Resumen de Oral Contraceptives and Periodontal Diseases: Rethinking the Association Based Upon Analysis of National Health and Nutrition Examination Survey Data

Dr. L. Susan Taichman, Stephen A. Eklund

• Background: Historic evidence suggests that use of high-dose combined oral contraceptives (OCs) (containing >50 µg of estrogen and ≥1 mg progestin) places women at increased risk for periodontal diseases. Since the mid-1970s, OC formulations have dramatically changed. This study investigated the association between OC use and periodontal diseases among 4,930 National Health and Nutrition Examination Survey (NHANES) I and 5,001 NHANES III premenopausal U.S. women, aged 17 to 50 years, before and after the reduction of hormone levels in OCs.

  Methods: Data for this cross-sectional study came from the first (NHANES I, 1971 to 1974) and third (NHANES III, 1988 to 1994) NHANES studies.

  Results: The prevalence of OC use in the U.S. premenopausal female population in NHANES I was 22% and in NHANES III, 20%. Using multivariable logistic regression, a protective association between current OC use and gingivitis was suggestive but not significant in both NHANES I (odds ratio [OR] = 0.65; 95% con- fidence interval [CI]: 0.42 to 1.01) and NHANES III (OR = 0.80; 95% CI: 0.61 to 1.02) surveys. Current OC use was also associated with a decreased risk of periodontal disease in NHANES I (OR = 0.36; 95% CI: 0.13 to 0.96) and a non-significant association in NHANES III (OR = 0.73; 95% CI: 0.50 to 1.07).

  Conclusion: This analysis failed to validate the theory that earlier high- or current low-dose OC use is associated with increased levels of gingivitis or periodontitis and suggests an important reexamination of the perceived association between OC use and periodontal diseases. J Periodontol 2005;76:1374-1385.