The convenience of a hormone birth control injection like Depo-Provera may be offset by increasing your risk of red, swollen or diseased gums.

A study has found a possible association between depotmedroxyprogesterone acetate (DMPA), the contraceptive injected into a woman’s muscle every three months, and periodontal disease in the gum tissues and the bones under your teeth.

Depo-Provera is one of the best known brands of DMPA.

Dental hygienist L. Susan Taichman, MPH, PhD, of the Department of Periodontics and Oral Medicine at the University of Michigan School of Dentistry, led the study using data from 1999 to 2004 in the National Health and Nutrition Examination Survey.

The researchers looked at 4,460 participants from age 15 to 44 who were not pregnant and reported receiving DMPA shots currently, in the past or never.

Approximately 4 percent of the women were currently using Depo Provera and about 12 percent had previously used it.

Each participant’s teeth and gums were examined by a dentist, who looked for bleeding in the gums, measured the spaces between the teeth and gums and noted how much ligament loss the patient had alongside their teeth.

Ligament loss and larger pockets between the teeth and gums, called periodontal pockets, are signs of periodontal disease. Gingivitis is the mildest type of gum disease, but it can cause painful, red and swollen gums that bleed easily.

After adjusting for age, race, education, income level and patients’ smoking status, the researchers found that women currently getting the DMPA shots were 73 percent more likely to have gingivitis.

Those who had previously used DMPA also had a slightly higher incidence of gingivitis, but it was not significant enough for researchers to believe the association posed a risk.

“Hormones can play a role in woman’s periodontal health,” said Dr. Pamela McClain, the president of the American Academy of Periodontology.

She cautioned that women who have received DMPA or any other hormone-based contraceptive shots need to pay special attention to their teeth.

“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,” she said.

In their analysis, the researchers also found that Hispanic and Black women were 30 to 50 percent more likely to have some form of periodontal disease. Women of lower economic levels or who had not visited the dentist within the past two years also had a higher rate of periodontal disease.

The study appeared online February 6 in the Journal of Periodontology. Information regarding funding was not available. The authors reported no conflicts of interest.

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By: Tara Haelle
Reviewed by: Joseph V. Madia, MD