A Guide to Birth Control Side Effects & Your Oral Health

Birth control and oral health are linked through hormone levels.

Hormonal birth control prevents pregnancy by changing the chemical makeup of a woman's body, increasing the levels of estrogen and progesterone in her system. It causes a woman to release fewer eggs during ovulation and makes it more difficult for those eggs to be fertilized and attach themselves to the uterine wall.

Unfortunately, excess estrogen and progesterone can also carry consequences for the health of your teeth, gums and mouth. They increase the sensitivity of your gums by increasing their blood supply and heightening the body’s response to bacteria in the mouth. This makes you significantly more vulnerable to gum disease and other oral health problems.

Side Effects 

Most of birth control's oral health-related side effects are related to gum inflammation. Depending on the level of inflammation present, you might notice any of the following symptoms: 

• Tender, swollen, or bleeding gums
• Bad breath
• Gum recession 
• Loss of gingival attachment (pocketing around the roots of the teeth)
• Bone loss in the jawbone
• Shifting or wobbly teeth

Some studies have shown that women using oral contraceptives experienced a lower salivary flow than women who did not use these medications. Saliva is a key component of sound oral health. It attacks bacteria, the primary cause of cavities and other negative effects on teeth and gums.

Other studies found that women taking oral contraceptives had 16 times more bacteria in their mouths than women who were not taking this type of birth control. 

Women taking oral contraceptives are also more prone to developing a painful condition called dry socket after a tooth extraction. This may be related to the blood clotting issues these medications have been known to cause.

These include:

• Oral contraceptives
• Birth control implants
• Intrauterine devices (IUDs)
• Vaginal rings
• Birth control patches
• Birth control injections

Every other type of birth control has no oral health-related side effects to worry about. These include:

• Barrier-based methods, including condoms, sponges, diaphragms and cervical caps
• Copper IUDs
• Natural rhythm methods (avoiding sexual intercourse during fertile times of the month)

Tubal ligation (commonly known as “getting your tubes tied”) and other forms of sterilization also protect against pregnancy without oral health complications, but they are almost always permanent. That makes them poor options for women who want temporary protection against pregnancy but think they may want to have children in the future.

Other Considerations

There are several other factors that impact a women’s risk of oral health problems while taking hormonal birth control. They include smoking, taking prescription medication and using birth control over a long duration.

Signs of Potential Problems 

If you are beginning to develop oral health problems due to birth control use, you may notice the following symptoms with your gums: 

• Inflammation (swelling and/or redness)
• Bleeding when brushing or flossing
• Tenderness when brushing, flossing, or eating certain foods. This may be worse in some areas than others

The longer you have been using birth control, the worse these issues tend to be. Symptoms can and wane over the course of a person’s life because they’re prompted by the body’s response to the presence of bacteria, not by the birth control itself.

If there are periods in your life where your oral hygiene is particularly good, these symptoms may become more mild and easier to manage.

Prevention 

Because only hormonal contraceptives can harm your oral health, the best way to prevent these problems is to choose a different form of birth control. Any barrier-based birth control (such as condoms or diaphragms) as well as copper IUDs offer similar contraceptive effects without the additional oral health risks.

If you must use hormone-based birth control methods, use them for as short a time as possible. The longer you are exposed to added estrogen and progesterone, the higher your risk of oral health-related side effects.

If you take oral contraceptives, use as low a dose as possible. Although higher doses are more effective at preventing pregnancy, they are also associated with a greater risk of periodontal problems.

You can ask your doctor about the effects of switching to a lower dose to help you decide which level of risk you are comfortable with. Your doctor can also help you determine whether combining birth control methods might help you improve your level of protection against pregnancy without putting your oral health at greater risk.

Finally, see your dentist regularly while you are on hormonal birth control. They can help you track any changes in your oral health and assess and treat any problems they find. Treating periodontal issues early can reverse the disease before the damage becomes permanent.

Tips to Keeping Up Oral Health Habits 

There are many oral health habits you can work on to help minimize your risk of gum disease while on hormonal birth control.

• Brush your teeth for at least two minutes at least twice a day. Make sure one of these brushing sessions happens right before you go to bed to minimize bacteria growth in your mouth overnight.
• Floss your teeth at least once each day. This removes the bacteria that may collect under your gumline or between your teeth.
• Do not smoke. Smoking significantly increases your risk of gum disease.
• If you take any medications that cause dry mouth, ask your doctor about switching to an alternative that does not. If that isn't an option, sip water and chew sugarless gum throughout the day to maintain adequate saliva in your mouth.
• See your dentist for a checkup at least once a year (preferably every six months).

References 

Effects of smoking and vaping on oral health. (April 2021). BetterHealth Channel.

Gingivitis. (August 2017). Mayo Clinic.

Oral contraceptives alter oral health. (May 2010). Annals of Saudi Medicine.

What Can Adults Do to Maintain Good Oral Health? (November 2021). Centers for Disease Control and Prevention.

Oral Health and Oral Contraceptive - Is it a Shadow behind Broad Day Light? A Systematic Review. (November 2016). Journal of Clinical and Diagnostic Research.

Impact of oral contraceptives on periodontal health. (March 2019). African Health Sciences.

Dental Hygiene Facts: Women and Oral Health. (2021). Ontario Dental Hygienists’ Association.

Hormones and Dental Health: What Every Woman Needs to Know. (2021). MouthHealthy.

Birth control methods. (February 2019). US Department of Health & Human Services: Office on Women’s Health.