17. Hypothyroidism. Hyperthyroidism. Dental management of the patients. Flashcards
1
Q
Hyperthroidism
A
*Caused by diffuse thyroid enlargement
* Hypersecreting nodule
* Adenoma in gland
* Autoimmune thyroiditis
2
Q
Symtoms of hyperthyroidism
A
- Irritability, anxiety, insomnia, agitation
- Tremor
- Sweating and high temperature
- Loss of weight
- Tachycardia
- Diarrhoea
- Cardiovascular disease, particularly in untreated
hyperthyroidism in older patients
3
Q
Treatment of hyperthyroidism
A
- Carbimazole
- Iodine
- Surgical removal of part of gland
- Beta blockers
4
Q
Dental management of hyperthyroid patients
A
- If clinical signs are seen but the patient is not under
treatment, refer to a physician - Control of nervousness and excitability
- Thiouracil drug treatment may cause salivary gland
swelling and stones - Iodine containing agents such as radiographic contrast
for sialograms or povidone iodine may disturb thyroid
function - Avoid general anaesthesia in patients with
longstanding thyrotoxicosis, particularly older patient
5
Q
Hypothyroidism
A
- Cretinism
- Deficient thyroid activity
- Iodine deficiency or thyroid developmental issues
- Hashimoto autoimmune thyroiditis in adults
6
Q
Clinical features of hypothyroidism
A
- Skeletal development and dental eruption greatly
delayed - Impaired mental development
- Broad, flat face
- Overlarge, protrusive tongue
- Short stocky build
- Sensitivity to cold
- Bradycardia and hypotension
7
Q
Dental management of hypothyroidism
A
- Avoid sedatives including diazepam, opioid analgesics
and general anaesthetics because of the risk of
myxoedemic coma - Anaemia or ischaemic heart disease may require
modification of dental treatment - Local anaesthesia always preferable
- Nitrous oxide/oxygen sedation acceptable
- Iodine containing agents such as radiographic contrast
for sialograms or povidone iodine may disturb thyroid
function - Sjögren’s syndrome occasionally associated with
autoimmune thyroiditis
