CPR Forth Year

1. Thyroid Gland Dysfunction
Badr AL-Jindan, BDS , MSc , Dip. ABOMS, FRCD(C )
Diplomate Of The American Board Of Oral And Maxillofacial Surgery
Fellow Of The Royal College Of Dentist Of Canada
Assistant professor, King Faisal university, AL-Khobar, Saudi Arabia
Adjunct professor, McGill university , Montreal, Canada

2. Objectives
• Hypothalamic -Pituitary-Thyroid Axis
• Thyroid dysfunction
– Etiology
– Clinical Manifestation
– Medical management
– Dental managements (modification)
– Management of associated emergencies

3. Hypothalamic -Pituitary-Thyroid
Axis

4. Thyroid function
•
Growth
–
–
•
Stature attainment
Promote bone formation and maturation
CNS
–
Prenatal ;,
•
–
Adult hood(
•
•
•
Resemble B adrenergic agonist
Metabolic rate
–
–
•
Hypo : decrease memory
Hyper: irritability
ANS
–
•
Hypo : mental retardation
basal metabolic rate
carbohydrate , proteins and fat metabolism
CVS
–
Increase cardiac output, increase O2 tissue delivery

5. Etiology
Hypothyroid
Hyperthyroid

6. Clinical Manifestation
Hypothyroid
Hyperthyroid

7. Clinical Manifestation
Hypothyroid
Hyperthyroid

12. Medical Assessment Of
Thyroid Dysfunction

15. Medical Management Of
Thyroid Dysfunction

16. Hyperthyroid

17. Hypothyroid

18. Dental Management Of
Thyroid Dysfunction

20. Dental Emergencies associated
with Thyroid Dysfunction

22. Thyroid Storm
Myxedema
fever (hallmark)
rapid heart rate nausea/vomiting
diarrhea
irregular heart beat
weakness
heart failure confusion/disorientation
Weakness
Confusion
Feeling cold
Low body temperature
Swelling of the body
Difficulty breathing
decrease thyroid hormone synthesis
control the heart rate (Beta blockers;
propranolol ))
I.V. fluids
Electrolytes replacement
correct the low thyroid hormone
I.V. steroids
Warming blanket
Glucose supplements (if the blood sugar
level is low)
treat underlying cause
Lower mortality compared to thyroid
storm
I.V steroids may be used to help support
the circulation.
mortality approached 100%. However,
now, with the use of aggressive
therapy ,death rate less than 20%.