Steroid-Abusing Athletes Risk Serious Gum Disease

ADANA, Turkey, July 7 - Illicit anabolic steroids may pump up athletes' gums as well as their muscles, according to periodontists here.

The overgrown gums make it easier for bacteria in plaque to accumulate, placing steroid users at risk for severe gum infection, said Onur Ozcelik, D.D.S., Ph.D., and colleagues of Cukurova University here in the July issue of the Journal of Periodontology.

The gingiva is affected by sex hormones, and clinical changes in periodontal tissue have been observed during puberty, pregnancy, menopause, and with the use of oral contraceptives, Dr. Ozcelik and colleagues said. "However, to the best of our knowledge, no clinical research has been performed about the effects of anabolic androgenic steroid abuse on gingival tissues."

Previous studies have indicated that 4% to 6% of American young adult athletes have tried steroids, they said. Few male bodybuilders, they added, go without steroids.

The current study compared the gums of 24 body builders who had been using anabolic steroids for less than one year with 20 body builders who had never used steroids. All participants were between the ages of 17 and 29. Gum thickness, encroachment of gum tissue onto teeth, and other measurements were rated on a scale from 0 (normal) to 3 (worst).

Compared with their steroid-free counterparts, the steroid users were found to have:

• significantly thicker gums (an average score of 1 versus 0.3; P<.001).
• more gingival encroachment onto teeth (an average score of 0.9 versus 0.2; P<.001).
• more overall gingival enlargement (average score 0.9 versus 0.3; P<.001).

However, the steroid users were not found to have significantly more plaque underneath their gums (a score of 1.1 versus 1.0; P=.18), the researchers reported.

"Although it has been reported that many of the adverse effects of anabolic androgenic steroid abuse are fully reversible within several months after the cessation of the drug, it is not known if the gingival enlargement would also regress after the withdrawal of anabolic androgenic steroids," the investigators said.

Steroid abuse is also associated with psychiatric and behavioral problems-such as depression, mania, psychosis, and aggression-which may increase one's risk for periodontal disease, they said.

"Because the non-medical use of anabolic androgenic steroid remains prevalent and seems to increase despite legislation, dentists and periodontists should be familiar with the adverse effects of these synthetic derivatives of testosterone on the gingival tissues," they concluded.