Any suspicion of thyroid disease in an undiagnosed case must accompany the postponement of every invasive dental treatment until a comprehensive medical assessment is completed. In case of controlled hypothyroidism, minor restorative dental procedures such as cavity filling may be carried out.
Prior to dental procedures, certain considerations should be evaluated. Patients with hypothyroidism may have lack of hemostasis and are at increased risk for infection due to decreased metabolic activity in fibroblasts. The possibility of delayed healing time is important to consider to prevent infection.
Oral manifestations of hypothyroidism
The common oral findings in hypothyroidism include the characteristic macroglossia, dysgeusia, delayed eruption, poor periodontal health, altered tooth morphology and delayed wound healing.
Treatment for hypothyroidism usually includes taking the thyroid hormone medicine levothyroxine (Levo-T, Synthroid, others) every day. This medicine is taken by mouth. It returns hormone levels to a healthy range, eliminating symptoms of hypothyroidism.
If a patient with a thyroid condition loses consciousness during dental treatment, the treatment should be discontinued immediately and emergency treatment performed. Patients should be placed supine with the legs raised and the airway secured. Ventilation and circulation should be assessed.
Any suspicion of thyroid disease in an undiagnosed case must accompany the postponement of every invasive dental treatment until a comprehensive medical assessment is completed. In case of controlled hypothyroidism, minor restorative dental procedures such as cavity filling may be carried out.
Treatment / Management
Typically, propranolol 40 mg to 80 mg is given every 4 to 6 hours. Then, either a loading dose of propylthiouracil (PTU) 500 mg to 1000 mg followed by 250 mg every 4 hours or Methimazole (MMI) 20 mg every 4 to 6 hours should be given.
An underactive thyroid (hypothyroidism) is usually treated by taking daily hormone replacement tablets called levothyroxine.
General symptoms — Thyroid hormone normally stimulates the metabolism, and most of the symptoms of hypothyroidism reflect slowing of metabolic processes. General symptoms may include fatigue, sluggishness, slight weight gain, and intolerance of cold temperatures. Skin — Hypothyroidism can decrease sweating.
If you aren't treated, your doctor should continue to monitor your thyroid function with blood tests every six to 12 months. If your TSH level is higher than 10 mIU/L, you should start treatment, because you will very likely develop symptoms of an underactive thyroid, even if you don't have them now.
Hypothyroidism is a condition in which the thyroid gland is underactive. In addition to other autoimmune concerns, hypothyroidism can cause patients to experience macroglossia (enlargement of the tongue), gum disease, slow healing of mouth sores, and, in children, delayed tooth growth.
But what if that tongue has wavy edges that look like the edges of a pie crust? You could have a condition known as scalloped tongue. It's a known sign of hypothyroidism and other underlying health conditions. Ahead, we'll look at the ins and outs of scalloped tongue and the connection to hypothyroidism.
We recommend choosing a toothpaste with nano-hydroxyapatite, as it is the only scientifically proven fluoride comparable that can improve the oral representation of hypothyroidism.
Dental implications of untreated or suboptimally treated hypothyroidism. Decreased vertical facial growth. Decreased cranial base length and flexure, maxillary protrusion, and open bite with typical immature facial patterns. Delayed eruption of teeth and increased spacing between both primary and permanent teeth.
It was found that fluoride has impacts on TSH, T3 hormones even in the standard concentration of less than 0.5 mg/L. Application of standard household water purification devices was recommended for hypothyroidism.
Patients with hyperthyroidism can have elevated blood pressure and pulse. It is dangerous to perform dental procedures on patients with elevated blood pressure. Regular communication between the dentist and patients' physician is important in helping the patients to maintain and control the thyroid disease.
Clinical manifestations of hypothyroidism range from life threatening to no signs or symptoms. The most common symptoms in adults are fatigue, lethargy, cold intolerance, weight gain, constipation, change in voice, and dry skin, but clinical presentation can differ with age and sex, among other factors.
Hypothyroidism can lead to a higher risk of heart disease and heart failure. That's mainly because people with an underactive thyroid tend to develop high levels of low-density lipoprotein (LDL) cholesterol — the "bad" cholesterol.
Hypothyroidism can affect the heart and circulatory system in several ways. Lower production of thyroid hormone slows your heart rate. Hypothyroidism also makes the arteries less elastic, and blood pressure rises in order to circulate blood around the body.
Myxedema crisis (also called myxedema coma), the most severe form of hypothyroidism, is rare. It occurs when thyroid hormone levels get very, very low.
Fatty foods – Fats are known to upset your body's ability to absorb thyroid replacement hormones. Fats can also prevent the thyroid's natural ability to produce hormones. Physicians recommend that you cut out all fried foods and limit your intake of fats from butter, mayonnaise and fatty meats.
Signs and symptoms of hypothyroidism can show up in the hands and nails. Hypothyroidism can cause dermatologic findings such as nail infection, vertical white ridges on the nails, nail splitting, brittle nails, slow nail growth, and nails lifting up.
People with hypothyroidism may also have headaches, including pulsing pain, on both sides of the head. In most cases, the headaches subside after the person receives effective treatment for hypothyroidism. either or both of the following: significant, simultaneous worsening of the headaches and hypothyroidism.
A more recent study of civilian (non-military) women also reported that those with PTSD have a greater risk of developing an underactive thyroid. The study found, however, that PTSD does not increase the risk of developing Graves' disease, the autoimmune thyroid condition that causes hyperthyroidism.