Steroid Abuse Harms Gingival Tissues

Gingival overgrowth is a condition in which the gingival tissues become swollen and grow over the teeth. Overgrown gums make it easier for bacteria found in plaque to accumulate and attack supporting structures of the teeth, potentially leading to severe periodontal infection.

"It was found that AAS abusers had statistically significant levels of gingival enlargement compared to non-users, requiring a gingivectomy for many cases," explains Onur Ozcelik, DDS, PhD, Faculty of Dentistry, Cukurova University, Department of Periodontology, Adana, Turkey. "Although it has been reported that many of the adverse effects of AAS abuse are fully reversible within several months after the cessation of the drug, it is not known if gingival enlargement would also regress after the withdrawal of AAS."

Researcher also found that gingival inflammation was higher in the AAS user group compared to the non-AAS users. "Further studies are required to find out if increased gingival scores in the user group are a direct effect of AAS or if the inflammation is a result of compromised oral hygiene due to gingival enlargement," said Ozcelik.

"It is not surprising that gingival tissue is a target for the actions of steroid hormones," said Kenneth A. Krebs, DMD and AAP president. "Clinical changes in tissues of the periodontium have been identified during periods of hormonal fluctuations such as puberty, the menstrual cycle, pregnancy, menopause, contraceptives and ovulation induction drugs in women."

People taking AAS without medical supervision should be informed of the adverse effects and strongly encouraged to begin a cessation program.

Since periodontal infection may be a risk factor for more serious conditions, such as cardiovascular disease, respiratory disease and pre-term, low birth weight babies it is important for patients to take care of their periodontal health.

Background Information

Researchers examined 24 athletes between the ages of 17 and 29 who had been using AAS for more than one year. All subjects were examined for plaque levels, gingival inflammation and gingival enlargement. The results were then compared with a control group of 20 bodybuilders who had never used AAS drugs and matched for age, educational level and oral habits according to the data obtained from the AAS user group.

The American Academy of Periodontology is an 8,000-member association of dental professionals specializing in the prevention, diagnosis and treatment of diseases affecting the gums and supporting structures of the teeth and in the placement and maintenance of dental implants. Periodontics is one of nine dental specialties recognized by the American Dental Association.