Dental Correlation Flashcards
Odontogenic infection of Ludwing’s Angina
most commonly from?
Etiology?
Most commonly from fisrt, second, third molars
local trauma, salivary gland infections, infected brachial cleft or thyroglossal duct cyst, oral surgery procedures
clinical presentation of Ludwing’s angina swelling
B/L swelling of the subandibular, submental, sublingual spaces
painful swallowing, difficulty swallowing, shortness of breathe, trismus, inability to handle oralsecretions, fever, malaise
clinical presentation of hyperthyroidism
nervous, diaphoretic (sweating), thin, with tremor and exopthalmus, heat intolerance
what are the levels of TSH and T3 and T4 with primary hyperthyroidism?
The TSH is LOW
and the T3 and T4 are higher
what tests do you order with a patient with hyperthroidism?
Thyroid functoin tests for T3 T4 and TSH
thyroid antibodies
thyroid radioactive iodine 123
what is the most common cause of hyperthyroidism? describe it
Grave’s Disease
Autoimmune disease that produces IgG type of antibodies known as thyroid stimulating immunoglobulins (TSI’s) – they bind to the TSH receptor in the thyroid gland and cause the release of T3 and T4
how is hyperthyroidism treated?
Antithyroid medication - to try and inhibit the synthesis of thyroid hormones
Radioactive iodine therapy – can destroy thyroid follicular cells – but could lead to hypothyroidism (avoid in pregnancy and children)
Thyroidectomy – side effects
Propanolol- treat tachycardia and hypertension
what oral findings may be associated with hyperthyroidism?
Increased susceptibility to caries
perio disease
enlargement of extraglandular thyroid tissue
maxillary or mandibular osteoporosis
accelerated dental eruption
burning mouth syndrome
describe dental management with hyperthyroidism patient
Establish the current diagnosis of the hyperthyroidism (primary / secondary?)
What tx are they one? – medication?
Know their medical status and latest findings on test
STRESS REDUCTION PROTOCOL – morning appointments, nitrous oxide, sedation, go WITHOUT A VASOCONSTRICTOR?? – so can use epi ONLY IF IT IS WELL CONTROLLED
describe thyroid storm
Life threatening – represents a sudden and severe exacerbation of the signs and symptoms of hyperthyroidism manifested by fever, restlessness, tachycardia, a fib, pulmonary edema, tremor, sweating….nnot treated = coma or death
Synthroid medication
treats hypo thyroidism – often patients with hyper will eventually take this b/c those medications can cause hypo
how does hypothyroidism present clinically?
cold intolerance weight gain weakness fatiue decreased BMR decreased CO dry, rough skin, edema, aemia?
oral maifestations associated with hypothyroidism?
MACRO-glossial - large tongue
Dysgeusia – alteration of taste
delayed eruption of teeth
poor perio health
delayed wound healing
Dental Tx considerations in Hypothyroiod patient
IF WELL CONTROLLED – no special precaustions for routine or emergency
if patient seems lethargic or decrease in respiratory rate – need to think maybe it is uncontrolled
Dental Tx considerations in Hypothyroidism pt that is undiagnosed, uncontrolled, or untreated
elected procedures should be delayed
surgical procedures should be avoided
acute orofacial infections treat aggresivly
BE OBSERVANT TO INCREASED LETHARGY– decreases in respiratory rates
oral implications of DIABETES
Xerostomia – 2nd to salivary gland dysfunction
increased risk of oral infections
increase incidence and severity of gingival inflammation, perio abscess, and chronic perio disease
increase incidence and severtiy of caries
glossodynia = burning mouth and some dysgeusia
