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Hypothyroid
Risks to the dental patient
Management During Treatment
Questions to Ask
Clinical Findings
References
Dental Management of the Medically Compromised Patient. Little, Falace, Miller and Rhodus. 8th Edition
Medical Consultation Recommended
Introduction
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Associated with insufficient circulating thyroid hormones
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Causes of hypothyroidism
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Iodine insufficiency - most common worldwide
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Abnormal enlargement of thyroid (goiters) develop in attempt to compensate for the deficiency
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Hashimoto's thyroiditis
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Autoimmune inflammatory thyroid condition - most common cause in the developed countries
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Congenital hypothyroidism - cretinism
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Myxedema - from prolonged untreated hypothyroidism
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Exaggerated response to CNS depressants - sedatives and narcotic analgesics
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Myxedematous coma can precipitated by:
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CNS depressants
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Infection
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Surgical procedures
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When were you diagnosed?
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How often do you see your physician about your condition?
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What signs and symptoms did you have that led to your diagnosis?
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Do you have any of these now?
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Do you have any disorders related to your diagnosis?
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What medications are you taking? Has the dosage changed recently?
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Did you take your medications today? Do you take them as directed?
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Weakness, lethargy, hoarse voice, weight gain
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Cold intolerance, decreased basal metabolic rate
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Slurring of words, sleep apnea, decreased concentration, mental slowness
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Decreased sweating, coarse hair, non-pitting edema (myxedema)
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Dyspnea, bradycardia, diastolic hypertension
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Macroglossia, salivary gland enlargement, chronic constipation, muscle cramps and pain
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Enlargement of thyroid gland
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Only if patient does not appear to be controlled
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Patients with well-controlled hypothyroidism require no special precautions for treatment
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Elective dental treatment should be deferred pending medical consultation if the patient is not adequately controlled.