First pill may have caused dental woes

I always read your column and was particularly interested in your article about dental problems caused by medication. I was one of the early users of the contraceptive pill and used it for 15 years from about 1968. I used to have strong, healthy teeth. In the 70s I began to suffer severe problems with my teeth and gums, resulting in much painful treatment and with ugly results. My teeth have been poor ever since, even though I stopped taking the pill in 1983. I have often wondered whether the pill was the cause of this dental deterioration, even though that has never been suggested by anything I have since read. What do you think?
- H.M.
My general rule of thumb on medicines is that you don't want to be an "early adopter". Whether we're talking mobile phones or medicines, it takes a couple of years to work out the bugs.
In the case of those first oral contraceptive pills, no one knew what dose of oestrogen was ideal. It turns out it was three times higher than what we use today. The older pills, with their higher oestrogen levels, caused more blood clots and strokes than today's pills.
Another curious side-effect of the old pill was gingival hyperplasia, which I suspect you suffered. The oestrogens in those pills caused overgrowth of gum tissues, leading to gingivitis, tooth decay and ultimately, tooth loss.
Dentists can pare down the diseased gums, cutting down to healthy tissue, but the real solution was stopping the hormones, which usually fixes the problem.
But though gingival hyperplasia is reversible, dental damage is not, as you discovered. Nowadays, with low dose pills, gingival hyperplasia is virtually unheard of. The pill is the safest it's ever been, but like everything else in life and medicine, it's not completely without risk. Then again, neither is pregnancy.
Gary Payinda MD is an emergency medicine consultant in Whangarei.
Have a science, health topic or question you'd like addressed? Email: drpayinda@gmail.com
(This column provides general information and is not a substitute for the medical advice of your personal doctor.)