The Alarming Importance of Dental Hygiene

We at Wellman have often talked about the causes of erectile dysfunction (ED) – we know that testosterone deficiency, or hypogonadism, is linked to erectile dysfunction [1], and that as we age, our testosterone levels naturally start to decline [2]. But we were interested to see a recent study conclude that erectile dysfunction may also have ties to something a little more unexpected – gum disease.

Gum disease, or periodontitis, is caused by the build-up of plaque in the mouth, and while it initially begins as gingivitis, it can develop into a serious condition [3], damaging your jawbone and even causing your teeth to fall out! While you may think the worst way gum disease could ever affect your sex life is give you bad breath, or an unappealingly gappy grin, in fact a recent study [4] by Dr. Zhigang Zhao of the First Affiliated Hospital of Guangzhou Medical University has suggested it may be linked to something which most men could be forgiven for finding a little more troublesome: erectile dysfunction.

Dr. Zhao analysed five studies into gum disease and erectile dysfunction conducted from 2009 to 2015, which in total gave a pool of over 213,000 participants. Dr. Zhao found that chronic periodontitis (CP) was indeed linked to erectile dysfunction – in fact, accounting for some confounders, it was found that those in the CP group were as much as 2.28 times as likely to suffer from erectile dysfunction than those who weren’t in the group.

Now, that’s no reason to drastically ramp up your flossing (though there may be others reasons for that). The crucial phrase here is “some confounders”. A confounder is some (often unknown) factor which causes two different effects, creating a distortion when we come to investigate the relationship between those two effects. For example, we know that diabetes may cause both erectile dysfunction [5] and gum disease [6] – so if we were show that gum disease causes erectile dysfunction, say, we would have to account for diabetes as a confounder. After all, as the old mantra goes, what looks like causation may be mere correlation – gum disease and erectile dysfunction look like they’re causally linked only because they are correlated by being caused by diabetes.

In the present study, Dr. Zhao was able to separate out the confounding effects of diabetes – and that 2.28 figure takes into account the causal role of diabetes. But, because some of the studies made no mention of factors like smoking, which is linked to both gum disease [7] and erectile dysfunction [8], Dr. Zhao was unable to separate off all potential confounders. So while certainly an interesting possibility, let’s not leap to any wild conclusions like gum disease directly causing erectile dysfunction.

Perhaps the more cautious approach would be to recognise the link between gum disease and erectile dysfunction, without making any claims about causation. If you have gum disease, say, and are worried about your ability to perform, that may lend added plausibility to the idea that you are suffering from erectile dysfunction. And if you are concerned about erectile dysfunction, the best thing to do is consult your GP or a specialist clinic like Wellman – though there’s probably no harm in giving your teeth a good brush as well.

References

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1476110/

[2] http://www.nhs.uk/conditions/male-menopause/Pages/Introduction.aspx

[3] http://www.nhs.uk/Conditions/Gum-disease/Pages/Introduction.aspx

[4] http://www.nature.com/ijir/journal/v29/n1/abs/ijir201643a.html

[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3949699/

[6] http://www.nature.com/bdj/journal/v217/n8/full/sj.bdj.2014.907.html

[7] https://www.cdc.gov/tobacco/campaign/tips/diseases/periodontal-gum-disease.html

[8] https://academic.oup.com/aje/article/161/4/346/92680/Association-between-Smoking-and-Erectile

 

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