Management of a case of generalized severe chronic periodontitis with pyogenic granuloma associated with the use of combined oral contraceptive pill: a case report

Combined oral contraceptive pill (COCP) is a birth control measure that reversibly inhibit female fertility and it includes a combination of estrogen and progesterone. Non contraceptive uses of COCP include amenorrhoea, menorrhagia, dysmenorrhoea, PCOS. Pyogenic granuloma is a reactive tumour like lesion which arises in response to various stimuli such as low grade local irritation, traumatic injury, hormonal factors or certain kind of drugs like oral contraceptive pills. A 32 year old woman with complaints of bleeding gums and pain while eating was on COCP for dysmenorrhoea and menorrhagia. The gingival inflammation as an exaggerated response to plaque due to the use of hormones further lead to inadequate maintenance of oral hygiene which further detoriated the periodontal status and association of pyogenic granuloma wrt 47. Patient was treated by discontinuation of COCP after consultation of gynaecologist which lead to visible minimisation of the gingival growth. Pyogenic granuloma was surgically excised and periodontal therapy completed subsequently.