The impact of oral contraceptives on women's periodontal health and the subgingival occurrence of aggressive periodontopathogens and Candida species.

Background: The purpose of this study is to evaluate the influence of oral contraceptive (OC) use on the subgingival occurrence of specific periodontopathogens and the host's periodontal status.

Methods: Ninety-two females aged 19 to 40 years were included in the study. They were divided into two groups, OC users and non-users, and subgrouped according to the most severe periodontal condition and duration of OC usage. A pooled subgingival sample from each subject was cultured to investigate the presence of Candida species, Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans), and Prevotella intermedia.

Results: OC users, particularly smokers, show a statistically significant increase in the prevalence of severe periodontitis. OC users had deeper probing depths (>or=5 mm) than non-users. Moreover, OC users had higher gingival index scores and clinical attachment loss, >or=2 and >or=5 mm, respectively, than non-users (P <0.01). Patients taking OCs had significantly higher numbers of cultures positive for Candida. Seven Candida species were isolated. Subgingival Candida was associated with P. gingivalis and P. intermedia in 82.9% and 85.4%, respectively, in patients taking OCs. A. actinomycetemcomitans was isolated in patients with moderate and severe periodontitis and was associated with subgingival P. gingivalis, P. intermedia, and Candida.

Conclusions: OC use may increase the risk of severe periodontitis and seems to cause a selection of certain Candida species in periodontal pockets. OC users showed a higher prevalence of P. gingivalis, P. intermedia, and A. actinomycetemcomitans compared to non-users. C. albicans, C. parapsilosis, C. krusei, C. tropicalis, and C. glabrata were the species with the ability to survive in the conditions created by the sex hormones after 3 years.