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How can men avoid gumming up a relationship? They might start by brushing their teeth every day.

According to a new study in The Journal of Sexual Medicine, men with erectile dysfunction (ED) are three times more likely to have gum disease than men who do not have ED.

Turkish researchers found that 53% of the male patients with ED had severe gum disease (chronic periodontitis) compared with 23% who did not have ED. The study included 80 male patients with ED and 82 male patients without the condition; none were smokers since lighting up is considered a risk factor for both ED and gum disease. The study was also limited to those 30 years to 40 years old in an effort to rule out age as a risk factor. Even after accounting for age, body mass index (BMI), household income, and education status, the association between poor dental health and ED held.

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“We think that it will be of benefit to consider periodontal disease as a causative clinical condition of ED in such patients,” the authors write.

What connects the two vastly different conditions? In a word, inflammation. Inflammation, which is the body’s immune response in action, may spread from the gums and harm other parts of the body. Gum disease is marked by bleeding of the gums and bone structure of teeth, and if left untreated, can cause tooth decay and tooth loss as immune cells launch an all-out attack on pathogens in the mouth. These bacteria can also seep into the bloodstream and damage blood vessels, and because erectile problems can be caused by impaired blood flow in the penis, poor dental hygiene can be associated with ED. About 150 million men worldwide suffer from erectile dysfunction, and nearly half of American adults over 30 (64 million) have periodontal disease — 56 percent of whom are men, according to the Centers for Disease Control and Prevention (CDC).

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“Many studies have reported that [chronic periodontitis] may induce systemic vascular diseases, such as coronary heart disease, which have been linked with erection problems,” Dr. Faith Oguz from Inonu University in Malatya, Turkey, said in a statement describing the results.

While these studies have linked periodontal disease to heart disease and diabetes, the American Heart Association (AHA) announced in April that there is not enough research to confirm that gum disease causes heart disease. Most of the data comes from observational studies, which means there may be other factors that raise the risk of both diseases — such as obesity, smoking, and aging — that could also be responsible for this association. The Turkish authors, however, excluded men who had a systemic disease from their study, which suggests the relationship is worth pursuing with further research.

“Even though it’s a small, preliminary study, there’s enough suggestion that periodontal disease is a significant risk factor that it begs more investigation,” says Dr. Nancy L. Newhouse, President of The American Academy of Periodontology (AAP).

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Faithful brushing can keep bacteria that trigger inflammation at bay, and regular visits to the dentist can detect periodontitis. That’s something that most men aren’t taking advantage of; according to recent research in the AAP’s journal Periodontology, women are twice as likely as men to get regular dental check-ups.

“This is a risk factor that you have some control over,” Newhouse says. If you have healthy gums, then “you have just eliminated one of the factors that may be impacting your overall health, of which ED is a part.”

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