Oral manifestations of the thyroid gland dysfunction

Kimberly Nyathi
COMPLIMENTS of the season.

This week’s article is about the oral manifestations of the dysfunction of the thyroid gland.

The thyroid gland is an endocrine gland found in the front of the neck, below the Adam’s apple.

The thyroid gland secretes thyroid hormones, which influence the metabolism and protein production. The hormones also have many other effects including development.The thyroid also produces the hormone calcitonin, which plays a role in calcium level regulation in the body.

Hormonal output from the thyroid is regulated by thyroid-stimulating hormone (TSH).

The two main thyroid gland dysfunctions are:

(1) Hperthyroidism: Occurs when the gland produces excessive amounts of thyroid hormones.

(2) Hypothyroidism: A state of insufficient thyroid hormone production.

Hyperthyroidism

Main causes are
— Graves disease
— Thyroiditis (inflammation of the thyroid gland)
— non-cancerous growth of the thyroid gland (for example goitre)
Firstly, will be a brief description of only a few of the main general signs and then most of the oral manifestations:
— exopthalmus (abnormal protrusion of the eyeball or eyeballs)
— hair loss
— staring gaze
— trembling hands
— weight loss

Oral manifestations include:
— Many teeth affected by caries or with restoration due to increased tooth decay susceptibility
— accelerated (premature) tooth eruption in children
— osteoporosis of the jaw bones (a condition in which the bones become brittle and fragile from loss of tissue)
— periodontal disease (gum disease: manifested as gum bleeding, tooth mobility, gum swelling, gum bleeding)
— burning sensation in the mouth
— Dry mouth: mouth may feel like it’s full of cotton, making it difficult to swallow or speak.

Hypothyroidism

Main causes are:
— Hashmitos thyroiditis: thyroid inflammation
— surgical removal of a portion or all of the thyroid gland
— Radioiodine damage of the thyroid gland

Firstly, will be a brief description of only a few of the main general signs and then most of the oral manifestations:
— sparse eyebrows
— swelling of face especially around the eyes (oedema)
— slow thinking
— unexplained weight gain
— brittle nails
— hoarseness of the voice

Oral manifestations include:
— tongue wasting: wasting away of the tongue muscle so that it eventually shrivels up and then cannot move.
— enamel hypoplasia: a defect of the teeth in which the enamel is hard but thin and deficient in amount, usually the condition involves part of the tooth having a pit in it.
— anterior open bite: malocclusion without contact in the anterior region of the dental arches.
— micrognathia: a condition in which the jaw is undersized.
— abnormally thick lips.
— Dysgeusia: a condition in which a foul, salty, rancid, or metallic taste sensation will persist in the mouth.
— mouth breathing: is breathing through the mouth rather than the nose.

Role of the Dentist
— A dentist can only treat the oral manifestations of thyroid gland dysfunction. If your dentist suspects that you may have any of the above oral manifestations as result of any type of thyroid gland dysfunction you will be referred to a physician for further evaluation and possible treatment.

Wishing you a Merry Christmas, peace, cheer, joy, laughter and love and a prosperous 2017.

Kimberley Eve Nyathi
Final year BDS student
Lviv National Medical University