Clinical Intro to Endocrine

Question 1

What are the major roles of hormones?

Answer 1

• Control of growth and differentiation
• Maintenance of homeostasis
• Regulation of reproduction

Question 2

What is the dental relevance of the effects of diabetes?

Answer 2

• Dry mouth from dehydration -> dental caries, peridontal disease, candidosis
• Periodontal disease is more common and aggressive in poorly controlled diabetics
• Oral candidosis from the immune defect and dryness
• Salivary gland enlargement (sialosis) from autonomic neuropathy
• Lichenoid reactions from oral hypoglycaemic drugs
• Dentoalveolar abscesses may be more common and severe
• Dry socket may also be more common following dental extractions.
• Increased risk of infections
-Diabetic emergencies

Question 3

What should a dentist advice a diabetic patient?

Answer 3

• Ensure meals and medications taken as normal
• Early morning appointments
• Ensure optimal oral hygiene
- Care must be taken when patients rise from the dental chair, as they may have postural hypotension (due to autonomic neuropathy).

Question 4

What is the dental relevance of Cortiocosteroids?

Answer 4

• Long term steroids suppress the hypothalamus- pituitary-adrenal axis
• Potentially reducing patient ability to deal with physiological stress leading to an Addisonian crisis
• Increased susceptibility to infections
- Impaired wound healing

• Reduce stress
• Careful pre-op assessment to ensure avoidance of Addisonian crisis
- Consider steroid cover

Question 5

Dental relevance of Acoromegaly:

Answer 5

• Macrognathia
• Widely spaced teeth
• Macroglossia
• Cementum deposition

Question 6

What are the dental relevance of hyperthryroidism?

Answer 6

• Avoid stressful situations and the spread of infectious foci.
• Restrict the use of adrenaline— myocardium sensitive-> may unleash arrhythmias, palpitations and chest pain.
• Severe stress may precipitate thyroid storm crisis- tachycardia, irregular pulse, sweating, high BP, tremor, nausea, vomiting etc