More than just oral health at stake for men – Dr Christoph Fiolka

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  Posted by: Dental Design      6th November 2018

Of all the diseases in existence, periodontitis is the sixth most prevalent health condition in the world, and is thought to affect around 50% of the UK population.[i]It may not be considered to be ‘deadly’ and strike fear into the heart like other diseases, but periodontitis is not to be underestimated – nor should it be ignored.

Periodontitis, after all, remains one of the leading causes of tooth loss, and can result in masticatory dysfunction and poor nutritional status.[ii] It is well known that living with periodontitis can also have a severe impact on happiness and quality of life, which can have a knock on effect into other areas such as relationships and career. Despite this, there are still a vast number of patients that are unaware of the common causal factors and dangers of periodontal disease, especially in areas of high deprivation. Even smoking, one of the leading risk factors associated with periodontitis, isn’t recognised by a large proportion of patients as a cause for concern. In fact, in one study just 6% of respondents were aware of the link between the two,[iii]which is highly disconcerting given the amount of people that still smoke. So what can be done?

First and foremost, patient education must be made a priority. If people understand the severity of their diagnosis, they are much more likely to change their lifestyle and take a more proactive approach with their oral hygiene. Warn them that it’s not just their oral health that will be affected either; they need to know that periodontitis is associated with a wide number of other health-related issues. They are unlikely to know, for instance, that periodontitis elevates the risk of abnormalities in blood sugar, insulin resistance and type 2 diabetes,[iv]and increases the possibility of clogged arteries, heart disease, stroke and respiratory disease.[v]Finding out that it’s more than their oral health at stake might be the push they need to take positive rehabilitative steps – or be more vigilant with prevention if periodontitis is not yet a problem.

Of course, it’s also up to you to keep abreast of the latest research, so that the minute you discover potential information that might make a difference to your patients, you can pass it on. Recently, for instance, there was a study carried out by the University of Granada in Spain that found that periodontitis plays a key role in the development of erectile dysfunction in men independently of other morbidities.[vi]It also found that patients with erectile dysfunction showed worse periodontal condition, indicating that the conditions have a bidirectional relationship.

Of the 158 men screened, 74% were diagnosed with chronic periodontitis. The number of sites with pocket probing depth 4-6mm and clinical attachment loss were higher in these cases, as were triglycerides (a type of fat found in the blood), C-reactive protein (CRP) and glycosylated haemoglobin. It is thought that CRP – which is produced in the liver and associated with inflammation and infection – is the likely culprit behind periodontitis and erectile dysfunction.

As shocking as this discovery may be, it might be the wake-up call some men need to take a more proactive approach with their oral health if the prospect of heart disease, diabetes and the like doesn’t do it. It is after all, a highly sensitive condition that can cause immense embarrassment and low self-esteem in any man that experiences it. Moreover, erectile dysfunction can lead to depression, which can have a severe impact on quality of life.[vii]

Luckily, there is evidence that suggests non-surgical periodontal treatment can improve the severity of erectile dysfunction,[viii]so if you have any patients suffering from periodontitis be sure to remind them of the importance of regular debridement. Frequent oral hygiene instruction is also integral to preventing and treating periodontal disease, as is providing patients with suitable adjuncts in which to complete their oral routine with. Indeed, using specially designed interdental brushes such as the CPS perio line from Curaprox along with a high-performance toothbrush can make all the difference to patients’ periodontal health. As such, it is crucial that you take that time to recommend quality products when informing your patients about oral health.  

Periodontitis is likely to be an ongoing issue in the UK, but by educating patients about possible symptoms and associated conditions, it may be possible to encourage patients to take a more active approach.


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[i]Dumitrescu A. Editorial: Periodontal Disease – A Public Health Problem. Front Public Health. 2015; 3:278. Accessed online July 2018 at

[ii]Chapple, I. (2014) Time to take periodontitis seriously. BMJ. 328:2645.

[iii]Lung ZH, Kelleher MG, Porter RW, Gonzalez J, Lung RF. Poor patient awareness of the relationship between smoking and periodontal diseases. Br Dent J. 2005; 199 (11):731-7; discussion 725. Accessed online July 2018 at
[iv]Sanz M et al. Scientific evidence on the links between periodontal diseases and diabetes: Consensus report and guidelines of the joint workshop on periodontal diseases and diabetes by the International diabetes Federation and the European Federation of Periodontology. Diabetes Research and Clinical Practice. March 2018; 137: 231-241. Accessed online July 2018 at

[v]NHS: The health risks of gum disease. Accessed online July 2018 at

[vi]Martín A, Bravo M, Arrabel M, Magán-Fernández A, Mesa F. Chronic periodontitis is associated with erectile dysfunction. A case-control study in European population. J Clin Periodontol. July 2018; 45 (7): 791-798. Epub 2018 May 28.

Accessed online July 2018 at
[vii]Araujo AB, Durante R, Feldman HA, Goldstein I, McKinlay JB. The Relationship Between Depressive Symptoms and Male Erectile Dysfunction: Cross-Sectional Results From the Massachusetts Male Aging Study. Psychometric Medicine. 1998; 60 (4): 458-465. Accessed online July 2018 at

[viii]Etlas A, Oguz F, Uslo MO, Akdemir E. The effect of periodontal treatment in improving erectile dysfunction: a randomised controlled trial. J Clin Periodontol. 2013; 40 (2): 148-154. Accessed online July 2018 at




Dr Christoph Fiolka

In 2008, Dr Christoph Fiolka was awarded the Diploma in Chemistry from the Department for Chemistry at the University of Cologne, before completing his PhD in Coordination and Solid-State Chemistry. Dr Fiolka then became a postdoctoral research assistant at the University of Berne. In 2015, he was appointed as a sales representative for the international research-based pharmaceutical company, Berlin-Chime, before he began to work as a chemist at Cell Care Lab Ltd in 2016. Dr Fiolka is now the Head of Product Management Chemical Products at Curaden AG in Switzerland.



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