LO 10 Flashcards
Describe Oral Manifestations of
Systemic Diseases
- Many systemic diseases are reflected in the oral mucosa, maxilla, and mandible
- Ulceration or mucosal bleeding
- Immunodeficiency can lead to opportunistic diseases such as infection and neoplasia
- Bone disease can affect the maxilla and mandible
- Systemic disease can cause dental and periodontal changes
- Drugs prescribed for a systemic disease can affect oral tissue
What local factors may be involved in the manifestation of systemic disease in oral mucosa?
- The mucosa may be more easily injured
- Mild irritation and chronic inflammation may cause lesions that otherwise would not occur
- Endocrine disorders
- Disorders of red and white blood cells
- Disorders of platelets and other bleeding and clotting disorders
- Immunodeficiency disorders
List the common endocrine disorders
- Hyperpituitarism
- Hyperthyroidism
- Hypothyroidism
- Hyperparathyroidism
- Diabetes mellitus
- Addison disease
Describe endocrine disorders
- The endocrine system consists of a group of integrated glands and cells that secrete hormones
- The amount of hormone circulating in blood triggers factors that control production
- Diseases may result from conditions in which too much or too little hormone is produced
- Diseases may result from gland dysfunction
- Diseases may result from a problem with hormone control and production
Describe Hyperpituitarism
- Excess hormone production by the anterior pituitary gland
- Caused most often by a benign tumor, a pituitary adenoma, that produces growth hormone
- Gigantism results if it occurs before the closure of long bones- before puberty
- Acromegaly results when hypersecretion occurs during adult life- after puberty
Describe the Clinical Features and Oral Manifestations of Hyperpituitarism
- Affects (mostly) men and women in their 40s
- Poor vision/Light sensitivity
- Enlargement of hands and feet
- Increase in rib size
- Facial changes - Enlargement of maxilla and mandible may cause separation of teeth and malocclusion; Frontal bossing (enlarged forehead) and an enlargement of nasal bones; Enlargement of maxillary sinus leads to voice deepening
- Mucosal changes - May have thickened lips and macroglossia
Describe the Diagnosis and Treatment
of Hyperpituitarism
- Diagnosis involves measurement of growth hormone
- Normal: Decrease in growth hormone through puberty
- Acromegaly: Growth hormone will not decrease
- Treatment - Pituitary gland surgery; Medical management; Radiation therapy
Describe Hyperthyroidism (aka Thyrotoxicosis or Graves Disease)
- Excess production of thyroid hormone
- More common in women than men, in 30s and 40s
- Most common cause is Graves disease
- Graves disease is an autoimmune disorder in which antibodies, thyroid-stimulating immunoglobulins (THIs), stimulate thyroid cells
- The thyroid gland enlarges
- Too much thyroid hormone is produced
- Increase in patient’s metabolism
List the Clinical Features of Hyperthyroidism
- Thyroid enlargement (goiter)
- Rosy complexion
- Erythema of the palms
- Excessive sweating
- Fine hair
- Softened nails
- Exophthalmos - bulging eyes
- Anxiety, weakness, restlessness, and cardiac problems may also be associated
- Thyroid storm - A serious flood of hormones that occurs during stress-can alter vitals and be fatal-CAN HAPPEN IN DENTAL CHAIR
What are the oral manifestations of Hyperthyroidism?
- May lead to premature exfoliation of deciduous teeth in children and premature eruption of permanent teeth
- Osteoporosis may affect alveolar bone
- Caries and periodontal disease may appear and develop more rapidly in these patients
- Burning tongue
Describe the treatment of Hyperthyroidism
- Surgery
- Medications to suppress thyroid activity
- Administration of radioactive iodine - kills off function of thyroid
- Clinical mismanagement of hyperthyroidism may lead to hypothyroidism
Describe hypothyroidism
- A decreased output of thyroid hormone
- Most common endocrine condition worldwide
List the causes of hypothyroidism
- Developmental disturbances
- Autoimmune destruction of thyroid: Hashimoto thyroiditis
- Iodine deficiency
- Drugs
- Treatment for hyperthyroidism
Describe Hypothyroidism Oral Manifestations in infants and adults
Infants
1. Thickened lips
2. Enlarged tongue (macroglossia)
3. Delayed eruption of teeth
Adults
1. Enlarged tongue (macroglossia)
Describe Hyperparathyroidism
- Results from excessive secretion of parathyroid hormone (PTH) from the parathyroid glands
- PTH plays a role in calcium and phosphorus metabolism
- Hypercalcemia: Elevated blood levels of calcium-can lead to muscle and heart problems - can be deadly
- Hypophosphatemia: Low levels of blood phosphorus
- May be the result of hyperplasia of parathyroid glands, a benign tumor of one or more parathyroid glands, or a malignant parathyroid tumor
- Much more common in women than men
- PTH increases the uptake of dietary calcium from the gastrointestinal tract and is able to move calcium from bone to circulating blood when necessary