Severe gum disease may significantly increase the risk of erectile dysfunction, adding to growing evidence that oral health is closely linked to overall wellbeing, according to new analyses highlighted by the European Federation of Periodontology (EFP).
Periodontitis — an advanced form of gum disease — has long been associated with diabetes, cardiovascular disease, rheumatoid arthritis and Alzheimer’s. Emerging research now shows men with periodontitis are two to three times more likely to experience erectile dysfunction.
Some studies also point to a possible association with prostate cancer.
“There are many diseases and conditions associated with erectile dysfunction, such as high blood pressure, cardiovascular disease, dyslipidaemia, poorly controlled diabetes and obesity,” said James Deschner, chair of the EFP’s Scientific Affairs Committee. “As these conditions also increase the risk of periodontitis, part of the association could result from these shared risk factors.”
‘Unknown risk factors’
Researchers typically attempt to control for these overlapping factors to better isolate the relationship between gum disease and erectile dysfunction, Deschner said. Still, “there may also be unknown or not yet fully understood risk factors influencing this relationship,” he added.
Scientists believe the link may stem from systemic inflammation. In advanced periodontitis, microorganisms and inflammatory molecules can enter the bloodstream and contribute to vascular damage elsewhere in the body. The disease has been shown to promote early vascular changes associated with atherosclerosis. Treating periodontitis, meanwhile, can improve these indicators.
Related: Study: Root canal treatments linked to better glucose control and lower systemic inflammation
Because erectile dysfunction involves impaired dilation of the penile blood vessels — a process that depends on nitric oxide — inflammation and oxidative stress triggered by gum disease may further reduce blood flow.
“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,” Deschner said. “While more research is needed, the evidence underscores the importance of oral health as part of overall wellbeing.”
Do men have lower health awareness?
Experts note that men tend to have lower health awareness, less consistent oral hygiene and higher rates of smoking and unhealthy diets, all of which increase the risk of gum disease.
The EFP recommends brushing twice a day with fluoride toothpaste, cleaning between the teeth daily, attending regular dental check-ups and seeking professional care when experiencing symptoms such as bleeding gums.
“Oral health is not a luxury — it is a vital part of general health, especially for men,” Deschner said. “Regular dental visits and proper daily oral hygiene can help prevent or delay heart disease, diabetes complications and even erectile dysfunction.”
Related: NYU researchers urge adding oral health as a ‘significant’ dementia risk factor
More men than women have periodontitis
Research also suggests gender plays a role in who develops gum disease — and how severe it becomes. Multiple studies and reviews have found that men generally have a higher prevalence and severity of periodontitis than women.
In the United States, about half of men aged 30 and older show some degree of periodontitis, compared with one-third of women, according to the U.S. Centers for Disease Control and Prevention. Periodontitis becomes more common with age, affecting roughly 60 per cent of adults 65 and older.
Canadian data from the Canadian Health Measures Survey show that about 21 per cent of adults with teeth have or have had moderate or severe periodontal problems. While the public summary does not break down prevalence by sex, global and North American research consistently finds men experience gum disease more often and more severely.
Experts say understanding gender differences in oral health could help improve prevention and treatment. Tailoring care to the specific needs of different genders may strengthen outcomes, especially as evidence grows linking periodontitis with systemic conditions — including erectile dysfunction.
Related: The Fundamentals of Oral & Systemic Health
“Recognizing and addressing these differences allows healthcare professionals to better meet the specific needs and challenges of individuals of different genders,” the Swiss Dental Journal has previously noted. “This can help improve overall oral health outcomes.”
Overall, the World Health Organization estimates that oral diseases, including periodontitis, affect 3.7 billion people worldwide.