Injectable Contraceptives May Be Harmful to Teeth and Gums

Injectable progesterone contraceptives may be associated with poor periodontal health, according to research published in the February 2012 Journal of Periodontology.

The study focused on depot medroxyprogesterone acetate, also known as DMPA, a long-lasting progestin-only injectable contraceptive administered intermuscularly every three months. Researchers found that women who are currently taking DMPA or who have taken DMPA in the past are more likely to have gingivitis and periodontitis than women who have never taken it.

Gingivitis and periodontitis are indicators of poor periodontal health. Periodontal disease is a chronic inflammatory disease that affects the gum tissue and bone that supports the teeth. Gingivitis—the mildest form of gum disease—causes the gums to become red, swollen and bleed easily. Periodontitis is the most severe form of gum disease and can lead to tooth loss. Research has associated gum disease with other chronic inflammatory diseases such as diabetes, cardiovascular disease and rheumatoid arthritis.

The data for the study, Depot Medroxyprogesterone Acetate Use and Periodontal Health in United States Women Ages 15-44, were obtained from the NHANES (The National Health and Nutrition Examination Survey)1999-2004 public use datasets. The participants were nonpregnant, premenopausal women aged 15-44 who had provided complete DMPA usage data, indicating current usage of DMPA, past usage of DMPA or no usage of DMPA at all. All participants received a dental examination that noted clinical attachment loss, periodontal pocket assessment at two or three sites per tooth, and presence of gingival bleeding.

After adjusting for age, race, education, poverty income level and smoking status, the study found that current and past DMPA users had significantly increased periodontal pockets, gingival bleeding and clinical attachment loss than women who have never used DMPA. Current DMPA users were more likely to have gingivitis, while past DMPA users were more likely to have periodontitis.

“Hormones can play a role in women’s periodontal health,” said Dr. Pamela McClain, president of the American Academy of Periodontology and a practicing periodontist in Aurora, Colo. “These findings suggest that women that use, or have used, a hormone-based injectable contraception such as DMPA may have increased odds of poor periodontal health. I would encourage women that use or previously used this form of contraception to maintain excellent oral care, and to be sure to see a dental professional for a comprehensive periodontal evaluation on an annual basis.”

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