Written By Kevin Kerfoot / Reviewed By Ray Spotts
Periodontal disease is a chronic, inflammatory disease that attacks the gums and supporting bone structure of the teeth. If left untreated, it can lead to tooth loss. Chronic inflammation that is caused by gum disease may damage your endothelial cells, which form the lining on all of your blood vessels. This damage can result in impaired blood flow which leads to erectile dysfunction (ED).
A recent study in the journal Andrology reveals that a fundamental cause of (ED) starts in your gums. They state that it’s possible that bacteria from infected gums can get into the bloodstream and cause inflammation in the penis arteries and this inflammation can accelerate arterial obstructions that can lead to ED as well as heart disease.
For the study, 19 other studies were reviewed with the number of participants ranging from 53 to 197,136, between the ages of 18 and 95. Eight studies found a significant association between ED and periodontitis.
Age was one of the most common factors the two conditions shared, with elderly people named the most likely to suffer from both periodontitis and ED. Tobacco use and systemic conditions such as cardiovascular disease and diabetes were also common in people with both conditions, as were obesity and medications that reduce saliva production.
Some of the studies also examined the relationship between periodontitis and sexual hormones, with lower testosterone levels found in people with periodontitis in two of the three relevant studies. Almost all found a significant link between periodontitis and ED, with the most severe cases of periodontitis also having the most severe cases of ED.
ED proportional to periodontitis severity
Two other recent studies hypothesized that periodontitis is linked to ED and it may be proportional to the severity of periodontitis. Both state that periodontitis could have a determining role in the pathogenesis of ED, independent of other conditions. Most of the researchers speculated that the high levels of inflammation in the mouth that result from the fight against bacteria become systemic and that inflammatory substances spread from your mouth through your bloodstream to your entire body, including the penis.
More studies linking ED and periodontitis
A 2009 study presented a hypothesis that steroid levels could influence the progression of periodontitis and tooth loss. It concluded that there is a significant association between ED and periodontitis, and that dentists and physicians need to be aware of the association between male sexual health problems and periodontitis to improve patient management.
A Reuters Health study concluded that ED is more common in men with gum disease. “In our opinion, the actual biological mechanism of ED in periodontitis patients remains poorly understood,” says senior author Dr. Zhigang Zhao of The First Affiliated Hospital of Guangzhou Medical University in China. “It might still be too early to suggest that men with ED should have their teeth checked, and that men with chronic periodontitis should worry about their sexual function, however, it might be beneficial to inform patients with chronic periodontitis about its association with ED.
“Since chronic periodontitis had been linked with several chronic disorders, it is sensible to recommend daily inter-dental cleaning to reduce dental plaque and gingival inflammation,” Zhao added. “Chronic periodontitis treatment can control or eliminate inflammation and may reduce the risk of ED. Furthermore, clinicians should be aware of the potential role played by periodontitis disease in the development of ED.”
This study concluded that chronic bacterial infection of the gums, or periodontitis, is common and a major cause of tooth loss for adults. The condition has been tied to a higher risk of cardiovascular disease and general inflammation, which in turn have been tied stroke and hardening of the arteries which are also associated with ED.
Another study found ED was more common among men being treated for chronic periodontitis, particularly for those younger than 40 and older than 59. After accounting for diabetes, which can influence both gum disease and sexual function, ED was 2.28 times more common for men with periodontitis than for men without it, according to the report in the International Journal of Impotence Research.
A 2013 study also found that treating periodontitis improves ED symptoms. This review did have limitations, including the fact that ED and chronic periodontitis are caused by similar risk factors, such as aging, smoking, diabetes mellitus and coronary artery disease. While some studies did account for diabetes, most did not account for smoking or alcohol consumption, which can also affect oral health and sexual function.
Improving Gums May Improve ED
With previous studies linking ED with periodontitis, a recent study of patients in Turkey showed that treating periodontitis in affected patients appears to lessen the symptoms of ED after three months. These findings add weight to the idea that gum disease may cause erectile problems.
The researchers studied 120 patients with severe or moderate erectile dysfunction and chronic periodontitis with half receiving treatment for their gum disease, while half did not. They filled out questionnaires about their erectile function, and patients who received treatment for their gum disease reported that levels of erectile function improved after three months.
Past studies in India, Israel and Taiwan have also linked periodontal disease with ED with some researchers speculating that gum disease and erection problems share a common cause, while others have suggested that gum disease can cause ED, but the issue is difficult to study and there has been no strong explanation for why gum disease could have such low-reaching effects.
"To our knowledge, this is the first study to assess a potential link between the severity of ED and the treatment of periodontal disease," stated the authors affiliated with Inonu University in Malatya, Turkey. "The results revealed that the severity of ED improved following periodontal treatment."
"Yes, I feel that an association does exist," says Dr. Andrew Kramer, an associate professor of urology at the University of Maryland School of Medicine. However, "there is nothing causal between the two. I feel that the causal element is probably vascular disease, poor general health status, lack of medical attention (gum disease), underlying diabetes/hypertension, or all of the above. They are related and correlated, but due to an underlying common factor."
While there doesn't appear to be an explanation for how tooth and gum diseases could affect nerves or blood flow to the male genitalia, there are many common denominators that may be behind the apparent link. "The results of the present study provide evidence that periodontal treatment can help to reduce ED," the authors added. "In addition, the findings are consistent with those of previous studies in which ED was found to be associated with low-grade inflammation caused by periodontal disease."
Men’s health and periodontal disease
Another study published in the Journal of Sexual Medicine found that men in their 30s who had severe periodontal disease were three times more likely to suffer from erection problems. While this study suggested an association between ED and periodontal disease, the American Academy of Periodontology believes more research is needed before conclusively linking the two.
“Research has indicated that periodontal disease may be associated with vascular disease, which is a common cause of ED,” says Nancy L. Newhouse, DDS, MS, President of the American Academy of Periodontology and a practicing periodontist in Independence, Missouri. “However, the association is thought to be related to inflammation; there is no direct evidence that one disease causes the other. Therefore, periodontal disease may be associated with or considered a risk factor for ED, but does not necessarily cause it.”
While there is no direct causal relationship between periodontal disease and ED, Dr. Newhouse encourages all men to take an active role in the health of their teeth and gums before it affects other areas of the body.
Research published in the Journal of Periodontology found women are almost twice as likely as men to receive regular dental check-ups. In addition, recent data from the Centers for Disease Control and Prevention estimate that over 64 million Americans, or almost half of U.S. adults, have periodontal disease. Of that, 56 percent of men have periodontal disease, compared to over 38 percent of women.
In summary, men’s health is uniquely impacted by periodontal disease in the areas of prostate health, heart disease, impotence, and cancer. Research finds that the prostate-specific antigen (PSA), an enzyme created in the prostate that is normally secreted in very small amounts, is secreted at higher levels in men with periodontal disease and prostate cancer than men with just one of the diseases. Studies indicate periodontal disease and cardiovascular disease are associated and may actually increase your risk of cardiovascular disease.
As the study published in the Journal of Sexual Medicine indicates, a man’s periodontal health could affect his sexual health. A study done by the American Urological Association found that prolonged chronic inflammation, like that found in men with periodontal disease, can cause damage to blood vessels which can lead to impotence.
Recent research also found men with a history of gum disease are 14 percent more likely to develop cancer than men with healthy gums. More specifically, 49 percent of men are more likely than women to develop kidney cancer, 59 percent were more likely to develop pancreatic cancer and 30 percent more likely to develop blood cancer.
To help prevent periodontal disease, everyone, regardless of gender, should receive a comprehensive periodontal evaluation (CPE) from a dental professional on an annual basis. A CPE is used to examine your teeth, plaque, gums, bite, bone structure and any risk factors you may have for periodontal disease.
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With over 30 years of writing and editing experience for newspapers, magazines and corporate communications, Kevin Kerfoot writes about natural health, nutrition, skincare and oral hygiene for Trusted Health Products’ natural health blog and newsletters.
Founder Ray Spotts has a passion for all things natural and has made a life study of nature as it relates to health and well-being. Ray became a forerunner bringing products to market that are extraordinarily effective and free from potentially harmful chemicals and additives. For this reason Ray formed Trusted Health Products, a company you can trust for clean, effective, and healthy products. Ray is an organic gardener, likes fishing, hiking, and teaching and mentoring people to start new businesses. You can get his book for free, “How To Succeed In Business Based On God’s Word,” at www.rayspotts.com.