DMPA intake may increase risk of periodontitis, gingivitis in women

Injectable progesterone contraceptives may be associated with poor periodontal health, according to research in the Journal of Periodontology. The study found that women who are currently taking depotmedroxyprogesterone acetate (DMPA) injectable contraceptive, or have taken DMPA in the past, are more likely to have indicators of poor periodontal health, including gingivitis and periodontitis, than women who have never taken the injectable contraceptive. DMPA is a long-lasting progestin-only injectable contraceptive administered intermuscularly every three months.

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. Additionally, research has associated gum disease with other chronic inflammatory diseases such as diabetes, cardiovascular disease, and rheumatoid arthritis.

The data for this study were obtained from the NHANES 1999-2004 public use datasets. The participants chosen were non-pregnant, 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 (CA) 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 CA 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.

According to Dr. Pamela McClain, President of the American Academy of Periodontology (AAP) and a practicing periodontist in Aurora, Colorado, women currently taking DMPA or that have used DMPA in the past should pay careful attention to their teeth and gums. "Hormones can play a role in woman's periodontal health. 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."