Oral contraceptives and the periodontium
Periodontology 2000
Abstract
Oral
contraceptives are a safe and effective means of contraception for
millions of women worldwide. The first formulations of these drugs
contained much higher doses of estrogens and progestins than those
available today, and these were associated with an unacceptably high
rate of unwanted effects including serious cardiovascular events. In
addition, a number of case reports and clinical studies suggested that
use of the first generation oral contraceptives was also associated with
an increased risk for gingival and/or periodontal disease.
Unfortunately, many of these early studies suffered from significant
methodological flaws which throw their findings into question.
Nonetheless, these studies provided the basis for a perception among the
dental profession that oral contraceptives increase the risk for
gingivitis and/or periodontitis. Realisation that the adverse events
profile of oral contraceptives was dose dependant led to the development
of the modern low dose formulations that are in use today. There have
been far fewer studies to investigate whether modern oral contraceptives
have any impact on the periodontium compared to studies of the early
contraceptive formulations, but the quality of the more recent research
is undoubtedly better. Following extensive review of the relevant
literature and consideration of the historical perspective, the best
available evidence strongly supports that oral contraceptives no longer
place users at any increased risk for gingivitis or periodontitis. Oral
contraceptives should not be viewed as a risk factor for gingival or
periodontal disease.
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