Influence of combined oral contraceptives on the periodontal condition

Abstract

Most studies investigating the impact of oral contraceptives have been performed some years ago, when the level of sexual hormones was greater than the actual formulations.Objective The aim of this study was to evaluate the effects of current combined oral contraceptives (COC) on periodontal tissues, correlating the clinical parameters examined with the total duration of continuous oral contraceptive intake. Material and methods Twenty-five women (19-35 years old) taking combined oral contraceptives for at least 1 year were included in the test group. The control group was composed by 25 patients at the same age range reporting no use of hormone-based contraceptive methods. Clinical parameters investigated included pocket probing depth (PD), clinical attachment level (CAL), sulcular bleeding index (SBI) and plaque index (Pl.I). Data were statistically evaluated by unpaired t test, Pearson's correlation test and Spearman's correlation test. Results The test group showed increased PD (2.228±0.011 x 2.154±0.012; p<0.0001) and SBI (0.229±0.006 x 0.148±0.005, p<0.0001) than controls. No significant differences between groups were found in CAL (0.435±0.01 x 0.412±0.01; p=0.11). The control group showed greater Pl.I than the test group (0.206±0.007 x 0.303±0.008; p<0.0001). No correlation between the duration of oral contraceptive intake, age and periodontal parameters was observed. Conclusions These findings suggest that the use of currently available combined oral contraceptives can influence the periodontal conditions of the patients, independently of the level of plaque accumulation or total duration of medication intake, resulting in increased gingival inflammation.

Impact of Oral Contraceptives on the Periodontium: A Histological Study

“…The loose connective tissue papillae are running to a long distance in the gingival epithelium near to the keratinous surface with increase in vascularity. These observations could be in accordance with the results of Domingues et al [28] who found that the sulcular bleeding index was significantly higher in the test group of women taking oral contraceptives compared to the control group.…”

Why screening and prophyl- axis remain to be vital components of oral cancer research?

“…The main factor that conditions gingival inflammation seems to be the concentration of steroid sex hormones, independently of the amount of dental plaque. [32] The current OCs have a very low concentration of these hormones with probably little influence on gingival inflammation. [2] In this meta-analysis, women who took OCs had BOP significantly higher than that presented by women without OC intake, with a statistically significant association (P < 0.01).…”

“…Figure 5a], the five studies [28,29,[31][32][33] that reviewed this parameter showed that OC intake did not affect PD, without a statistically significant relationship (MD = 0.19; 95%: −0.03-0.40, P = 0.08). Six studies [28][29][30][31][32][33] compared the loss of CAL in women who take OCs and those who do not take them [ Figure 5b]. The loss of CAL was greater in women taking OCs, with statistically significant differences (MD = 0.16, 95% CI: 0.01-0.30, P = 0.03).…”

“…As previously mentioned, this may be due to the extremely low levels of progesterone and estrogens present in the current OCs, without a significant influence on periodontal tissues or on the risk of periodontal disease, especially in women with good oral hygiene habits. [32] However, the effects of OCs on periodontal tissues may be aggravated in women with a natural predisposition to periodontitis. [29] Women with OC intake had a mean loss of CAL 0.16 mm higher than that of women who did not take them, with statistically significant differences (P = 0.03).…”

Chronic stress associated to contraceptives use on the progression of ligature-induced periodontitis in rats

“…Changes in periodontal conditions are associated with variations in the levels of these substances 1 . In this respect, the use of oral contraceptives plays an important role 2 , as these drugs modify the estrous cycle to prevent pregnancy. Nevertheless, it seems that estrogen and progesterone receptors located in the gingival tissue allow a greater accumulation of immunoinflammatory products, altering defense responses to microbial biofilm challenges 3 .…”