Teeth and ED

Beyond taking some breath mints if you go crazy on the garlic bread, you might not think that teeth and ED have much to do with each other.

But you’d be wrong.

There’s a growing body of evidence that periodontitis, or gum disease, is linked to erectile dysfunction. Taking care of your teeth might just be the solution you’ve been looking for for your erectile problems, as well as a way to future-proof yourself against ED from age.

Here’s a rundown of the evidence linking gum disease and ED, as well as what you can do to improve your dental health and hopefully, cure your erectile dysfunction.

Gum Disease and Erectile Dysfunction

First, let’s clarify what we’re talking about.

Gum Disease

Gum disease isn’t just bad breath or the odd cavity. Gum disease is when your gums start to pull away from your teeth, exposing tiny holes that bacteria can collect in and fester. That bacteria can easily then spread to the surrounding bone (source).

The symptoms of gum disease can range from sensitive gums (gingivitis) all the way to severe damage to teeth, soft tissue, and bone (periodontitis). It can even require a tooth extraction to fix.

Gum disease is caused by the buildup of bacteria into plaque. Brushing and flossing will get rid of plaque, but if left for long enough, it will harden into tartar. This can be removed by a dentist, but that’s it — brushing and flossing certainly won’t move it. 

And that’s how you get gum disease — poor oral hygiene, plaque builds up under the gum line, plaque turns to tartar, tartar evolves into pockets of bacteria, and then the infection spreads until the offending tooth falls out.

Now that we’re on the same page, let’s turn our attention to how this impacts your wood.

Periodontitis and Erectile Dysfunction

There are a few different theories of what links periodontitis, none of which are conclusively proven. What we DO know is there is definitely a correlation between rates of periodontitis and ED. This has been found in multiple studies from around the world.

For example, one study from Taiwan in 2012 looked at the relationship on a national scale. They looked at over 32,000 men who suffered from ED as well a comparison group of 162,000.

It was a truly enormous study.

They found that of the 32,000 men suffering from ED, 26.9% of them suffered from periodontitis, compared to only 9.4% of the control group. What’s more, when they applied more statistical controls, the researchers found that this relationship only became clearer for men under 30 and over 69 (source).

But these researchers aren’t alone. Other studies have confirmed these findings.

A group of researchers out of the Department of Urology from Inonu University in Turkey published a paper in 2013 in the Journal of Sexual Medicine finding the same link.

They looked at 80 men between 30 and 40 years old suffering from ED and compared them to 82 men without ED, based on the International Index of Erectile Function (IIEF). Of the 82 men in the non-ED group, 19 had severe periodontitis, or 23%.

This number skyrockets to 53%, or 42/80 men in the ED group. What’s more, evidence of past periodontitis like decayed or missing teeth was far higher in the ED group. The researchers concluded that the scientific community should “consider periodontal disease as a causative clinical condition of ED in such patients” (source).

Both of these studies approached this problem from a fairly simplistic standpoint: do men who have ED also have periodontitis more often than the population at large?

A study from Western China took a different approach.

In 2011, a group of scientists from Luzhou Medical College published a study in the Journal of Sexual Medicine. Their goal wasn’t to identify a correlation — it was to find the cause.

First, they gave half the rats they were studying periodontitis. Then, they looked at a number factors that are normally used as indicators of erectile dysfunction, including:

• NOS activity
• C-reactive protein levels
• Cavernous tissue structure

What they found was that the rats who were induced with periodontitis performed worse across every measure. Conclusion? Penile functionality is impaired by periodontitis (source).

Of course, not everyone agrees with this aggressive causal statement. The American Academy of Periodontology (you can think of them as Big Dental) argues that there’s not enough evidence to say that bad teeth causes erectile dysfunction.

They argue that sure, these studies definitely support the theory that there’s a link between periodontitis and your ability to get it up. But they stipulate that there’s no evidence that an infection in your teeth is causing you to go soft.

Their theory?

It’s all about inflammation.

Which brings us to cause.

Why Periodontitis Causes Erectile Dysfunction

To be blunt, we don’t really know. All the research so far has only indicated that there’s a correlative relationship rather than a causal one.

That said, there are a few prevailing theories.

Inflammation & eNOS / NOS3

The most popular theory is that it’s all about inflammation.

It goes like this.

As you develop periodontitis, your body has a natural immune response to it. As part of this, white blood cells flood into the area around the infection to help your body fight it. This causes inflammation. However, an infection in one part of the body can have spillover effects on others.

In this case, the chronic inflammation caused by periodontitis can lead to damage in the endothelial cells. These are the cells that form the barrier that lines the inside of blood vessels, and thus are everywhere where there’s a lot of blood (like your heart and your penis).

So why does damage to the endothelial cells causes you to lose your morning wood?

Because that’s where nitric oxide is produced.

And since getting a solid erection depends on nitric oxide, the more chronic inflammation that’s occurring in your body, the more damaged your blood vessels are going to get, and the less nitric oxide they’re going to produce.

Specifically, damage to the endothelial cells interferes with the creation of the enzyme that catalyzes nitric oxide production, endothelial nitric oxide synthase 3, or eNOS (it’s sometimes called NOS3).

What’s more, your body will often use your penis like an early warning system. Chronic inflammation can have serious effects on your heart and brain and can raise the likelihood of having a heart attack or a stroke, significantly.

ED might be an early and comparatively harmless way for your body to tell you something isn’t right.

Quick note: Chronic doesn’t mean ‘really really bad.’ It means ‘happening all the time.’ When you bite your lip and it swells up, that’s acute inflammation. Periodontitis is chronic because it’s always there.

Of course, this theory doesn’t really link teeth to ED. It links inflammation to ED, but that inflammation could come from anywhere. Arthritis, chronic back pain, asthma, or even hepatitis are all sources of inflammation.

Or, it could also be something else completely. So it’s not a 100% causal relationship. That said, given that the men studied in these experiments and others are 2.28 times more likely to suffer from periodontitis compared to their more erect control groups, I think that a visit to the dentist is a good place to start.

The Alternative Theory: Correlation Only

There is another theory out there. It’s a little less involved but it basically argues that there is no merit to this research.

People who have periodontitis are more likely to experience erectile dysfunction not for any teeth-related reason, but rather because the men who have periodontitis are more likely to be unhealthy in general, which decreases erectile functionality for a number of reasons.

However, most of these studies have made at least some effort to control for confounding lifestyle factors. So yes, there is the possibility that there’s some other common thread uniting these men suffering from erectile dysfunction.

But I don’t think that’s any reason to avoid brushing your teeth.

My take? I think that for whatever reason, curing your periodontitis will only help your sex life. At best, you get a better erection and better breath. And at worse, you end up with better dental hygiene. What have you got to lose?

How To Improve Dental Health & Fix Erectile Dysfunction

Let’s set aside the causal/correlative relationship and focus on the positive: how to improve your dental health and cure your erectile dysfunction.

There are two key components to dental health: putting the right stuff in so that your body can repair your teeth itself, and taking care of your teeth with positive dental behavior (flossing, brushing, etc…).

Diet, Teeth and ED:

There are few key components to getting (and maintaining) healthy teeth — specifically, fat-soluble vitamins A, D, and K2.

Now you’ll notice that none of these vitamins are calcium, the usual star of the dental health world. The thing is, calcium is great, but it can actually cause problems.

Just like calcium in water can clog pipes, calcium in your body can build up into plaque that clogs your arteries. This is part of atherosclerosis, or the hardening of your arteries.

And as we know, what happens to your heart…

… usually happens to your penis too. When your arteries harden from too much calcium, the flexible, delicate blood vessels in your penis struggle to engorge correctly, making it more difficult to get hard. What’s more, as plaque builds up in your arteries, it’s harder to get enough blood to get your penis hard in the first place!

Enter the fat-soluble vitamins.

First K2. K2, which comes from fermented foods like natto and hard cheeses, activates a protein which binds calcium in your body to your teeth and bones where it belongs.

Basically, you can drink all the milk in the world but unless you have enough K2, it’s just going to harden your arteries, do nothing for your teeth, and make your ED worse.

Second, vitamin D. Where K2 helps your body pick up the calcium off your arteries and get it to where it needs to go, vitamin D helps you absorb it into your bones and teeth, providing strength and opacity, keeping your teeth hard and whole.

Finally, vitamin A. Vitamin A works to promote bone density (which is good). But it also works to promote mucus and saliva production, which coats your teeth and gums and protects them from harsh foods like acidic foods.

To keep your teeth healthy you need to balance all three of these vitamins:

• Vitamin K2 removes calcium buildup from your arteries
• Vitamin D allows that calcium to bond to your bones and teeth
• Vitamin A creates a protective layer over your teeth

Together, they form the core to oral health.

Brushing & Flossing

When it comes to brushing and flossing, the rules are pretty clear.

Brush twice a day, 2 minutes each and floss once a day.

But here are some tips to keep your teeth as healthy and clean as possible.

Don’t Over-brush

Overbrushing is when you brush your teeth too much and too hard. Much like sandpaper wearing down a piece of wood, overbrushing causes toothbrush abrasion, wearing away protective enamel and causing your gums to recede.

In terms of periodontitis, receding gums opens up more opportunities for small pockets to form, which are likely to grow into a major problem.

Don’t think that you’re overbrushing? Think again. According to The Wall Street Journal, 10-20% of people are overbrushing.

Because the thing is…

… plaque is easy to remove. It’s not stuck on like flecks of a label on a jar that needs to be scrubbed off. It could be wiped off with a clean rag, if you could get a rag that gets all the way to the back. Cleaning off plaque is more like cleaning a window than scrubbing a stove.

Here’s how you can avoid overbrushing:

• Get a soft-bristle brush. No one needs a medium or hard one.
• Angle your toothbrush at 45 degrees to the gum line.
• Use short, circular strokes, moving from tooth to tooth. Don’t try to power-brush half your teeth at once.
• Don’t squish the bristles. If you’re squishing the bristles, you’re brushing too hard.

Get Your Teeth Cleaned Professionally

Most dental plans include an annual checkup and two teeth cleanings a year.

Use them.

A dentist can check the health of your teeth and help you solve small problems before they become big ones. Second, even the most vigilant tooth-brusher and flosser will miss a spot or two.

Most people develop a tooth brushing pattern, missing the same spots again and again. While self-correction is important, regular teeth cleaning will help you identify these areas and a dentist will help you clean the tartar off your teeth — tartar that’s impossible to remove on your own.

Teeth and ED — Conclusion

Keeping your teeth clean and clear isn’t just about minty fresh breath (despite every Colgate ad ever). It’s also about holistic, whole-body health — including the health of your penis.

There’s a growing body of evidence that poor dental health like the chronic inflammation caused by periodontitis correlates to worse penis performance.

The stress your body has to go through to constantly be pumping white blood cells into your gums, bones, and teeth causes inflammation of other cells too — namely, your endothelial cells.

When these cells are inflamed, they’re not as good at their job of moving blood around your body. Plus, inflammation compromises their ability to synthesise eNOS, a critical component to your body’s ability to get hard.

Fortunately, the cure is easy.

Make sure you’re putting the right stuff in, like fat soluble vitamins A, D, and K2. These are found in dozens of supplements as well as liver (vitamin A), fermented products and cheeses (K2) and, well, the sun (vitamin D).

All of these work together to protect your teeth and ensure that your body is moving calcium where it’s needed, when it’s needed. This has the spin off effect of improving your cardiovascular health, so it’s a win-win.

Second, look after your teeth. Brush regularly with a soft-bristle brush, avoid overbrushing, and visit your dentist regularly.

Keeping your teeth is important in its own right. But since it’ll also help you get (and keep!) your erection, you’re only set up to gain from the experience.

Now go dig up $2 and get a new toothbrush. It might just turn your (sex) life around and fire up those spontaneous erections that have disappeared.