Chronic Periodontitis and Erectile Dysfunction

Abstract

We read the article by Oguz et al. [1] with great interest. The cited study is an interesting contribution to the literature. The relationship between erectile dysfunction (ED) and periodontal disease is explored. The cited authors conclude that an association exists between clinical periodontal parameters and ED. Further, they suggest that periodontal disease should be considered when it is sought to understand the etiology of ED in young adults. However, we suggest that these findings should be viewed with caution because some necessary data are lacking. First, the mean International Index of Erectile Function (IIEF) scores of participants were not reported. It is well known that IIEF scores can be used to grade ED severity as absent, mild, moderate, or severe [2]. Why did the authors not subdivide their group I patients in terms of the severity of ED? Had they done so, it would have been possible to draw a firm conclusion as to the existence of any correlation between ED and the presence of chronic periodontitis (CP). We would make another technical point. The possibility that some cases of ED were psychological in terms of etiology should have been explored in more detail [3]. The exclusion criteria were the presence of a systemic disease (including diabetes mellitus, heart disease, and hypertension); such conditions can affect periodontal health and ED. It was shown in the literature with a rat model that experimental model of periodontitis may cause ED [4]. Also, the authors argue that CP is an organic cause of ED, because CP may induce systemic vascular disease by triggering endothelial dysfunction, but in the study no psychological exclusion criterion was listed. It would have been possible to identify appropriate exclusion criteria had patients been asked about the presence of nocturnal erections, or had a nocturnal penile tumescence and rigidity test been performed.