Erectile Dysfunction is a global health concern. Among males aged 45 years or more, erectile dysfunction is the fourth most common sexual problem in the United States. Because erectile dysfunction is commonly associated with age, it is important to investigate the risk of both diseases in men of this age group.
Objective. To conduct a detailed literature review exploring the relationship between chronic periodontal disease (CP), and erectile dysfunction. Methods. The research literature was identified using a method of selective publishing of studies that showed a consistent link between erectile dysfunction and CP. Studies were categorized according to the characteristics of patients, methods of treatment, design of the study, outcome of treatment, demographics of patients, research methodology, and definitions of terms used in the studies. The four categories of studies are listed below:
Case-Control Studies. Two specific studies were identified by using a case-control design, which involved using oral antibiotics to treat patients with mild to moderate periodontal disease and controlling for factors known to affect severity of the condition. In a study conducted by James Kennedy, DDS, and colleagues at the University of Alabama, participants were asked to complete a questionnaire about their sex life and history of erectile dysfunction. These patients had previously been diagnosed with either stage I or stage II CP, and those with no history of erectile dysfunction were excluded from the study. In a secondary analysis, this exclusion was applied to a subset of patients that met the initial eligibility criteria.
Cross-Cycle Study. In a large prospective study by Dr. Miguel Delgado, M.D., at the University of Florida, patients with mild to moderate periodontal disease were matched according to their severity of the disease with control patients who had not suffered from any history of erectile dysfunction. Patients were categorized as having mild, moderate, or severe periodontal disease. After one year, there was a significant increase in the number of patients classified as having erectile dysfunction, when compared with the matched controls. This suggests that the disease may result from increased severity of periodontal disease and a delay in diagnosis.
Meta-analysis. In an analysis of results from seven published studies that combining data from multiple studies examining the effects of periodontal disease on sexual dysfunction, Dr. Miguel Delgado, M.D., at the University of Florida, identified three specific studies that strongly suggest a link between periodontal disease and erectile dysfunction. Specifically, the three studies collectively showed a significant increased risk of erectile dysfunctions in patients with and/or treated periodontitis. Furthermore, the three studies also indicated a significant increased risk of strokes in patients with and/or treated periodontitis. Finally, according to Dr. Delgado, these studies indicate a similar but less significant relationship between periodontal disease and diabetes.
Effect of Periodontal Therapy on ED: A total of eleven studies that directly addressed the effect of periodontal therapy on erectile dysfunction and/or ejaculatory response were included in the meta-analysis. The results indicated that patients with and/or treated periodontitis had significantly increased risk of erectile dysfunction when compared with patients without periodontal disease. When examining the effect of periodontal therapy on sexual dysfunction in a broader perspective, the results were even more powerful, indicating a statistically significant effect of the therapy on sexual dysfunction. The majority of patients (n = 8) with and/or treated periodontitis had significantly decreased erectile function and increased ejaculatory response, compared with controls.