Dental Management Endocrine Flashcards
(22 cards)
What are concerns with Hyperthyroidism?
- Adverse interaction with epi
- Life threatening arrhythmias
- Congestive heart failure
- Hypertension, angina, MI
- Thyrotoxic crisis precipitated by infection, surgery
Dental management of untreated/poor controlled hyperthyroidism
Treat infection- ABX
- Avoid surgery, epi
- Monitor BP
- Refer to physician and med consult
What are signs and symptoms of thyroid storm?
- Restlessness
- Very high fever
- Severe tachycardia
- pulmonary edema
- Tremor, sweating, stupor
- Coma and death
What do you do in a thyrotoxic crisis?
- Seek medical assistance
- Monitor vitals
- Ice packs
- CPR as needed
Dental management for well controlled hyperthyroidism
- Tx acute and chronic infections
- Use ASA and NSAIDs appropriately
- Routine dental care
PTU and methimazole may increase infection risk
What are oral manifestations of hyperthyroidism?
- Osteoporosis
- periodontal disease
- Caries
- Premature loss of deciduous teeth with early eruption of permanent teeth
- Early jaw dev
Dental management of untreated hypothyroidism
- Avoid surgery
- Tx infection aggressively
- Avoid CNS depressants, sedatives if severe
- Myxedematous coma may be precipitated by surgery, infection, CNS depressants
What are signs and symptoms of myxedamatous coma?
- Hypothermia
- Severe bradycardia
- Severe hypotension
- Epileptic seizures
Dental care for well controlled hypothyroidism
Avoid infection
Routine care ok
What are signs and symptoms of congenital hypothyroidism?
- Thick lips
- Enlarged tongue
- Delayed eruption fo teeth
- Malocclusion
- Hoarse cry
What are oral manifestations of hypothyroidism in adults?
- Enlarged tongue
- Hoarse speech
- Puffy face
- Dry skin
- Coarse hair
What are signs and symptoms of adrenal insufficiency?
Weakness, fatigue, anorexia, nausea, vomiting, abdominal pain, muscle and joint pain, amenorrhea
Pt has Addisons disease, do you supplement for routine dentistry?
No
Pt has addisons, do you supplement for minor surgery?
Yes, 25mg hydrocortisone
Dental management of secondary or tertiary adrenal insufficiency during routine care or minor-major surgery
- Pt takes their usual dose
- Morning appointments after their dose
- Stress reduction- N2O, benzo
- Monitor BP
- Obtain good local anesthesia and post op pain
What are oral manifestations of addisons?
- Abnormal pigmentation
- Delayed healign
- Infection
What does HbA1c assay measure?
Nonenzymatic glycosylation of hemoglobin- irreversible
In health, patients should have A1C levels less than
5.7%
What are signs/symptoms of Mild stage insulin shock?
- Hunger
- Weakness
- tachycardia
- pallor
- Sweating, skin wet and cold
- Paresthesias occasionally
Signs and symptoms of moderate stage insulin shock
-Incoherence
- Uncooperative
- Belligerence
- Lack of judgement
- Poor orientation
Signs and symptoms of severe stage insulin shock
- Unconsciousness
- Tonic/clonic movements
- Hypotension
- sdhypothermia
- Rapidly thready pulse
What are some drugs that can cause hyperglycemia?
- Corticosteroids
- Sympathomimetics such as phenylephrine, pseudoephedrine, albuterol, epi
