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Severe Gum Disease May Be Linked to Impotence

By Barbara Bronson Gray
HealthDay Reporter

TUESDAY, Dec. 4 (HealthDay News) -- If you're a man, new research suggests that brushing and flossing regularly could have an impact on your sex life.

A small Turkish study found that men in their 30s who had severe periodontal disease were more than three times as likely to suffer from erection problems than were those with healthy gums.

The study showed that 53 percent of those with erectile dysfunction -- problems getting or maintaining an erection -- had inflamed gums, as compared with 23 percent of those without signs of gum disease.

The potential link between dental problems and sexual performance is vascular health. Erections are created when the brain senses sexual stimulation, causing the muscles in the penis to relax and increasing blood flow into the organ's spongy tissue. The veins are then shut off to keep blood from flowing out of the area.

The study was based on the premise that because gum disease can reduce the elasticity of the endothelial lining of blood vessels, it may also be linked to erectile dysfunction.

"We know that periodontal diseases cause systemic endothelial dysfunction, which leads to vascular pathology," said lead study author Dr. Fatih Oguz, an assistant professor in the department of urology in the School of Medicine at Inonu University in Malatya, Turkey. "And vascular pathologies are the most common cause of erectile dysfunction."

Previous studies have shown a correlation between chronic periodontitis -- gum disease -- and systemic vascular diseases such as coronary heart disease, diabetes, stroke and premature births, according to the U.S. Centers for Disease Control and Prevention. According to the CDC, advanced gum disease affects 4 percent to 12 percent of adults in the United States.

"Erectile dysfunction and chronic periodontitis in humans are caused by similar risk factors, such as aging, smoking, diabetes mellitus and coronary artery disease," Oguz explained. His study was published Dec. 4 in the Journal of Sexual Medicine.

The researchers compared 80 men with erectile dysfunction to 82 men without the problem. All were between 30 and 40 years old and were patients of Oguz's urology department.

People were excluded from the study if they had a systemic disease such as diabetes, heart disease or high blood pressure, if they had been undergoing therapy for gum disease within the last year, if they were taking oral antibiotics within the last six months and if they smoked. The results of the study were also adjusted for body mass index (a measure of body fat), household income and education level.

All of the patients underwent a periodontal exam by a periodontist who had no knowledge of whether any patient had an erectile dysfunction problem. The researchers found that chronic periodontitis is present more often in patients with erectile dysfunction than in those without the problem.

Some experts questioned the study results.

"Periodontal disease might be associated with other underlying disease, but erectile dysfunction? I would strongly disagree; it's not a causative condition," said Dr. Bruce Gilbert, a professor of urology at Hofstra North Shore-LIJ School of Medicine, in Lake Success, N.Y. "But I would say that the study results implore us to consider that diseases of the mouth are something to consider when we assess the overall health of the body."

Gilbert was concerned that researchers did not find out enough about the men who reported erectile dysfunction. Erectile dysfunction, he explained, is typically a problem for much older men. "The problem can be neurological, hormonal, psychogenic, especially in men of this age," he noted. "The participants just filled out a form about sexual dysfunction? That was not enough."

Dr. Nancy Newhouse, president of the American Academy of Periodontology, agreed. But she added that the study makes an important contribution because it shows how diseases of the mouth can affect the rest of the body. "Our medical colleagues don't spend much time dealing with the oral cavity," she said. "The mouth is connected."

Newhouse said people with evidence of periodontal disease -- a treatable chronic condition -- should be wondering about their general health. "If your gums bleed, you're really not healthy."

While the study found an association between severe gum disease and sexual problems for men in their 30s, it did not prove a cause-and-effect relationship.

More information

To learn more about erectile dysfunction, see the U.S. National Library of Medicine.

SOURCES: Fatih Oguz, M.D., assistant professor, department of urology, School of Medicine, Inonu University, Malatya, Turkey; Bruce R. Gilbert, M.D., Ph.D., professor, urology, North Shore-LIJ School of Medicine, Hofstra University, Lake Success, N.Y.; Nancy L. Newhouse, D.D.S., M.S., president, American Academy of Peridontology; Dec. 4, 2012, Journal of Sexual Medicine

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