Thyroid Deseases:

This is a butterfly shaped organ located below the thyroid cartilage prominent(Adam's apple).

Thyroid Gland uses iodine from food to make T3(triiodothyronine) and T4(thyroxine) hormones.

The production of T3 and T4 is regulated by Hypothalamus together with pituitary Gland. Hypothalamus will release Thyrotropin-releasing hormone (TRH) which stumulate pituitary to release thyroid stimulating hormone (TSH) which in turn as the name says stumulate the production of T3 and T4.

Thyroid Gland functions as a regulator of Breathing, Heart rate,
Central and peripheral nervous systems, Body weight, Muscle
strength, Menstrual cycles, Body temperature, Cholesterol levels, metabolism

When there is high levels of T3 and T4 it is called hyperthyroidism and when levels are low hypothyroidism.

Hypothyroidism: is caused by thyroiditis,
radioactive iodine,
lithium(anti-depressant drug), imiodarone(antiarrhythmic drug) and surgery.

hyperthyroidism: is caused by unregulated
production of thyroid hormones.

Change in functions due to low and high levels of T3 and T4:

Functions	Low T3 and T4(Hypothyroidism)	High T3 and T4(hyperthyroidism)
Breathing	low respiratory rate	High respiratory rate
Heart rate	low heart rate(bradycardia)	high heart rate(tachycardia)
Body weight	weight gain	weight loss
Muscle strength	Joint and muscle pain	Hand trembling
Menstrual cycles	Frequent, heavy menstrual periods	Missed or light menstrual periods
Body temperature	cold(shivering)	Sweating
Cholesterol levels	Higher to normal cholesterol	lower to normal cholesterol
Central and peripheral nervous systems	Trouble sleeping, Tiredness and fatigue, Difficulty concentrating	Anxiety, moodiness, Nervousness, hyperactivity
Metabolism	low metabolic rate(constipation due to low Peristalsis{bowel movements})	high metabolic rate(diarrhea due to high Peristalsis)

⚠ If you're using a phone and you're unable to see very well the right side of the table,

rotate the Screen.

Oral health concerns

🚩 Cretinism: This is a congenital hypothyroidism. And it will affect the oral health as follows:

Wikimedia commons

📌Thick lips

📌Macroglossia(large tongue).

📌Decreased ability of small blood vessels to constrict.
The above are caused by high accumulation of subcutaneous glucosaminoglycans due to it's decreased degradation(metabolism).

📌Malocclusion.

📌Delayed tooth eruption.

📌Lower 2nd molars
impaction: caused by ramus growth and
failure of it's internal aspect
resorption which leads to an insufficient space to accommodate molars.

📌Metallic taste(altered sense of taste and feel like tasting metal spoons).

⚠ Please when your child present the above symptoms and signs visit your physician, and together with a dentist they will give early treatment. Early detection of cretinism increases it's chance to be treated.

For patient with Hyperthyroidism, may have following oral manifestations :

📌Increased rate of
caries and periodontal diseases.

📌Accelerated dental
eruption.

📌Burning mouth syndrome.

📌Sjogren's syndrome(dry mouth).

🚩🚩🚩🚨 Dentist should know this:

hypothyroidism:

🚨 Should always get etiology, medical complications and therapy.

🚨 X-ray: when taking x-ray patient have to wear thyroid colar.

🚨Decreased ability of small blood vessels to constrict: so when you cut or injure one be aware of delayed haemostasis, you may even need coagulants.

On hyperthyroidism:

🚨Be aware of Increase anxiety.

🚨⚠Epinephrine is contraindicated as hyperthyroidic patient has increased heart rate, high blood pressure so Epinephrine will boost those effects. For anaesthesia choose solutions that doesn't contain Epinephrine.

🚨 For patients on ß blockers NSAIDs increase efficiency of ß blockers, so prescribe Analgesics
Other than NSAIDs
🚨 Analgesics containing acetylsalicyclic acid(ASA) are contraindicated.

🚨 Propylthiouracil(PTU) : that is used to treat hyperthyroidism has an Anti vitamin K properties hence hypoprothrombinemia which may lead prolonged bleeding in case surgical treatments.

To conclude, oral cavity is an entrance of food but also some systemic deseases be aware of oral manifestations of systemic deseases.

If this is not your cercle of competence and you wish to comment just for anything unusual in your mouth visit your dentist and always brush as it is recommended by your dentist if you don't know the best way to brush Click here. To make it easy be the best patient who will visit a physician as early as he or she detect unusual things inside or outside the body. Will you be that patient?

References:

1.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3169868/

2.https://www.endocrineweb.com/conditions/thyroid-nodules/thyroid-gland-controls-bodys-metabolism-how-it-works-symptoms-hyperthyroi

3.http://www.yourhormones.info/glands/pituitary-gland/

4.https://www.healthline.com/health/thyroid-storm

5.https://www.healthline.com/health/thyroid-issues-and-cholesterol#thyroid-and-cholesterol

Thank you!

By Jado

@bmotives

SHALLOM!