Depot medroxyprogesterone acetate use and periodontal health in 15- to 44-year-old US females.
BACKGROUND
It has been suggested that progestins may have an inflammatory component and/or increase in prostaglandin synthesis. Thus, extended progestin use may be associated with higher risk of periodontal diseases. This study investigates the association between depot medroxyprogesterone acetate (DMPA) injectable contraception and the prevalence of periodontal diseases among US premenopausal females.


METHODS
Data for this cross-sectional analysis comes from the 1999 to 2004 National Health and Nutrition Examination Surveys. This analysis includes 4,460 US females (15 to 44 years of age) with complete DMPA usage and periodontal status data.


RESULTS
Current and past DMPA use was 4.1% and 12.0%, respectively. The prevalence of gingivitis was 53.9% for females who reported having used DMPA compared with 46.1% for DMPA never-users. Females taking DMPA were more likely to be young, single, and non-white, have a history of smoking, have lower levels of education and income, and have ≥1 live births and were less likely to visit the dentist. Using logistic regression, DMPA use was associated with an increased risk of gingivitis (odds ratio [OR] =1.7; 95% confidence interval [CI] = 1.09 to 1.67) and periodontitis (DMPA, OR = 1.49; 95% CI = 1.01 to 2.22) after adjusting for age, race, education, poverty income ratio, dental care use, and smoking status. A significant interaction between smoking status and DMPA use was also found (P = 0.029).


CONCLUSIONS
This study suggests that DMPA use may be associated with periodontal diseases. Additional investigation is warranted as a result of the disproportionate usage of DMPA among low-income populations who are at an increased risk for poor dental health.
Department of Periodontics and Oral Medicine, Room 3345, University of Michigan School of Dentistry, 1011 N. University Ave., Ann Arbor, MI 48109-1078, USA. hipolite@umich.edu
L Susan
LS
Taichman
Woosung
W
Sohn
Giselle
G
Kolenic
Maryfran
M
Sowers
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000367:Age Factors; D003271:Contraceptive Agents, Female / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D003692:Delayed-Action Preparations; D003729:Dental Care / Q000706:statistics & numerical data; D004522:Educational Status; D005260:Female; D005884:Gingival Hemorrhage / Q000453:epidemiology; D005891:Gingivitis / Q000453:epidemiology; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D050498:Live Birth / Q000453:epidemiology; D017533:Marital Status; D017258:Medroxyprogesterone Acetate / Q000627:therapeutic use*; D017622:Periodontal Attachment Loss / Q000453:epidemiology; D010510:Periodontal Diseases / Q000453:epidemiology*; D010514:Periodontal Pocket / Q000453:epidemiology; D010518:Periodontitis / Q000453:epidemiology; D017697:Premenopause; D015995:Prevalence; D012847:Single Person / Q000706:statistics & numerical data; D012907:Smoking / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult
D003271:Contraceptive Agents, Female; D003692:Delayed-Action Preparations; D017258:Medroxyprogesterone Acetate