically the three that we just mentioned, are living beneath the gum tissue. So doing a cleaning above the gum line is not going to do anything for those because there are different type of bacteria. The ones above the gums like oxygen. The ones below the gums that cause damage don't like oxygen. So you have to go underneath the gums to treat them. Then those bacteria are not gonna respond, are not gonna be killed off by just the cleaning. So then you have to go in and do some sort of microbial, antimicrobial irrigation or some iodine will work, ozone will even work if you wanna take a more holistic approach. And then you, not only do you clean the root of the tooth, but the bacteria are translocating through the gum tissue into the bloodstream. That's where our blood vessels are. That's why our gums bleed. So you have to go in and now clean the gum tissue. If you don't treat the gums, the teeth can be as clean as you want, but the gums are always gonna stay infected. So to do that, oftentimes clinicians will use lasers to go in and kind of obliterate the gum tissue and remove all of the granulation tissue inside the gums. Because once the gums heal and they've been treated, they tighten back up around the tooth and seal the tooth off so that nothing can get back down into those pockets.
Dara: Can we do that laser? Is that laser fine during pregnancy? Do they know?
Dr. Lee: Yes. Yeah, laser is actually fine during pregnancy, so that's totally fine to do that.
Rena: What about, I feel like now people are probably listening who have, you know, maybe been trying to conceive for a while and feeling frustrated. Now they're thinking, oh my gosh, I need to do this. This is what I need to do that it's something I can control, an avenue I can pursue. Is there, so is there research, if you've been cycling unsuccessfully, if you sort of go treat this, that it may increase then your chances to conceive?
Dr. Lee: You know, I don't know if there's ever been direct studies that look at that just because infertility is such a multifactorial thing. But what we know is that if you have inflammation in the mouth, and that can be either gingivitis or gum disease. So what's important to understand is there's a distinction between both of those. Gingivitis is just where you have swollen gum tissue but no death of the bone around the teeth. Gingivitis is completely treatable and reversible. But once that infection has spread to the bone, that's called gum disease or periodontitis. And that's where the bone starts to die away from around the teeth. So even though there are two different disease processes, what's important to know is that either one, you have essentially leaky gums. We've all heard of leaky gut? In both gingivitis and periodontal disease, the gums are still perforated, they're still leaky. And so the bacteria from the mouth are still getting into the body. And so if you have inflammation in the mouth, we know that that inflammation is now spreading to the rest of your body. Whether it goes to your heart and causes heart disease, whether it goes to your pancreas and causes diabetes or whether it goes to the male and female reproductive system, you're still gonna have inflammation there. So that's why, like, endometriosis is heavily correlated to oral health. PCOS, all these things are tied, they're all inflammatory based diseases.
Dara: I'm, like, so shocked by this because I remember learning that your oral health plays a role in your heart health. But it makes sense - if there's inflammation there, it really can be connected to inflammation anywhere else in your body.
Dr. Lee: Anywhere. Our blood vessels don't just stop at one organ. Right? We have regulatory system and no, I mean I'm, I'm being kind of cheeky here, but I'm trying to simplify it, right? 'Cause common sense, you can think, you know, if things go from our mouth or everything goes through a heart, then it, the blood goes through a heart, it gets pumped out and goes everywhere else, deposits oxygen, and then comes back to the heart and it filters, right? And so it's not like our, we only have one blood vessel that goes to one organ and that's it. So if it goes, you know, if it gets into the bloodstream, it's fair game to go wherever.
Rena: I just think it seems like this is such an untapped or understudied sort of area of the body. You know, it's not, I'm someone like who's very attuned to health and wellness and always trying to, you know, do testing or whatever so I can feel my best and oral hygiene, it just, it's never a part of any panel ever.
Dr. Lee: I know, I know. And it's so shocking 'cause the research is there and like if, if you go to my website, I list all the sources that are in the book too because people were like, do you have this study? Do you have this study? And so I want people to know that, like, this is all research based. This isn't just anecdotal stuff that I would see in my practice. But yeah, you know what I always recommend for patients who are thinking about fertility or who are pregnant, go get a saliva test. There's lots of providers out there that will do saliva tests for you or a lot of people actually contact me and I can ship them a saliva test and we can get the results and then I'll go over the results with them and then they can go back to their current provider or we can find them a provider who will treat it based on what the results are.
Rena: So I feel like these days everything is sort of trending that way, right? Like a at-home test, you know, you can ship back and you know, they, we have people come on here, we talk about sperm tests at home or obviously there's blood tests, genetic tests, whatever. So is this sort of the new thing, the at-home saliva test for oral health and hygiene?
Dr. Lee: In terms of it being at home? I would say it's been around for probably and I'm, someone's gonna like blow me up and say no, it's been around for this long. I would say I've known about it for about five or six years. But saliva testing for the oral microbiome's been a long, been around for quite some time. It's just not mainstream. Even in the dental community, there's, I would probably say less than 5% to dentists do this microbiome testing. Yeah. It's kind….That's also why you hear patients that say like, my gums bleed, but they've always bled since I was a kid. Right? It's because they have certain types of bacteria that aren't being treated according to how the bacteria need to be treated. So they're just keep getting cleanings and cleanings and cleanings all the time and they just never seem to get better. Those patients often have gut issues. So a lot of people have IBS, Crohn's, digestive issues, leaky gut. If you have leaky gut, you have leaky gums. I mean there's, that's like a hundred percent tied together. And so oftentimes we'll see people that have oral problems have a lot of gut issues too, because it's all, it's all the same bacteria. Right?
Rena: I've never tried that together!
Dara: Me neither!
Rena: Yeah, it's, it's, well it's never talked about, you know, there's so much I feel, you know, like the gut microbiome has been one of those trending hugely buzzy things sort of in the health world, you know, for the past few years and everyone like, let's fix our gut microbiome. But never…
Dr. Lee: When you think about it, how does the bacteria get to your gut? Right?
Rena: But I, that's never presented in that, right?
Dara: Never thought of.
Dr. Lee: Totally. But through the start of the digestive system, right? The mouth is the opening to the digestive system. It's the first stop on the digestive system, right? We start digesting carbohydrates in the mouth by secretion of amylase, the enzyme to break down carbohydrates. Then we swallow and then our stomach start, you know, continues to process. But people don't think, like, think where, where's microbiome coming, coming from? And it starts in the mouth. So we swallow 80 trillion bacteria a day, 80 trillion. Then what we don't swallow and what becomes pathologic or the pathogens go in through leaky gum tissue that's been broken down. So when we have these pathogens in our mouth, whether it be bad bacteria, viruses, fungi, protozoa, any of these things, our immune system initiates an inflammatory response. And in order to let our inflammatory cells get to the site of the insult, our body releases an enzyme called MMP-8. MMP-8 acts like a scissor goes ahead and I talk about this in the book, goes ahead all of our immune immune cells and cuts down our tissue. So that's the same enzyme that causes leaky gut. Same enzyme causes leaky gums. It's the same process. So what we don't swallow, we get into our system through leaky gums.
Rena: Wow, that's so interesting. Yeah. Well I'm so happy that you're setting the….I'm so happy that you're trying out there putting this on the map. I think this will be really interesting to so many people. And just another great sort of knowledge is power thing of, hey, okay, maybe there's something to explore. You know, my physician didn't suggest this and I'm having a lot of trouble conceiving. Okay, well let me figure out, is this something that might be going on that I can, and and it, the great thing about this is it sounds like it's very treatable and fixable if you find out.
Dr. Lee: Yeah, it's easy, it's super easy, it's painless. You know, when you're undergoing IVF treatment, I can say this 'cause I've done it. I mean the amount of pain that women have to go through with shots and exams and hysteroscopies and everything else we do. And the cost of that, like, this is inexpensive. If you do have something, you can treat it and get rid of it and at least you can say unequivocally you will be healthier. Whether you end up pregnant or not, you will be healthier by treating your oral health. But this is something that very easily you can do to improve your chances of conception and a healthy outcome.
Rena: Yeah. And I think that's great news. It's not like, oh my gosh, this is gonna be, I can't fix this. Or it's months and months of expensive treatment. Whatever. Just yeah.
Dara: A simple test and somewhat painless procedure. Yeah, that's great.
Dr. Lee: And what's important to know too is like the partner has to be tested and treated as well because fertility is a two-way journey. Right? And the bacteria that we have in our mouth, they're all communicable bacteria. So when we're born, we're essentially sterile. We're not born with any cavity causing bacteria in our mouth. We're not born with any kind of periodontal pathogens in our mouth. Everything that we have, we've acquired from our environment and those around us. So if someone's trying to conceive, they need to get their partner tested as well because they could be the one causing all the damage, you know, in the woman or the bacteria in the man or in the partner can actually affect their sperm count, motility and, morphology leading to infertility in the woman as well.
Dara: I'm happy you brought that up.
Dr. Lee: Yes. It's not just about the woman, it's not always woman's fault.
Dara: That is true. If, you know, if you're intimate, if you're sharing food with one another, like you're sharing your bacteria, which is, so now it makes sense of like even, like, my parents growing up not sharing their food with me, like not letting me like lick from their ice cream. Like, now I see the benefit of it, which I don't know if I did that with my kids, but like I see the benefit of it because whatever you have in your mouth, you know, which is fully developed. Your kids who are, you know, they're kids they, they're developing constantly and they're building all of their bacteria can also much more easily get it.
Dr. Lee: Yeah, exactly. So when babies are born, you know, their microbiome comes from the birthing process, so through the vaginal canal and then through breastfeeding. And so their microbiome is very immature and not very diverse when they're born. So they have to, the only way they get their microbiome is through those around them and their environment. And so as they age up until about early twenties, that's when the microbiome is the most robust. That's also why when you're 20. You can eat and drink whatever you want, never exercise and you're like super-human. Right? But then as you age, your microbiome starts to deplete again in both numbers and diversity. And then that's when we are more prone to illness. That's why babies are super prone to illness and elderly are super prone to illness.
Rena: This has been so fascinating. I'm so happy to have you on to present this information. Anything else that you think is really important for our listeners to know about?
Dr. Lee: I just think it's, it's really important for them to know that oral health and dentistry, especially during pregnancy, is safe. And you want to go and see your dentist. 40% of all pregnant women have some form of gum infection. And we know that if you have some form of gum infection, you're 30 to 50% more likely to have an adverse pregnancy outcome. So please go see your dentist. I'm not saying get veneers while you're pregnant. That's not what I'm saying. But what I'm saying is go at least get your teeth and gums cleaned. I recommend patients to come in every three months, especially if they're trying to conceive or they are pregnant, even if they have no gum issues. Because the whole idea is prevention here. The more preventative we can be, the healthier our baby and the moms will be afterwards.
Dara: And also consider getting that salivary test.
Dr. Lee: Yes, get the test. Absolutely. You should know what's in your mouth. 'cause Then we know how to best treat it and test all throughout pregnancy too. You know, I'd probably say if, if someone's pregnant I test every six months. You don't need to do it every three. Probably every six.
Rena: And it sounds like that's something they could get from you? Is that, where else can you access the test?
Dr. Lee: Yeah, they can go to my website, Katie Lee dds and they can order a test there. Or if you just go to like oral dna.com, that's another one. There's a find a provider button on there that they can go and see if there's a local provider. I also just started looking into a company called Bristol Health, which is going direct to consumer, which I really love. I actually had a call with them yesterday. I think what they're doing is great. Now, obviously there's not a provider associated with that, so you don't really have someone explaining things to you. But yeah, there's lots of options out there.
Dara: And where can our listeners find your book?
Dr. Lee: There's, I have a landing page. They can go to savebythemouth.com. They can look up the book on Amazon. They can buy it there. My website will also direct them there. So pretty much everything is on the website or they can follow me on Instagram @katieleedds.
Rena: Lovely. Well thank you so much for taking the time to come on. I, I found this so fascinating and something I like we said I never thought about before. Yeah. But I think this is such a whole new interesting component to the journey of trying to conceive, pregnancy and beyond and to really be attuned to that.
Dr. Lee: Yeah. Thanks for giving me the opportunity. I'm trying to get the word out there because there are more options for women. We just need to educate them on that.
Dara: A-men on that. That's amazing. So how we like to end our podcasts are with words of gratitude. So Katie, what are you grateful for today?
Dr. Lee: So I ended up being able to have my son via a surrogate. And so I am, I wake up every morning forever grateful for her, for giving me the joy and the light of my life. So he's nine months old. He just started crawling yesterday, which was mind blowing. So yeah, super grateful that she gave up a year and a half of her life so I can have my baby.
Rena: That's so beautiful. And congratulations.
Dr. Lee: Thank you.
Dara: Congrats.
Rena: What about you Dara?
Dara: All this talk about teeth. I'm grateful for my father and brother who are dentists.
Dr. Lee: Oh, you're in it!
Dara: I’m in it! But I have never, that's why I was so excited for today because you know, I have basic knowledge. You know, I go to clean my teeth every three months. But just the, the notion of never seeing and also like as a dietician, I'm very familiar with the gut microbiome, but this is something totally new and it makes sense. Like it's something that I should have realized. But it's kind of opened my eyes into, there's so much out there to learn and so much more that we all can learn from. Our bodies are quite complex, but little things can really make a big difference in terms of our overall health and wellness. And really, I've learned so much from you today. Thank you. Rena?
Dr. Lee: Sorry to interrupt you. There's a really good book you should read. Yeah. Since you're in nutrition, it's called The Dental Diet.
Dara: The Dental Diet.
Dr. Lee: Yeah. By Dr. Steven Lin. I'm looking at it right now. I think he's from Australia, but he basically talks about nutrition for a healthy mouth.
Dara: Yeah. I know certain things. Like I, you know, my, I've definitely learned from my father that it's great to brush your teeth after meals, but if not even chewing gum. But even the notion of like rinsing with water after you eat, how dairy can be really, you know, somewhat good. And it's amazing how certain things can be helpful and some things can be somewhat harmful, but still there's so much more to learn.
Dr. Lee: Yeah. Yeah. Check out that book I'll, but it's, I just find the book really fascinating.
Dara: Thank you. I appreciate that. Something to add to my list. A great book. What about you Rena? What's, what are you happy for today?
Rena: I guess all this talk about teeth makes me think about my daughter. Last week she chipped her tooth and so just grateful, I guess, for good dental care, right? And being able to go get that taken care of because just stuff, we don't think about it until something happens, right? And so just grateful for, for care and that she's fine. And just grateful, Katie, for you coming on our podcast and just being another woman in this space who really cares about women's health spreading the word and improving treatment and care for women. So just a lot of gratitude for that. I love having this podcast because we get to meet people like you. So that was a pleasure.
Dr. Lee: Thank you. Yeah, this was fun. Thanks for having me.
Rena: Yeah. Thank you so much for coming on.
Dara: Thank you so much for listening today. And always remember: practice gratitude, give a little love to someone else and your yourself, and remember you are not alone. Find us on Instagram @fertility_forward and if you're looking for more support, visit us at www.rmany.com and tune in next week for more Fertility Forward.