The Association Between Periodontitis and Erectile Dysfunction: A Systematic Review and Meta-Analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of non-randomized/observational studies
PubMed 34013796 · doi:10.1177/15579883211007277
What was done
Authors conducted a systematic review and meta-analysis adhering to PRISMA guidelines by searching MEDLINE, EMBASE, Scopus, Web of Science, and CENTRAL from inception to August 2, 2020. They included randomized and nonrandomized controlled studies evaluating the association between periodontitis and erectile dysfunction, excluding case reports, case series, and narrative reviews. Study quality was appraised via the Newcastle-Ottawa Scale and GRADE approach. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were computed using a random-effects model.
What was found
Six studies totaling 215,008 individuals (38,675 cases and 176,333 controls) were analyzed. Periodontitis was significantly associated with erectile dysfunction (OR = 2.56, 95% CI: 1.70–3.85, p < .0001). However, statistical heterogeneity across studies was extremely high (I² = 98%, p < .00001). Effect estimates remained generally consistent across sensitivity and subgroup analyses.
Why it matters
This review pools large-scale observational data indicating a strong statistical link between periodontal disease and erectile dysfunction. It highlights the potential clinical relevance of oral health in men presenting with vascular or sexual dysfunction.
Limits
The primary limitation is the extreme statistical heterogeneity (I² = 98%), indicating substantial methodological or clinical diversity among the included studies. The analysis was limited to only six studies, relied largely on observational data subject to residual confounding (such as smoking, diabetes, and cardiovascular disease), and could not determine causality or temporal sequence.
Cited by
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