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Oral manifestation of hypothyroidism and hyperthyroidism

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ledraman ledraman

on 15 May 2014

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Transcript of Oral manifestation of hypothyroidism and hyperthyroidism

Oral manifestation
of hypothyroidism
and hyperthyroidism

HYPOTHYROIDISM
Hypothyroidism is defined
by a decrease in thyroid
hormone production and
thyroid gland function.

Etiology
Chronic thyroiditis (Hashimoto′s disease),
Radioactive iodine
Surgery and pharmacological agents such as Lithium and Amiodarone.
General Symptoms
Slower metabolic rate.
Weight gain.
Lethargy.
Intolerance to cold.
Dry and cool skin, and puffiness of the face and eyelids.

Presented By
LINDA JENHANI

Oral Manifestations Of Hypothyroidism
Impaction of the mandibular second molars
Anterior Open bite
Delayed eruption of teeth.
Micrognathia
Mouth breathing

Hemostasis - The presence of excess subcutaneous mucopolysaccharides may decrease the ability of small blood vessels to constrict when cut and may result in increased bleeding from infiltrated tissues. Local pressure for an extended time will probably control the bleeding from the small vessels.

Susceptibility to infection - Patient with hypothyroidism may have delayed wound healing due to decreased metabolic activity in fibroblasts.



Often referred to as an overactive thyroid, is a condition in which the thyroid gland produces and secretes excessive amounts of T3 and T4

Impaction of the mandibular second molars and diastema

Micrognathia


Enamel Hypoplasia in both dentition



Large protruding tongue (macroglossia)

Dental Management of Hypothyroidism
Hemostasis - The presence of excess subcutaneous mucopolysaccharides may decrease the ability of small blood vessels to constrict when cut and may result in increased bleeding from infiltrated tissues. Local pressure for an extended time will probably control the bleeding from the small vessels.

Susceptibility to infection - Patient with hypothyroidism may have delayed wound healing due to decreased metabolic activity in fibroblasts.

HYPERTHYROIDISM
Often referred to as an overactive thyroid, is a condition in which the thyroid gland produces and secretes excessive amounts of T3 and T4

Tremor
Emotional instability
Intolerance to heat
Sinus tachycardia
Hypertension
Increased appetite
Weight loss
Exophthalmus

General Symptoms
Oral Manifestations Of Hypothyroidism
Increased susceptibility to caries
Burning mouth syndrom
Accelerated dental eruption
Sjogren’s syndrome, that causes dry mouth

Hemostasis
- Patients with hyperthyroidism may have elevated blood pressure. Patients with high arteriolar pressures may require increased attention and a longer duration of local pressure to stop bleeding.
Anti-thyroid drugs namely propylthiouracil (PTU) has anti-vitamin K activity and can cause hypoprothrombinemia and bleeding that poses a risk for hemorrhage.

Drug actions and interactions - Combination analgesics containing acetylsalicylic acid (ASA) are contraindicated in patient with hyperthyroidism because ASA interferes with the protein binding of T 4 and T 3, thereby increasing their free form.

Fluoride was used as a drug to treat hyperthyroidism because it reduces thyroid activity quite effectively. This is due to the ability of fluoride to mimic the action of (TSH). Patient who wish to avoid the effect of fluoride on their thyroid can utilize fluoride free toothpaste

Dysgeusia
Thick lips
Anterior Open bite and Mouth breathing
Delayed eruption of teeth

Periodontal disease

Jaw osteoporosis

Dental Management of Hyperthyroidism
Full transcript