Effects of hormonal contraceptives on the periodontium, in a population of rural Sri-Lankan women

Aims: Women using hormonal contraceptives can be considered to be a 'risk group' for periodontal disease, due to prolonged, sustained serum levels of oestrogens and progesterone. This investigation aims to study the effects of hormonal contraceptives on periodontal tissues. Methods: 32 women using hormonal contraceptives for less than 2 years, 17 for 2-4 years and a matched control group of 39 non-users were selected for the study. They were clinically examined for plaque levels (plaque index: PLI), gingival condition (gingival index: GI) and loss of periodontal attachment (LA). Results: Contraceptive users of less than 2 years and 2-4 years duration (n=32, n=17 repectively) and non-users (n=39) had similar oral hygiene levels; yet the contraceptive users had a significantly higher level of gingival inflammation, compared to the non-users (P<0.001; I-way ANOVA). Usage of hormonal contraceptives for 2-4 years (n=17) caused a significantly higher LA (p<0.001) compared to that of controls (n=39). Conclusions: Usage of contraceptive preparations containing oestrogen and progesterone resulted in hormonal changes similar to those seen in pregnancy, associated with increased prevalence of gingivitis. There was significantly higher LA with prolonged usage of hormonal contraceptives, compared with controls.