Past associations between gum
disease and cardiovascular health were the focus of several studies, whose
findings were ultimately considered not to be of clinical significance.
However, a recent study has now shifted the focus towards the potential
relationships between gum disease and erectile dysfunction.
The study, which was published in
Journal of Sexual Medicine, was a
case-control study where approximately half of the participants presented with
erectile dysfunction. In total 162 men between the ages of 30 and 40 took part,
of those 80 belonged in the erectile dysfunction group and 82 were controls. No
participants were smokers. In addition to getting data on the patients BMI,
household incomes and highest achieved education, the researchers also measured
dental health via the Plaque Index, and testing bleeding on probing, probing
depth and clinical attachment level. The data was then put though a logistic
regression to see if the relationship between any factors reached statistical
significance. Overall, the key findings indicated that 53% of the participants
in the ED group exhibited gum disease, whereas this was only the case for 23%
of the participants in the control group. This led the researchers to urge for
more research to consider whether the relationship between gum disease and ED
could be causative in patients between the ages of 30 and 40.
This study had a good design,
which was evident in their use of established clinical measures and the fact
that known confounding factors such as smoking status, educational level, BMI
and household incomes were considered. This was clever, as past studies
considering the relationships between gum disease and cardiovascular health
have been criticised mainly on the basis that they were observational and did
not address smoking, obesity and ageing sufficiently.
However, this was a very small
study that cannot justify the conclusion that gum disease and erectile dysfunction
could be causative for this group of patients. For instance, the basis for this
study being conducted in the first place clearly indicated that sufficient
evidence regarding this topic is currently scarce. In particular, the proposed
mechanisms underlying these findings appear to be inflammation that may spread
throughout the blood stream and affect other areas. This is far too vague and
comes at a cost of ignoring the role of the temporal relationship between gum
disease and erectile dysfunction. Moreover, the results are likely to be
limited as the measurements were only obtained once from a sample consisting of
individuals willing to discuss a sensitive condition.
We understand the importance of a
holistic view of a person, and feel that it is important that research into
erectile dysfunction continues to look for potential mechanisms that may play a
role in developing the condition.
However, we also advocate that our patients always maintain caution when
reading about new research, as medical research is a long process and
misleading or overly optimistic reports may lead to unnecessary disappointment.