2. Parathyroid

Question 1

Dental management of hyperparathyroidism - What do you have to avoid and why?

Answer 1

Avoid iatrogenic jaw fracture during oral surgery (bone lesions and loss of cortical bones)

Question 2

Dental management of hypoparathyroidism - Why do they need more frequent exams?

Answer 2

If hypo plastic teeth present, they have increased caries risk

Question 3

Signs and symptoms of hypoparathyroidism

Answer 3

1. Tetany (due to low Ca)
2. Chovostek’s / Trousseau’s sign (twitching of facial muscles)
3. Changes in memory / emotion
4. Seizures
5. Blurred vision

Question 4

How is hypoparathyroidism managed?

Answer 4

Maintain serum calcium levels to prevent tetany

Question 5

What are dental findings of hypoparathyroidism?

Answer 5

1. Disturbances in eruption
2. Enamel hypoplasia
3. Blunted roots
4. Dentinal dysplasia
5. Hypodontia
6. Increased radiographic bone density

Question 6

What are s/sx of primary hyperparathyroidism?

Answer 6

1. Stones (ectopic calcifications)
2. Bones (bony lesions)
3. Groans (abdominal cramping)
4. Moans (psychic lability)

Question 7

What are the risk factors for primary hyperparathyroidism?

Answer 7

1. Adenoma
2. Females
3. Incidence increases with age
4. May occur secondary to radiation, familial, or syndrome

Question 8

What are the oral manifestations of hyperparathyroidism?

Answer 8

1. Generalized rarefaction/lytic lesions
2. Ground glass appearance
3. Loss of lamina dura
4. Teeth appear more radiopaque
5. Mobility
6. Sensitivity to chewing (due to mobility)
7. Decreased bone density