The South African Dental Association (SADA) today announced the theme of its public education programme for 2013 and warned that there is clinical evidence that impotence (Erectile dysfunction) may come about as a result of gum disease and poor oral hygiene.
Professor Londi Shangase, Head of the Wits Department of Oral Medicine and Periodontology, is acting as SADA’s spokesperson on the overall subject of Periodontitis (Gum Disease) and Systemic Health. The focus this year will be on four groups of different systemic diseases - and conditions – that may arise as a result of poor oral hygiene and, resultant gum diseases.
“Blockage of the smaller arteries in the extreme parts of the body such as the penis comes about as a result of the penile arteries becoming blocked by plaque build-up on the artery walls (atherosclerosis), or a clot (thrombus) lodging in the smaller arteries of the organ, having broken away from the plaque build-up in the main arteries of the body. Another cause may be the malfunction of lining cells (endothelial cells) of the blood vessels of the penis, resulting in compromised dilatation of these vessels.
Male impotence may also be caused by a combination of these two processes. Given the association between gum disease, blocked arteries and/ or endothelial dysfunction we, therefore, may assume safely that there is an association between poor oral hygiene, gum disease and male impotence.”
Maretha Smit, Chief Executive of SADA said that Cardiovascular Diseases (CVDs) are regarded as the leading causes of death worldwide. “The WHO International statistics indicate that an estimated 17,3 million people died from CVDs in 2008. It is estimated that by 2030 almost 23,6 million people will die from CVDs. It is even more alarming when these figures show that over 80% of CVD deaths occur in low and middle-income countries. It is estimated that gum disease affects an estimated 35% of people globally and is spread across the spectrum of young and old.”Londi adds: “In South Africa 14.7 % of total deaths are linked to cardiovascular diseases. Smoking, stress, high blood cholesterol levels and diabetes, amongst others, have been identified as the traditional risk factors associated with CVD. However, not all patients with CVD exhibit these traditional risk factors. Therefore, there are other factors that may predispose these patients to CVD. Whilst the causes of CVD are diverse, blocked arteries and appears to be the most common. High blood pressure may further compromise the patient suffering from CVD.”
The primary cause of gum disease relates to the bacteria that live within the plaque build-up on teeth. Whilst these bacterial agents initially cause the gum disease, the propagation and sustenance of such a disease also depends on the level of other risks the patient is exposed to – and is seen particularly in those patients who are smokers, immune compromised, have diabetes or display abnormal changes in their genetic make-up.
These afflictions render the patient more vulnerable in that the poisons secreted by the oral bacteria involved in gum disease, stimulate the immune system to produce substances that will result in tissue breakdown and bone destruction if gum infections remain untreated. These substances normally play a protective role in a healthy body but, in a disease situation, can become destructive in the extreme.
From research it is eminently clear that blocked arteries play a significant role in the development of CVDs and form the basis for the different manifestations of these diseases. CVDs include coronary heart diseases (CHD), strokes, increased blood pressure, peripheral artery diseases and heart failure.
Plaque build-up in arteries may result in ruptured plaque surfaces which in turn may manifest clots. If sufficiently large such clots may completely block the already narrowed passage or, may dislodge and travel to a smaller arteries where blockages will be caused at those locations.
Reduced blood supply to the heart may lead to an angina attack, heart attack or heart failure.
Narrowing of the blood vessels also accounts for increases in blood pressure. As the passages of the blood vessels progressively becomes narrower, the blood flow becomes more forceful, causing damage to the vessel wall which, in turn, causes more plaque accumulation and further blockage.
Blocked arteries are also at the base of what happens when one suffers a stroke. Clots that break loose from the plaque on the arterial walls may travel to a distant site resulting in the obstruction of blood flow through the arteries that supply oxygenated blood to the brain.
“The association between gum disease and many other systemic diseases is fairly recent and the discipline of periodontics deals with all issues affecting tissue and the other structures surrounding and supporting the teeth, says Londi. “The mouth, without a doubt, forms an integral part of the body and it is impossible to maintain good systemic/general health in the presence oral disease.”
“Current thinking on the subject represents a radical departure from previous views and places dentistry in the midst of a more holistic approach to the overall health of the patient. The future might see the dental and the medical fraternity collaborating more closely on the management of patients.”
These statistics are most relevant to South Africa when one considers the statistics that illustrate how gum disease is more prevalent in developing countries than in developed countries. It is of critical importance for SADA to highlight the general health dangers associated with gum disease and to make the South African public aware of the positive role that dental professionals can play in the early detection and relatively inexpensive treatment of the disease.”
Johannesburg, 26th February 2013
NOTES TO EDITORS:
1. Erectile dysfunction (ED), the inability to attain and maintain an erection necessary and sufficient for satisfactory sexual performance, has a prevalence of 52% affecting males, mostly from the age of 40 onwards.
2. Coronary heart disease is defined as a disease in which, as a result of the processes discussed above, plaque accumulates on the inside walls of the coronary arteries thus compromising supply of oxygenated blood to the heart muscles. The long-term effects of the plaque accumulation are significant narrowing, or even complete occlusion of the coronary arteries. Complete occlusion leads to myocardial infarction as a result of the lack of oxygen supply to the myocardium.
3. Whilst causality in the relationship between periodontitis and systemic disease has not been fully proven, the possibility of the reduction of morbidity and mortality related to systemic diseases by treating periodontitis and improving periodontal health renders further evaluation of this relationship inarguably vital.
FOR FURTHER INFORMATION:
1. Maretha Smit
Tel: +27 (0)11 484 5288, Mobile: 084 627 3842, Fax: +27 (0)11 642 5718
2. Prof Londi Shangase
Tel: 011 488 4887, Mobile: 072 395 2335, Fax: 011 488 4902 /0862074358
3. Mixael de Kock
Tel: 011 646 8501, Mobile: 083 651 4424
