Exploring the Association between Periodontitis and Erectile Dysfunction: A Systematic Review
Downloads
Background: Periodontitis (PD) remains a global public health problem. Evidence revealed that PD contributes to the development of systemic diseases, including effects on men's sexual health such as erectile dysfunction (ED). Objective: To review and explore the association between PD and ED. Methods: Following PRISMA guidelines, a systematic review of studies published in Scopus, PubMed, ScienceDirect, and Google Scholar was conducted. A comprehensive literature search until February 2024 by combining several keywords and applying eligibility criteria was performed. JBI critical appraisal checklist was employed for quality assessment. Results: A total of 15 studies involving 216,753 subjects were included. Of the 15 studies, 13 of them demonstrated a significant association between PD and ED, the other two did not. Only one study included examination of hormonal and biochemical levels. Also, one study revealed that periodontal treatment was significantly associated with improving ED. Summary: According to the findings, a significant association between PD and ED is evident. It is believed that the inflammatory processes associated with PD contributes to the emergence of ED, yet the exact underlying mechanism remains unclear. The scarcity of research and the complexity of the association between PD and ED suggest that future rigorous studies should be conducted. Additionally, dentists and general practitioners must be aware of the interconnection between these diseases, enabling them to provide comprehensive education to patients, particularly concerning the prevention and management of periodontal disease.
Gasner NS, Schure RS. Periodontal Disease. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [cited 2024 Apr 9]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK554590/
Botirovna SJ, Qizi ZMA, Qizi RSB. Dental periodontitis. Texa Jour of Medi Scie. 2021 Dec 18;3:38–9.
Mehrotra N, Singh S. Periodontitis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 [cited 2024 Feb 9]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK541126/
World Health Organization. Oral Health. 2020.
Eke PI, Borgnakke WS, Genco RJ. Recent epidemiologic trends in periodontitis in the USA. Periodontology 2000. 2020 Feb;82(1):257–67.
Penelitian dan Pengembangan Kesehatan Kementerian Kesehatan RI. Riset Kesehatan Dasar 2018 [Internet]. 2018 [cited 2024 Jan 26]. Available from: https://layanandata.kemkes.go.id/katalog-data/riskesdas/ketersediaan-data/riskesdas-2018
Isola G, Santonocito S, Lupi SM, Polizzi A, Sclafani R, Patini R, et al. Periodontal Health and Disease in the Context of Systemic Diseases. Brzozowski T, editor. Mediators of Inflammation. 2023 May 13;2023:1–19.
Liccardo D, Cannavo A, Spagnuolo G, Ferrara N, Cittadini A, Rengo C, et al. Periodontal Disease: A Risk Factor for Diabetes and Cardiovascular Disease. IJMS. 2019 Mar 20;20(6):1414.
Naderi S, Merchant AT. The Association Between Periodontitis and Cardiovascular Disease: an Update. Curr Atheroscler Rep. 2020 Oct;22(10):52.
Deschamps"Lenhardt S, Martin"Cabezas R, Hannedouche T, Huck O. Association between periodontitis and chronic kidney disease: Systematic review and meta"analysis. Oral Diseases. 2019 Mar;25(2):385–402.
Gobin R, Tian D, Liu Q, Wang J. Periodontal Diseases and the Risk of Metabolic Syndrome: An Updated Systematic Review and Meta-Analysis. Front Endocrinol. 2020 Jun 9;11:336.
De Oliveira Ferreira R, De Brito Silva R, Magno MB, Carvalho Almeida APCPS, Fagundes NCF, Maia LC, et al. Does periodontitis represent a risk factor for rheumatoid arthritis? A systematic review and meta-analysis. Therapeutic Advances in Musculoskeletal. 2019 Jan;11:1759720X1985851.
Kavarthapu A, Gurumoorthy K. Linking chronic periodontitis and oral cancer: A review. Oral Oncology. 2021 Oct;121:105375.
Gomes"Filho IS, Cruz SSD, Trindade SC, Passos"Soares JDS, Carvalho"Filho PC, Figueiredo ACMG, et al. Periodontitis and respiratory diseases: A systematic review with meta"analysis. Oral Diseases. 2020 Mar;26(2):439–46.
Jakovljevic A, Sljivancanin Jakovljevic T, Duncan HF, Nagendrababu V, Jacimovic J, Aminoshariae A, et al. The association between apical periodontitis and adverse pregnancy outcomes: a systematic review. Int Endodontic J. 2021 Sep;54(9):1527–37.
Ridho FM, Algifnita AO, Pramaztri NN, Laksono EP, Allifiah BPN, Mahesa A. Periodontitis as a Risk Factor of Preeclampsia in Pregnancy: A Scoping Review. IIMJ [Internet]. 2024;5(2). Available from: https://journal2.unusa.ac.id/index.php/IIMJ/article/view/5316
Lecaplain B, Badran Z, Soueidan A, Prud'homme T, Gaudin A. Periodontitis, erectile dysfunction, reproductive hormones, and semen quality: A systematic review. Andrology. 2021 May;9(3):769–80.
Martínez-García M, Hernández-Lemus E. Periodontal Inflammation and Systemic Diseases: An Overview. Front Physiol. 2021 Oct 27;12:709438.
Hegde R, Awan KH. Effects of periodontal disease on systemic health. Disease-a-Month. 2019 Jun;65(6):185–92.
NIH Consensus Conference. NIH Consensus Development Panel on Impotence. JAMA. 1993;270(1):83–90.
Rew KT, Heidelbaugh JJ. Erectile Dysfunction. American Family Physician. 2016;94(10):820–8.
Wessells H, Joyce GF, Wise M, Wilt TJ. Erectile Dysfunction. Journal of Urology. 2007 May;177(5):1675–81.
Goldstein I, Goren A, Li VW, Tang WY, Hassan TA. Epidemiology Update of Erectile Dysfunction in Eight Countries with High Burden. Sexual Medicine Reviews. 2020 Jan 1;8(1):48–58.
Pellegrino F, Sjoberg DD, Tin AL, Benfante NE, Briganti A, Montorsi F, et al. Relationship Between Age, Comorbidity, and the Prevalence of Erectile Dysfunction. European Urology Focus. 2023 Jan;9(1):162–7.
Kessler A, Sollie S, Challacombe B, Briggs K, Van Hemelrijck M. The global prevalence of erectile dysfunction: a review. BJU International. 2019 Oct;124(4):587–99.
Weber MF, Smith DP, OˈConnell DL, Patel MI, Souza PL, Sitas F, et al. Risk factors for erectile dysfunction in a cohort of 108 477 Australian men. Medical Journal of Australia. 2013 Jul;199(2):107–11.
Xiong Y, Zhang F, Zhang Y, Wang W, Ran Y, Wu C, et al. Insights into modifiable risk factors of erectile dysfunction, a wide-angled Mendelian Randomization study. Journal of Advanced Research. 2024 Apr;58:149–61.
Safarinejad M. Prevalence and risk factors for erectile dysfunction in a population-based study in Iran. Int J Impot Res. 2003 Aug 1;15(4):246–52.
Molina-Vega M, Asenjo-Plaza M, Banderas-Donaire M, Hernández-Ollero M, Rodríguez-Moreno S, Álvarez-Millán J, et al. Prevalence of and risk factors for erectile dysfunction in young nondiabetic obese men: results from a regional study. Asian J Androl. 2020;22(4):372.
Nguyen HMT, Gabrielson AT, Hellstrom WJG. Erectile Dysfunction in Young Men”A Review of the Prevalence and Risk Factors. Sexual Medicine Reviews. 2017 Oct;5(4):508–20.
Eastham J, Seymour R. Is oral health a risk factor for sexual health? Dent Update. 2015 Mar 2;42(2):160–5.
Connolly L. The effects of oral health on erectile dysfunction. BDJ Team. 2022 Jan 21;9(1):29–31.
Singh V, Nettemu S, Nettem S, Hosadurga R, Nayak S. Oral health and erectile dysfunction. J Hum Reprod Sci. 2017;10(3):162.
Zadik Y, Bechor R, Galor S, Justo D, Heruti RJ. Erectile Dysfunction Might Be Associated with Chronic Periodontal Disease: Two Ends of the Cardiovascular Spectrum. The Journal of Sexual Medicine. 2009 Apr 1;6(4):1111–6.
Sharma A, Pradeep AR, Raju P. A. Association Between Chronic Periodontitis and Vasculogenic Erectile Dysfunction. Journal of Periodontology. 2011 Dec;82(12):1665–9.
Keller JJ, Chung S, Lin H. A nationwide population"based study on the association between chronic periodontitis and erectile dysfunction. J Clinic Periodontology. 2012 Jun;39(6):507–12.
Eltas A, Oguz F, Uslu MO, Akdemir E. The effect of periodontal treatment in improving erectile dysfunction: a randomized controlled trial. J Clinic Periodontology. 2013 Feb;40(2):148–54.
Oğuz F, Eltas A, Beytur A, Akdemir E, Uslu MÖ, Güneş A. Is There a Relationship Between Chronic Periodontitis and Erectile Dysfunction? The Journal of Sexual Medicine. 2013 Mar 1;10(3):838–43.
Matsumoto S, Matsuda M, Takekawa M, Okada M, Hashizume K, Wada N, et al. Association of ED with chronic periodontal disease. Int J Impot Res. 2014 Jan;26(1):13–5.
Tsao CW, Liu CY, Cha TL, Wu ST, Chen SC, Hsu CY. Exploration of the association between chronic periodontal disease and erectile dysfunction from a population-based view point. Andrologia. 2014;47(5):513–8.
Uppal RS, Bhandari R, Singh K. Association between erectile dysfunction and chronic periodontitis: A clinical study. Indian J Dent Res. 2014;25(4):430.
Chou MH, Liu CY, Yang MH, Chou YC, Wu ST, Cha TL, et al. Chronic periodontal disease correlated with sezual function in young males. Formosan Journal of Surgery. 2018;51(5):175–9.
Martín A, Bravo M, Arrabal M, Magán"Fernández A, Mesa F. Chronic periodontitis is associated with erectile dysfunction. A case–control study in european population. J Clinic Periodontology. 2018 Jul;45(7):791–8.
Alenzi MJS. Prevalence of Erectile Dysfunction and Associated Risk Factors among Patients with Chronic Periodontitis Attending Various Dental Clinics. Bahrain Medical Bulletin. 2020;42(4):257–60.
Huang N, Li C, Sun W, Yang Y, Tang Q, Xiao F. Association Between Chronic Periodontal Disease and Erectile Dysfunction: A Case–Control Study. Am J Mens Health. 2022 Mar;16(2):155798832210847.
Kamaludin H, Kwong JCK, Marmuji LZ, Abidin KZ. Prevalence of Periodontitis in Erectile Dysfunction Patients. AOS. 2022 Aug 3;17(Supp. 1):73–84.
Mohd Sood Z, Nik-Azis NM, Baharin B, Md Zainuddin Z, Razali M, Hussaini HM. An Insight into the Role of Periodontitis as a Potential Risk Factor for Development of Erectile Dysfunction. AOS. 2022 Aug 3;17(Supp. 1):107–18.
Diouf A, Ndjidda Bakari W, Sounlin MH, Diallo AM, Thiam D, Guirassy ML, et al. Periodontitis as a risk factor for organic erectile dysfunction: A case-control study in a sub-Saharan population. J Adv Periodontol Implant Dent. 2023 Nov 8;15(2):80–5.
Trombelli L, Farina R, Silva CO, Tatakis DN. Plaque"induced gingivitis: Case definition and diagnostic considerations. J Clinic Periodontology [Internet]. 2018 Jun;45(S20). Available from: https://onlinelibrary.wiley.com/doi/10.1111/jcpe.12939
Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. Journal of Periodontology. 2018 Jun;89(S1):S159–72.
Elnashar A, Gadallah AM, Abdelaal AA, Soliman IF, Youssef MAFM. Can the International Index of Erectile Function (IIEF-5) be used as a diagnostic tool to the severity of vasculogenic erectile dysfunction? Middle East Fertility Society Journal. 2012 Jun;17(2):101–4.
Ismail K, Hamid SRA. Communication about Sex-Reproductive Health Issues with Adolescents: A Taboo among Malaysian Parents? European Journal of Social Sciences Education and Research. 2016 Mar 16;6(1):26–40.
Ma M, Yu B, Qin F, Yuan J. Current approaches to the diagnosis of vascular erectile dysfunction. Transl Androl Urol. 2020 Apr;9(2):709–21.
Mazzilli F. Erectile Dysfunction: Causes, Diagnosis and Treatment: An Update. JCM. 2022 Oct 30;11(21):6429.
De Leonardis F, Colalillo G, Finazzi Agrò E, Miano R, Fuschi A, Asimakopoulos AD. Endothelial Dysfunction, Erectile Deficit and Cardiovascular Disease: An Overview of the Pathogenetic Links. Biomedicines. 2022 Aug 1;10(8):1848.
Zuo Z, Jiang J, Jiang R, Chen F, Liu J, Yang H, et al. Effect of Periodontitis on Erectile Function and Its Possible Mechanism. The Journal of Sexual Medicine. 2011 Sep 1;8(9):2598–605.
Gratzke C, Angulo J, Chitaley K, Dai Y tian, Kim NN, Paick JS, et al. Anatomy, Physiology, and Pathophysiology of Erectile Dysfunction. The Journal of Sexual Medicine. 2010 Jan 1;7(1_Part_2):445–75.
Kulshrestha R, Ray Chaudhuri G, Bhattacharya K, Dutta S, Sengupta P. Periodontitis as an Independent Factor in Pathogenesis of Erectile Dysfunction. Biomed Pharmacol J. 2020 Mar 28;13(1):01–4.
Bizzarro S, Loos BG. The link between periodontitis and erectile dysfunction: a review. Br Dent J. 2019 Oct;227(7):599–603.
Tonetti MS, D'Aiuto F, Nibali L, Donald A, Storry C, Parkar M, et al. Treatment of Periodontitis and Endothelial Function. N Engl J Med. 2007 Mar;356(9):911–20.
Liu G, Zhang Y, Zhang W, Wu X, Jiang H, Huang H, et al. Novel predictive risk factor for erectile dysfunction: Serum high"sensitivity C"reactive protein. Andrology. 2022 Sep;10(6):1096–106.
Piconi S, Trabattoni D, Luraghi C, Perilli E, Borelli M, Pacei M, et al. Treatment of periodontal disease results in improvements in endothelial dysfunction and reduction of the carotid intima"media thickness. FASEB j. 2009 Apr;23(4):1196–204.
Seinost G, Wimmer G, Skerget M, Thaller E, Brodmann M, Gasser R, et al. Periodontal treatment improves endothelial dysfunction in patients with severe periodontitis. American Heart Journal. 2005 Jun;149(6):1050–4.
Blum A, Kryuger K, Mashiach Eizenberg M, Tatour S, Vigder F, Laster Z, et al. Periodontal care may improve endothelial function. European Journal of Internal Medicine. 2007 Jul;18(4):295–8.
Copyright (c) 2024 Fiki Muhammad Ridho, Arista Widya Agustina, Novi Nurul Hidayati, M. Ilham Pratama, Eko Puji Laksono
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
