3BDS: Endocrinology 2 0.0 / 5 ? Dentistrythyroid diseaseUniversityAll boards Created by: DianaIspasCreated on: 10-12-20 15:24 what do the thyroid hormones do stimulate an increase or decrease in the metabolic rate of many tissues 1 of 14 what is too little and too much thyroid hormone called hypo and hyperthyroidism 2 of 14 what are the thyroid investigations Blood tests: TSH, T3, T4, autoantibodies Imaging- USS, nuclear medicine 3 of 14 what is hypothyroidism caused by autoimmune disease with thyroid auto-antibodies (-Atrophic thyroiditis - Hashimotos thyroiditis) 4 of 14 what are the less common causes of hypothyroidism congenital hypothyroidism iodine deficiency drug side effect (lithium, amiodarone) hypopituitarism after DXT infiltration by tumour 5 of 14 hypothyroidism features goitre, cold intolerance, weight gain, tiredness, hairless, dry thin hair/skin/flaky, constipation, nausea, prolonged menstruation, bradycardia, anxiety, irritability, insomnia 6 of 14 Hypothyroid oro-facial presentation • Goitre in neck • Macroglossia • Thinning hair • Loss of eyebrows • Peri-orbital oedema • Puffy skin 7 of 14 Treatment of hypothyroidism - Replace thyroid hormone with thyroxine (T4) - Lifelong therapy - Adequacy of replacement checked with thyroid functions tests (TSH) and patient reported response to therapy 8 of 14 what is the dental aspect for someone with hypothyroidism Care with sedation if clinically hypothyroid 9 of 14 what causes hyperthyroidism Graves disease: commonest cause: autoimmune disease Toxic thyroid nodule Toxic multinodular goitre Acute thyroiditis Drugs: amiodarone 10 of 14 hyperthyroidism features weight loss, tremor, heat intolerance , tachycardia/ AF, goitre, finger clubbing, 11 of 14 Hyperthyroidism orofacial presentations: Graves eye disease Facial flushing Goitre or neck lump Tremor or hands 12 of 14 Treatment of hyperthyroidism Suppress thyroid hormone secretion - Carbimazole, propylthiouracil - B blockers to reduce symptoms initially Radioactive iodine 131 Surgery (less common) 13 of 14 what are the dental aspects in someone with hyperthyroism Uncontrolled hyperthyroidism is a contraindication to the use of adrenaline in LA Carbimazole and propylthiouracil can cause taste disturbance 14 of 14
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