Oral contraceptive use is linked to increased gingival inflammation due to an increase in the concentration of sex hormones in the gingival tissues. Newer formulations of oral contraceptives contain lower levels of hormones; however the number of years taking the drug may influence gingival conditions. There were 21 smokers in the oral contraceptives group and 20 smokers in the control group. The incidence of moderate to severe periodontitis was nearly twice as high in those taking oral contraceptives and smoking compared to controls who smoked. Those taking oral contraceptives more than three years also had a higher prevalence of moderate to severe periodontitis. Clinical Implications: Women taking oral contraceptives and smoking are at greater risk of periodontal disease and should be advised to pay careful attention to their daily oral hygiene.