A healthy mouth is also key to a healthy body, as gum disease has been linked to non-communicable diseases such as diabetes, cardiovascular disease, rheumatoid arthritis and Alzheimer's. Growing evidence shows that periodontitis - a severe form of gum disease - is also associated with erectile dysfunction and possibly prostate cancer, highlighting once again how closely oral health is connected to overall health. Men with periodontitis are two to three times more likely to experience erectile dysfunction, according to recent analyses.
There are many diseases and conditions associated with erectile dysfunction, such as high blood pressure, cardiovascular disease, dyslipidaemia, poorly controlled diabetes, and obesity. As these conditions also increase the risk of periodontitis, part of the association could result from these shared risk factors."
James Deschner, chair of the Scientific Affairs Committee, European Federation of Periodontology
"Studies therefore attempt to exclude, control for, or statistically adjust for such common risk factors where possible to better understand the relationship between these two diseases. However, there may also be unknown or not yet fully understood risk factors influencing this relationship", highlights Deschner.
Severe gum disease is a major global health issue, affecting more than 1 billion people worldwide. According to the World Health Organization, oral diseases, including periodontitis, affect approximately 3.7 billion people globally (11).
In severe periodontitis, microorganisms, their components and products, and inflammatory molecules enter the systemic circulation. They can thus cause direct and indirect damage, including vascular damage, in other parts of the human body. Periodontitis can promote early vascular changes that are considered initial indicators of atherosclerosis. Conversely, treatment of periodontitis can lead to an improvement of these changes. Therefore, it is reasonable to hypothesise that periodontitis could also impair penile vessel function. Erectile dysfunction is characterized by reduced dilatation of the penile vessels. Nitric oxide is necessary for dilatation, and therefore for blood flow, in the penile vessels; however, the nitric-oxide concentration decreases in the presence of oxidative stress. Atherosclerotic changes, which are promoted by proinflammatory cytokines, also lead to a decrease in dilatation and blood flow in the penile vessels. Through inflammatory molecules and oxidative stress, periodontitis could therefore contribute to vascular erectile dysfunction.
"Studies also suggest that periodontitis may affect sperm quality and quantity, and several meta-analyses have found an association between gum disease and prostate cancer. While more research is needed to confirm these relationships, experts agree that the evidence underscores the importance of oral health as part of overall wellbeing", says Deschner.
Men tend to have lower health awareness, less consistent oral hygiene, and higher rates of smoking and unhealthy diets. Strengthening oral health habits could be a simple yet important step toward improving men's overall wellbeing. The EFP recommends brushing twice a day with fluoride toothpaste, cleaning between the teeth daily, scheduling regular professional cleanings, and seeking dental advice promptly in case of bleeding gums.
"Oral health is not a luxury - it is a vital part of general health, especially for men. Regular dental visits and proper daily oral hygiene can help to prevent or delay heart disease, diabetes complications, and even erectile dysfunction," stresses Deschner.
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