Have you ever wondered why dental professionals ask about Thyroid Disease on their medical history forms? Your Thyroid is part of your endocrine system. When it is not working properly it can cause an imbalance in your body, effecting your oral cavity.
Thyroid disfunction is a glandular disorder of the endocrine system and it’s most common in women. When you have Thyroid disease, it can lead to an imbalance in the homeostasis of the body, affecting the healing capacity of tissues (1). There are two types of Thyroid disfunction; Hypothyroidism and Hyperthyroidism.
Hypothyroidism is when you have a decrease in gland function resulting in insufficient hormone production. When it comes to dental procedures, patients who have hypothyroidism lack homeostasis, putting them at a greater risk for infection due to a decrease in metabolic activity in fibroblasts (2). Oral signs and symptoms that correlate with Hypothyroidism are; Salivary gland enlargement, glossitis (painful burning of tongue), lack of taste, macroglossitis (enlarged tongue), compromised periodontium, delayed dental eruption, anterior open bite, thick lips, mouth breathing, and xerostomia (dry mouth).
Hyperthyroidism is when a person has unregulated production of thyroid hormones, causing an increase in thyroid hormones. This can be identified by tremors, intolerance to heat, hypertension, increased appetite, weight loss and sinus tachycardia. Changes in your thyroid hormones can affect your blood pressure and pulse which can increase your bleeding during dental procedures. You can also be more sensitive to epinephrine which is commonly found in local anesthesia. Oral signs and symptoms include; increased caries risk, burning mouth syndrome, accelerated dental eruption, maxillary and mandibular osteoporosis, increased risk of periodontal disease, and enlargement of thyroid tissues. Knowing the oral signs and symptoms of both types of Thyroid disease is important for patients, as well as dental professionals. Our goal as dental professionals is to provide our patients with the finest care. Part of that is knowing oral side effects of systemic health concerns and medications. This knowledge allows us to be able to provide clinical suggestions on homecare products that best suit you as well as dental treatment that may be needed to keep your oral cavity healthy.
This blog focuses on Thyroid disease and its relationship with your oral health. As I have mentioned in many of my blogs, periodontal disease is an inflammatory process that effects systemic health. I feel there is a relationship between thyroid hormone imbalance and periodontal health. It’s important to remember that in addition to dental concerns, Thyroid disease can be something small that does not need treatment or it can also be life-threatening. As part of our dental exams, we always perform an intra- oral and extra-oral exam during which we are checking your Thyroid gland for any abnormalities. As dental professionals we tend to ask questions and encourage discussion about Thyroid disease so we can make sure we are providing comprehensive oral care to all our patients. Be sure to discuss any questions or concerns with your dentists in addition to your primary care physician.
(1) Kothiwale S, Panjwani V. Impact of thyroid hormone dysfunction on periodontal disease. J Sci Soc 2016;43:34-7.
(2) Raymon-Allbritten J. How dental hygienists can help patients with thyroid disease. RDH magazine; January 2019, Volume 39, No.1 Page 37-40