Erectile dysfunction might be associated with chronic periodontal disease: two ends of the cardiovascular spectrum

Erectile dysfunction might be associated with chronic periodontal disease: two ends of the cardiovascular spectrum - Together with Drs. Heruti, Bechor, Justo and Galor, we studied 815 Israeli male adults of whom 305 had complete data and were included in the statistical analysis. In the analyzed population, 2.1% of people without erectile dysfunction (ED) had advanced periodontal disease (defined as recession of periodontal bone of 6 mm or more) in comparison to 9.8% of the mild ED and 15.8% of the moderate/severe ED populations, respectively. However, due to the relatively small groups, we could not present the odds ratio. We are now planning a large-scale study to further establish the association between the two conditions.

The proposed pathogenesis for this association is based on the previous findings of DNA of periodontal pathogenic bacteria in athermanous plaques and the epidemiological association between periodontal disease and coronary heart morbidity found in many world-wide large-scale studies. And since ED too was proven to be an early sign of coronary heart disease, it is reasonable to believe that extra-oral inflammation induced by periodontal bacteria might be associated with atherosclerosis and dysfunction of vessels first in the small vessels, such as the penile vasculature, and later in larger vessels such as the coronaries. Thus, as we conclude in the article, "CPD might be associated first with ED in young men and later with coronary artery disease in middle-aged men." Laboratory studies are needed, however, to confirm that hypothesis.

Indeed, it is too early to make practical recommendations based on these initial results. However, the general population, as well as healthcare providers, have to remember that oral and periodontal health conditions as well as sexual function are both parts of individual well-being. Both conditions are linked to other serious diseases such as coronary heart disease and diabetes mellitus, thus the healthcare provider has to pay attention to early signs of impaired health or function and refer the patient for evaluation by the appropriate health care worker.

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