7. Clinical features
All body functions slow down
basic …..hypothermia, hypotension, hypoxia,
bradycardia ….
More in females, between 60—70 y
Clinical p.
In children------cretinism
physical & mental retardation
bone develop is delayed…. Teeth
temperature is decreased
tongue …is large
skin thick…..myxedema seen later
Face is broad & puffy
8. In adults------hypothyr [ MYXEDEMA]
weakness, fatigue
Nonpitting ,gelatinous mucinous
infiltrates beneath the skin [myxod.]
Sudden increase of weight, without
increased appetite
---- myxedema coma
9.
10.
11.
12.
13. Hyperthyroidism [thyrotoxicosis]
Other names : toxic goiter, Basedow’s disease,
Graves’ ,Parry’s , Plummer’s disease
Excess Thyroid hormons especially T 4 & T 3
Clinical picture. :
All body functions are increased
More in females,
Between 20—40 y
20. DENTAL considerations
In hypothyroidism
ask medical advise before dent treatment
avoid CNS depressant….
take care of CVS
In hyperthyroidism
ask medical advise before dent treatment
avoid atropine and adrenaline
take care of CVS
NB :hypothyr is more presenting in dentistry than
hyperthyroidism, so more significant .
21. Management of hypothyroidism
No specific manag for hypothyr…
if doubt ask medical advise
treatment by thyroid hormone
Pt. is sensitive to: sedatives, antihistamine, codeine
In unconscious patient
Terminate dental procedures
Supine position
A B C, assess and perform basic life support as needed
D : definitive management
Summoning of medical assistance
IV line: dextrose 5% or normal saline
Administration of O2
massive dose of thyroid hormone in hospit for days
22. Management of hyperthyroidism
In unconscious patient
Terminate dental procedures
Supine position
A B C, assess and perform basic life support as needed
D : definitive management
Summoning of medical assistance
Administration of O2
transport to a hospital
1- Antithyroid drugs ex propylthiouracil
2-Propranolol [blocker of the TH receptors]
3-Glucocorticoids
Cold packs, Sedatives with careful monitoring of
hydration and electrolyte balance
NO DRUGS ARE USED IN MANAG OF THYR DIS IN
DENTAL OFFICE