Influence of hormonal contraceptives on microbial flora of gingival sulcus.

ABSTRACT

PIP: Several studies have suggested an association between sex hormones and chronic inflammatory periodontal disease. This study investigated the impact of two oral contraceptives (OCs) on bacterial microflora of gingival sulcus samples obtained from 29 women 20-32 years of age recruited from Jena (Germany) University Women's Hospital. Study participants were randomly assigned to receive an OC containing either 0.02 mg of ethinyl estradiol and 0.15 mg of desogestrel (n = 14) or 0.03 mg of ethinyl estradiol and 2.00 mg of dienogest (n = 15). Subgingival plaque samples were obtained before and 10 and 20 days after the initiation of OC use. No changes in clinical parameters of the upper incisors (i.e., bleeding on probing, pocket depth, plaque) occurred in either study group during 21 days of OC use. Although Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans were not detected, 22 plaque samples showed evidence of the periodontopathogenic bacteria Prevotella intermedia. The mean cultivable content of this microorganism increased significantly in users of the OC containing desogestrel from 1.2% at day 10 of OC use to 10.0% at day 20, but decreased slightly in women assigned to the OC containing dienogest and a higher dose of ethinyl estradiol. Good oral hygiene is essential in pregnancy and during OC use to compensate for hormonal influences and prevent gingivitis.