The most common cause is Graves’ disease, although toxic multinodular goiter and thyroid adenomas can also contribute.
While it is primarily a systemic condition, its oral manifestations and implications for dental treatment are important for all dental professionals to understand.
Identifying oral signs that may indicate thyroid dysfunction and adapting dental care accordingly can help avoid serious complications.
Oral Manifestations of Hyperthyroidism
Patients with hyperthyroidism may exhibit various oral signs and symptoms, such as:
✔ Increased risk of dental caries and periodontal disease due to heightened metabolic activity and oxidative stress.
✔ Mandibular and maxillary osteoporosis, often seen radiographically as reduced bone density.
✔ Tremors of the tongue and lips resulting from neuromuscular hyperactivity.
✔ Accelerated dental eruption in children with juvenile hyperthyroidism.
Increased pain sensitivity, complicating dental procedures.
✔ Xerostomia and altered salivary flow rates.
A visible goiter may also be present, potentially complicating airway management during procedures requiring general anesthesia.
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Key Considerations for Dental Management
Dentists should be well-prepared to treat patients with hyperthyroidism. Below are essential clinical recommendations:
1. Thorough Medical History
Confirm diagnosis, type of treatment (antithyroid drugs, radioactive iodine, or thyroidectomy), current disease control status, and any comorbid conditions like hypertension or arrhythmias.
2. Stress Reduction
Stress may precipitate a thyroid storm. Short, relaxed appointments and stress-reduction techniques are highly recommended.
3. Use of Vasoconstrictors
Use epinephrine with caution. High doses may trigger tachycardia or thyroid storm. In poorly controlled patients, anesthetics without vasoconstrictors are safer.
4. Cardiovascular Monitoring
Hyperthyroid patients often have arrhythmias or elevated blood pressure. Monitoring vital signs is critical, especially during surgical or invasive procedures.
5. Surgical Care
For extractions or periodontal surgery, anticipate delayed healing and higher bleeding risk. It’s advisable to consult the endocrinologist to ensure the patient is euthyroid prior to surgery.
6. Drug Interactions
Avoid medications that stimulate the sympathetic nervous system (e.g., epinephrine in gingival retraction cords or certain decongestants). Be cautious when prescribing antibiotics or analgesics that might interact with antithyroid medications.
Conclusion
Hyperthyroidism significantly impacts oral health and dental treatment planning.
Awareness of its manifestations and tailored management strategies ensure safe and effective dental care.
Close communication with the patient’s medical team is essential, particularly in uncontrolled or medically complex cases.
📚 Scientific Reference
- Journal of Research in Medical and Dental Science 2022, Volume 10, Issue 9, Page No: 012-016. Oral Manifestations of Thyroid Disorders. Aparna Achanta, Suwarna Dangore Khasbage
