Thyroid Disease Hypothyroidism Hyperthyroidism Thyroid Nodules Goiter Thyroid

Thyroid Disease Hypothyroidism Hyperthyroidism Thyroid Nodules Goiter Thyroid Cancer Thyroiditis LIT Dental Hygiene Student: Sierra Joffrion Tierany Wallace

Thyroid • A large ductless gland in the neck that secretes hormones regulating growth and development through the rate of metabolism • A large cartilage found under the larynx or voice box • Two inches long, brownish red, highly vascular gland • Two lobes located on each side of the windpipe that are both connected by a tissue called the isthmus • A projection of which forms the Adam’s apple, butterfly shaped • Regulates metabolism and weight by controlling the fat-burning process

How does your thyroid work? • Thyroid hormone production is regulated by a feedback loop between the hypothalamus, pituitary gland the thyroid gland • Uses iodine from food to make these two hormones: triiodonthronine (T 3) and thyroxine (T 4) • The pituitary gland, in the brain helps to control the thyroid gland by releasing thyroid-stimulating hormone (TSH) • The release of TSH in the bloodstream stimulates the growth of thyroid tissue • https: //youtu. be/x. KQa-Mb. ZUPY

Most common Thyroid diseases • Thyroid nodules • Hypothyroidism • Hyperthyroidism • Goiter • Thyroiditis • Thyroid cancer

Hyperthyroidism What is hyperthyroidism? • Over activity of the thyroid gland, resulting in a rapid heartbeat and an increased rate of metabolism. • Thyroid overproduces hormones • Can also be known as Graves Disease Occurrence: • More prevalent in women than men, 8: 1 Etiology: • An overactive thyroid

Hyperthyroidism Signs and Symptoms • Unexpected weight loss • Rapid or irregular heartbeat • Sweating • Irritability • Menstrual, irregular menstruation or short and light menstruation • Abnormal protrusion of eyes or puffy eyes • Elderly often experience no symptoms

Hyperthyroidism Treatment • Medical procedure - Radioactive iodine • Surgery • Medications • Antithyroid agent – prevents the thyroid gland from making or releasing thyroid hormone • Beta blocker – slows heart rate and decreases blood pressure. When taken in eye-drop form, it reduces eye pressure

Hyperthyroidism • Indications and Contraindications • Epinephrine & other vasopressors should be used with caution – Vasopressors stimulate the cardiovascular system & can precipitate cardiac dysrhythmias, tachycardia, & thyroid storm in hyperthyroid patients whose cardiovascular system have already been sebsitized. However, LA with vasoconstrictors may be used when the following precautions are taken: • Used the least-concentrated effective solution of epinephrine (1: 200, 000 is preferred to 1: 100, 000 which is preferred to 1: 50, 000) • Injecting the smallest effective volume of anesthetics/vasopressors •

Hypothyroidism What is hypothyroidism? • • A condition in which the thyroid gland doesn't produce enough thyroid hormone Can also be known as Hashimoto’s thyroiditis Occurrence: • More prevalent in older women Etiology: • When your immune system produces antibodies that attack your own tissues

Hypothyroidism Signs and Symptoms • • • Fatigue Cold sensitivity Constipation Dry skin Unexplained weight gain Hair loss or dryness • • Delayed puberty or slow growth Brittle nails Constipation High cholesterol Slow heart rate Irregular uterine bleeding Mood swings

Hypothyroidism Treatment • Thyroid hormone replacement Medications • Hormone therapy – affects body processes by regulating the activity of the organs.

Hypothryodism • Indication and Contrainidications • Medical consultation considered prior to start of any dental procedure – Caution must be exercised when prescribing CNS depressant • Sedativehypnotics (barbiturates) • Opiod analgesic & • Other anti-anxiety drugs – Administration of a “normal” dose may produce an overdose, leading to respiratory or cardiovascular depression or both

Thyroid Nodules

Thyroid Nodules What is a thyroid nodule? • A solid or fluid filled lump Occurrence: • Both males and females, usually older adults 40+ Etiology: • Lack of iodine in ones diet

Thyroid Nodules Signs and Symptoms • Most can not be felt • Can be seen as swelling at the base of your neck • Shortness of breath or difficulty swallowing

Thyroid Nodules Treatment • Most do not require treatment • Monitor for change or improvement • Treatment options for larger or cancerous nodules may include medication or surgery Medications • Levothyroxine – taken in pill form to supply additional thyroid hormone will signal the pituitary to produce less TSH

Goiter

Goiter What is goiter? • Abnormal enlargement of the butterfly-shaped gland below the Adam’s apple (thyroid) Occurrence: • Can affect both males and females, more in females above the age 40 Etiology: • Develops as a result of iodine deficiency or inflammation of the thyroid gland

Goiter Signs and Symptoms • • • Not all cause symptoms Swelling Coughing Throat tightness Trouble breathing Fast heart rate • • Heat intolerance Shortness of breath Underactive thyroid Weight gain

Treatment Goiter • If no symptoms are caused treatment may not be needed • Medications • Surgery – thyroidectomy & partial thyroidectomy • Medical procedure - Radioactive iodine Medications • Antithyroid agent – prevents the thyroid gland from making or realeasing thyroid hormone • Hormone therapy – affects body processes by regulating the activity of the organs

Thyroiditis

Thyroiditis What is thyroiditis? • • • Inflammation of the thyroid, the butterfly-shaped gland in the neck Causes a leak of hormones that results in symptoms of an overactive thyroid (hyperthyroidism) Inflammation impairs thyroid hormone production resulting in underactivity (hypothyroidism) Occurrence: • Can affect both males and females usually ages 19 and older Etiology: • Caused from hyperthyroidism or hypothyroidism

Thyroiditis Signs and Symptoms • • • Not all cause symptoms Excess sweating Fatigue Heat intolerance Feeling cold GI effects Anxiety or nervousness Abnormal protrusion of eyes or puffy eyes Weight gain or loss • • • Dry hair/skin Enlarged thyroid Fast heart rate Irregular menstration Muscle weakness Overactive thyroid Sensitivity to cold Sexual dysfunction Tremor Underactive thyroid

Thyroiditis Treatment • Focused on the underlying cause as well as regulating thyroid function • Medical procedure – radioactive iodine therapy Medications • Hormone therapy – affects body processes by regulating the activity of the organs

Thyroid Cancer What is thyroid cancer? • A cancer of the thyroid, the butterfly-shaped gland at the base of the neck Occurrence: • Can affect both males and females younger age, but usually females exposed to radiation Etiology: • Cause is poorly understood, but may involve a combination of genetic and environmental factors

Thyroid Cancer Signs and Symptoms • • • Some have no symptoms Lump in neck Pain in the neck Enlarged lymph nodes Swelling Thyroid nodules

Treatment Thyroid Cancer • Surgery – thyroidectomy, endocrine surgery, partial thyroidectomy, lymphadenectomy and neck dissection • Medical procedure - Radioactive iodine, Radiation, Chemotherapy • Dental treatment- Patient should get all dental treatment completed before proceeding with radiation therapy Medications • Hormone therapy – affects body processes by regulating the activity of the organs • Antithyroid agent – prevents the thyroid gland from making or releasing thyroid hormone

Dental Considerations and Indications • Always update medical history • Ask about medications patient is on • Encourage meticulous homecare • When doing head and neck examination check for thyroid enlargement • IF known thyroid disease always use thyroid collar when taking radiographs

References • Bowers, Marcia, Karen Hill, and Kathleen S. Holm. Pathophysiology. Upper Saddle River, NJ: Pearson Prentice Hall, 2008. 267 -75. Print. • Wilkins, Esther M. Clinical Practice of the Dental Hygienist. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2009. N. pag. Print. • "Thyroid Medications, Tests, and Treatments. " Web. MD, n. d. Web. 27 Nov. 2016.