Men's Health Month is a good reminder to check in on a patient population that consistently underutilizes dental care and to reflect honestly on whether we are reaching them effectively.
The ADA data are worth keeping front of mind: Women brush twice daily at rates 8% higher than men, and women are 26% more likely to floss daily. Male patients visit less frequently, tend to come in for emergent problems rather than prevention, and they are less likely to follow through on recommended treatment even after they come in. The downstream consequences show up clearly in our hygiene chairs and periodontal assessments.
Dr. Nitish Gangoli.
The disparity in periodontitis rates alone is significant. The U.S. Centers for Disease Control and Prevention indicates that nearly 1 in 2 men have some form of periodontitis compared with 1 in 3 women. Some of that is biological -- testosterone has been shown to suppress immune function, and hormonal differences affect inflammatory response.
But behavioral factors compound the biology: Our male patients carry higher rates of alcohol use and tobacco use, both smoking and smokeless. Alcohol increases the permeability of the oral mucosa to carcinogens. Tobacco's role in periodontitis and oral cancer needs no elaboration for this audience.
What may be worth revisiting with patients is the systemic cascade. Bacterial inflammation in periodontal tissue drives mediators into the bloodstream, linking periodontitis to cardiovascular disease, diabetes, stroke, and dementia.
For men specifically, the connection to erectile dysfunction deserves a place in our patient conversations. Chronic periodontal inflammation has been associated with vascular damage that contributes to impotence. Elevated prostate-specific antigen levels have also been associated with periodontal disease, which gives us a natural bridge when patients mention prostate concerns.
Medication-induced xerostomia is another area worth flagging. Antihypertensives, alpha blockers for benign prostatic hyperplasia, antihistamines, antidepressants, and cannabis all reduce salivary flow to varying degrees. Some antihypertensives produce gingival enlargement that further complicates hygiene. Vaping and e-cigarettes have emerging evidence linking them to periodontitis as well -- a conversation that is increasingly relevant across age groups.
The preventive message for our male patients remains straightforward: twice-daily brushing with fluoride toothpaste, daily flossing, a balanced diet low in fermentable carbohydrates, tobacco cessation, and adequate hydration. The challenge, as we know, is getting them in the door consistently enough to deliver it.
Men's Health Month is a reasonable hook for patient outreach -- a newsletter item, a social post, or a conversation with patients who are already due for recall. It is also a useful prompt for us to consider whether our own recall and prevention habits are as consistent as what we recommend.
Dr. Nitish Gangoli is a board-certified oral and maxillofacial surgeon. He is a New Jersey native and proud to be working at Riverside Oral Surgery and living in the area where he grew up.
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