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Men: Gums Can Impact Erectile Dysfunction (ED) and Heart Health


Posted on Jan 24, 2023 by William J. Claiborne, DDS MS

It may be an awkward subject, but the issue of erectile dysfunction (ED) seems to appear rather frequently via TV commercials. I see ads for pills and medical clinics rather often. Agreeably, it is a problem estimated to affect a rather large percentage of men. For those ages 40 – 70, it affects over 40%. Nearly 70% of men at age 70 are affected. 

https://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/endocrinology/erectile-dysfunction/

In no way am I wanting to dissuade a male from medications or seeking treatment. However, as an Asheville NC periodontal specialist, I want to relay an issue that may be a bigger influence in ED than many are aware.

Below are findings of several studies showing that periodontitis (advanced gum disease) to be a significant risk factor for erectile dysfunction. Rather telling is as gum disease worsens, so does erection impairment.


• In a study of 162 males ages 30 to 40, Turkish researchers found that 82 of the participants had normal erection function while 80 who complained of ED, nearly half. Some men in both groups had chronic periodontitis, but the condition was more than twice as prevalent in the ED group. Men with periodontitis accompanied by decayed or missing teeth had the greatest level of ED.


• In another study conducted at the University of Granada School of Dentistry, 80 male participants who had severe gum disease were more than twice as likely to suffer from erectile dysfunction. This was true even after adjustments were made for other issues that could distort the findings. In the study, 74% of the participants with ED also presented with chronic periodontitis. 


• Israeli researchers conducted a survey of the erection function of 305 men with an average age 40. The participants were given a thorough examination of their gums. Those with chronic periodontitis had the greatest risk of ED.


• Research has shown that men with indicators of periodontal disease such as red, swollen or tender gums as well as prostatitis (inflammation of the prostate) have higher levels of PSA than men with only one of the conditions. This means that prostate health may be associated with periodontal health, and vice versa.

Men with gum disease showed a higher risk of developing impotence due to inflammation associated with periodontal disease. This inflammation has been known to damage to blood vessels, which can lead to impotency. Men younger than 30 or older than 70 are especially at risk.


A separate study found that men with a history of gum disease are 14% more likely at risk for cancer than men with healthy gums. Specifically, men with periodontal disease are 49% more likely than women to develop kidney cancer, 54% more likely to develop pancreatic cancer, and 30% more likely to develop blood cancers.

For over two decades, medical researchers have closely focused on inflammation in the body and its power to activate health problems, heart and cardiovascular diseases in particular. However, men have notably higher risks in some areas in addition to ED, one being the heart.

When it comes to ED and heart disease, the connection to periodontal disease has emerged as an independent risk factor. Cardiovascular disease raises risk for ED. Thus, anything that increases the risk for cardiovascular disease (such as smoking, obesity, chronic stress, high cholesterol, high blood pressure, and chronic sleep apnea) also raises the risk of ED.

Men, especially, need to know that they should be committed to having healthy teeth and gums. Research has found that periodontal disease is higher in men (56.4%) than in women (38.4%) – an 18% difference. https://www.perio.org/consumer/gum-disease-and-men

According to a survey by the Centers For Disease Control & Prevention (CDC), only 66% of males brush their teeth twice or more a day compared with 86% of females who do so.

This was revealed through a study of over 800 participants. Evaluation included a written questionnaire on dental knowledge and oral health habits. It also included an oral exam of each participant to detect signs of periodontal disease. (https://www.perio.org/consumer/gender-differences)

Flossing had even worse numbers, but that pertains to both sexes. Only 49% in the survey claim to floss daily. Only 1 out of 3 assumed that seeing blood in the sink when brushing is normal and unaware of it as a sign of periodontal (gum) disease.

Regardless of gender, over time an inadequate daily oral hygiene leads to an overload of bacteria in the mouth. For people who have habits such as smoking, unhealthy diets, and alcohol consumption, their vulnerability is even greater.

This is also true for people as they age. Aging contributes to a reduced ability to produce saliva, the mouth’s oral rinsing agent. When saliva flow fails to rinse away bacteria at sufficient levels, the accumulation runs rampant.

As a Western NC periodontist, I have an up-close view of the damaging affects of insufficient oral hygiene. It often results in tooth loss, which is (contrary to many perceptions) NOT a natural part of the aging process. Having natural teeth for a lifetime is more than achievable and has even been shown to add to one’s lifespan (by up to ten years).

If you haven’t been fully committed to your oral health, there is no better time to begin than the present. Start the year with a thorough periodontal examination. Call 828-274-9440.

If dental fears have caused you to delay or avoid having regular dental care, consider beginning with a consultation. This occurs in a comfortable, private consultation room that is removed from the clinical side of the office. Too, many treatments can include oral or I.V. sedation (sleep dentistry, or “twilight sleep”).

And, if financial constraints are an obstacle in receiving treatment, we offer several payment plans. Most are interest-free with no down payment required (for qualified individuals). Feel free to ask about these during your consultation.

Get Dental Fear Out Of The Way and Enjoy A Healthy Confident Smile


Posted on Jan 18, 2023 by William J. Claiborne, DDS MS

It’s a new year. Hopefully, this new beginning has given you renewed determination to conquer challenges that have held you back from living the life you want.

While some people want to lose weight and others wish to learn something new, I tend to see many people at the first of each year who wish to achieve a healthy, confident smile. A large number of these people have been less-than-successful in the past because of having dental fear.

Dental fear and high anxiety associated with dental visits is not uncommon. These fears are often borne from a traumatic incident in the patient’s past. Or, in some cases, it exists for unknown reasons. Too, certain smells, sounds or sights can trigger reactions that evoke fear at even mere thoughts of dental visits.

Oral health is an integral part of your overall health. For decades, studies have proven a direct contact between poor oral health and disease related to other organs. By neglecting dental hygiene, people are at greater risk of developing (or the worsening of) serious diseases and conditions. To avoid these risks, good dental care at home and having regular dental check-ups help empower adults in improving oral health and wellness.

As a periodontist in Asheville, I have a firsthand view of just what dental fear can do to oral health. Certainly, avoiding regular dental care is a sure recipe for cavities, periodontal (gum) disease, and eventual tooth loss. However, the repercussions of poor oral health can wreak havoc on one’s overall health.

It’s not uncommon for adults who avoid dental visits to feel they are doing a “good enough job” at maintaining their oral wellness at home. In some minds, “I brush twice a day,” can be the justification to bypass regular dental cleanings and exams. Yet, even the best of at-home dental hygiene can be insufficient.

Even people who feel they are dong a good job at the sink can easily miss areas of bacteria accumulation. Grooves in the tops of teeth and the tight nooks formed by crooked teeth become ideal hiding spots for bacteria growth.

Oral bacteria reproduce rapidly and, when at a certain point, can trigger inflammatory reactions. In addition to being the origin of cavities and periodontal (gum) disease, these reactions can extend far beyond the mouth (some of which are listed below).

Gum disease is the nation’s leading cause of adult tooth loss. The same infectious bacteria that destroy gums and structures that support natural teeth aren’t confined to the oral proximity. Through tears in diseased gum tissues, these infectious bacteria can enter the bloodstream.

Research has correlated oral bacteria to an extensive list of serious health problems. Some can be activated by the bacteria of periodontitis, some are worsened. For those who avoid dental care due to anxiety or fear, knowing this is not necessarily going to quell their anxiety. However, allowing dental fear to prevent you from achieving a healthy smile can increase health risks you may not realize.

Just how bad are the risks?

Dementia & Alzheimer’s disease: Gum disease occurs when infection of the oral tissues develops. It causes bleeding gums, putrid breath odor, loose teeth, and tooth loss. Oral bacteria and the inflammatory molecules that develop can enter the bloodstream, making their way to the brain. Previous lab studies have suggested that this is a potential risk factor in the sequence of events that lead to dementia.
https://www.nia.nih.gov/news/large-study-links-gum-disease-dementia

Alzheimer’s disease is the most common form of dementia that destroys memory, shrinks the brain, and affects the brain cells to die. It degenerates the functioning of mental health, which leads to memory loss and confusion. During Alzheimer’s, loss of appetite may worsen, eventually giving rise to oral health problems. The bacterium P. gingivalis appears to migrate from the mouth to the brain of some individuals as they age with a significant proportion of subjects developing Alzheimer’s disease.


Cardiovascular disease: A potential association exists between atherosclerosis (i.e. plaque deposition in blood vessels) and periodontal pathogens. There is a broad base of common genetic variants which increase both the risk of cardiovascular disease and the risk of periodontitis.


Endocarditis: Bacteremia (defined as the entry of bacteria into the blood stream) is a precondition for endocarditis. The vast majority of bacteremia do not cause endocarditis, even in patients at high risk. However, in high-risk patients, the more frequently and the more intensely bacteremia occurs, the greater the likelihood of endocarditis. Periodontal therapy has been shown to have a protective effect in people at risk of endocarditis.


Erectile Dysfunction: In the U.S., an estimated 18% of males have erectile dysfunction (ED). Men over the age of 70 are more likely to have ED compared to 5% between ages 20 – 40. Studies have shown an association between gum disease and pancreatic cancer. From analyzed data of five studies between 2009 – 2014, studies followed 213,000 participants aged 20 – 80.

Each study found erectile dysfunction was more common among men with chronic periodontitis, particularly for those younger than 40 and older than 59. After accounting for other health factors, erectile dysfunction was found to be 2.28 times more common for men who had advanced gum disease than for men without it.
https://www.reuters.com/article/us-health-periodontitis-erectile-dysfunc/chronic-gum-disease-tied-to-risk-of-erectile-dysfunction-idUSKBN13K1UP


Stroke: In one study of 265 stroke patients, researchers found that patients with gum disease had twice as many strokes due to thickening and hardening of brain arteries as patients without. Additionally, patients with gum disease were three times as likely to have a stroke involving blood vessels in the back of the brain, which controls vision, coordination and other functions.

In a separate study of over 1,100 patients who had not experienced a stroke, researchers noted that 10% had severely blocked brain arteries. They also found that patients with gum inflammation were twice as likely to have moderately severe narrowing of brain arteries.


Arthritis: For decades, it was perceived that RA (rheumatoid arthritis) patients had such a high risk of gum disease due to poor oral hygiene because of dexterity problems with using a toothbrush. However, more recent studies now show that gum disease is actually a risk factor for arthritis.

While genetic factors certainly contribute to greater RA susceptibility, the true source has been determined to be inflammatory reactions. This inflammation is triggered primarily by bacterial infections, with oral bacteria being a significant contributor to inflammatory arthritis.

Researchers found that people with severe periodontal disease also had severe rheumatoid arthritis. Patients with the most plaque, bleeding and gum tissue breakdown had worse RA by all measures, including disease activity and inflammatory markers. Other studies have found that even with treatment, RA patients with periodontitis continue to have worse arthritis symptoms and are 50% less likely to be in remission.

The relationship between gum disease and arthritis isn’t just seen in adults. Kids with juvenile idiopathic arthritis (JIA) have inflammatory mouth bacteria not found in their healthy peers.  Different types of bacteria seem to correspond to specific aspects of JIA.

Some are associated with higher disease activity and others with a greater number of affected joints.
https://www.arthritis.org/health-wellness/about-arthritis/understanding-arthritis/mouth-bacteria


Diabetes: It has been known that acute inflammation may lead to poor glycemic control. This is due to the fact that infections reduce the uptake of glucose into cells, and endotoxins and inflammatory mediators reduce the efficiency of insulin. Due to these pathways, periodontitis (advanced gum disease) has long been regarded as a risk factor for poor blood glucose control in diabetes patients.


Pre-Term Babies: The elevated hormone levels during pregnancy create a higher vulnerability to gum disease; the reason about half of pregnant females experience swollen, red and tender gums that bleed while brushing. Known as Pregnancy Gingivitis, the gums are more susceptible to inflammation, thus more sensitive to the bacteria of gum disease.

Studies have shown that gum disease increases the risk for preterm delivery (before 37 weeks) and low birth weight babies. Gum disease also increases the risk for poor obstetrical outcomes, late miscarriage and pre-eclampsia. For example, the preterm birth rate for women without periodontal disease is approximately 11% compared to nearly 29% for females with moderate to severe gum disease.

Through tears in gum tissues, oral bacteria can enter the bloodstream. Once this bacteria reaches placental membranes, it can trigger inflammation that can cause preeclampsia or labor.


While these health concerns are all reasons to renew your commitment to achieving and maintaining a healthy smile, the image of having a terrific smile you want to share often is an added perk of having good oral health. As a periodontist, I have advanced skills in the treatment of all stages of gum disease as well as the placement of all types of dental implants.

If dental fear is holding you back, let us help your 2023 be the year you take your smile back! Begin by understanding that having discomfort or pain is NOT a part of today’s dentistry. In our Asheville periodontal dental office, we have advanced skills and technology that enhance comfort and minimize treatment time.

Here, we make patient comfort a priority at every visit. We have even designed our reception area to pamper you from the moment you enter.

We offer a private consultation room for patients as well. In this room, we can discuss your treatment and answer your questions in a comfortable setting. This allows patients to become better informed about their treatment needs and options versus communicating while they are seated in a treatment chair.

Our surgical suite offers a rather unique setting for a periodontal office. A large window provides beautiful mountain views, very soothing to our patients. In addition, we offer oral sedation as well as I.V. sedation (twilight sleep) for most procedures, if desired.

Oral sedation is a pill that helps patients relax. It also has an amnesiac effect, leaving most with little or no memory of treatment afterward. I.V. sedation places the patient in a deeper sedative state, also erasing memory of the procedure. It is administered by a doctor of anesthesiology for optimal comfort and safety. With both, patients are monitored with advanced safety equipment throughout treatment.

Our entire staff provide a unified team, each bringing a sincere level of compassion and commitment to excellent care. While the doctors involved in your care are top-notch, I must admit that our staff are the pros at making our patients feel truly pampered.

When patients realize that our goal is to provide exceptional care in TOTAL comfort, they relax. When they experience this, they relax even more. When they experience this more than once, a sense of trust is born. When patients trust us, they feel they no longer need to avoid dental care. Like everyone, fearful patients desire a healthy, confident smile. Once the obstacle of fear is removed, their ability to achieve that is greatly heightened.

If you or someone you know has fear that has prevented needed or desired dental care, schedule a consultation appointment. This will take place in our private consultation room. Here, we can discuss your needs and concerns and have your questions answered thoroughly. From there, you can determine what pace is best for you.

Call 828-274-9440 to learn more. Our friendly phone staff will make you feel good from the very beginning!