Link Between Thyroid Disorders and Oral Health

How your Oral Health can be Affected by a Thyroid Disorder

There is a significant link between thyroid disorders and oral health, as thyroid hormones affect nearly every bodily system, including the mouth. Thyroid hormones impact metabolism, inflammation, and moisture levels in the mouth. Additionally, poor oral health can exacerbate thyroid issues through chronic inflammation. Thyroid dysfunction can lead to issues like dry mouth, increased gum disease, enlarged tongues, and tooth decay.

In this article, we explain thyroid disorders, discuss oral health problems caused by thyroid disorders and how oral health can affect thyroid health, as well as what you can do if you have a thyroid condition and if you have persistent oral health issues.

The Link Between Thyroid Disorders and Oral Health is a Two-Way Relationship

Thyroid Disorders

The thyroid gland is a bilobular structure located on either side of the trachea. According to the article “Oral manifestations of thyroid disorders and its management” in the National Library of Medicine, dysfunction of this gland is the second most common glandular disorder of the endocrine system. This means that dentists see many patients with thyroid disorders–hypothyroidism or hyperthyroidism. Dentists know that the thyroid gland is directly linked to oral health and are experienced in what to look for when examining patients regarding thyroid disorders.

Hypothyroidism

Hypothyroidism is defined by a decrease in thyroid hormone production and thyroid gland function. Insufficient levels of thyroid hormone cause symptoms such as a slower metabolic rate, weight gain, lethargy, intolerance to cold, dry and cool skin, and puffiness in the face and eyelids, as well as others. With hypothyroidism, the blood pressure appears to be normal, but the heart rate is slow.

Hyperthyroidism

Hyperthyroidism is caused by unregulated production of thyroid hormones and is characterized by tremor, emotional instability, intolerance to heat, sinus tachycardia, increased cardiac output (increased susceptibility to congestive heart failure), systolic heart murmur, hypertension, increased appetite, and weight loss.

How Thyroid Function Affects Oral Health

Some effects of thyroid disorders that must be considered in oral health include:

• Hemostasis: Patients with long-standing hypothyroidism may have thickened skin, joint stiffness, and airway obstruction. Patients with hyperthyroidism may exhibit elevated blood pressure and heart rate.
• Susceptibility to Infection: Patients with hypothyroidism may have delayed wound healing, while those with hyperthyroidism may have more oral infections than patients without the disorder, as well as delayed wound healing.
• Cardiovascular Disease: Patients who have hypothyroidism are susceptible to cardiovascular disease from atherosclerosis and elevated LDL. Pain can complicate cardiac functions in patients who have hyperthyroidism and symptomatic disease, and alternative pain medications need to be used.

These are some of the oral health problems that are either caused by or are side effects of thyroid disorders:

• Gum Disease: An increased risk of gingivitis and periodontitis is linked to thyroid disorders.
• Dry Mouth: A lack of saliva (a common side effect of thyroid disorders) makes it harder to neutralize acids, flush away food particles, and fight bacteria, increasing the risk of cavities and gum disease.
• Gum Inflammation: Thyroid imbalances can increase gum sensitivity, inflammation, and the risk of developing gingivitis or periodontitis. Healing from gum issues may also be delayed.
• Tooth Decay: Both hyperthyroidism and hypothyroidism can contribute to tooth decay. Hyperthyroidism can lead to tooth decay due to the increased metabolic rate, while hypothyroidism can cause issues in tooth development in children.
• Tongue Problems: This can include enlargement (macroglossia), swelling, and a scalloped appearance of the tongue. Problems with the tongue can make it difficult to chew, swallow, and maintain proper oral hygiene.
• Delayed Healing: Thyroid hormones are vital for healing. In conditions like hypothyroidism, this can result in slower healing of gum tissue.
• Developmental Issues: In children, thyroid imbalances can cause delayed or premature tooth eruption.

How Oral Health Affects Thyroid Function

Our teeth, gums, and throat are so important to our overall health; however, you may not be aware of the impact your oral health has on your thyroid health. Primarily, the relationship involves chronic inflammation. The bacteria that cause chronic gum disease can lead to systemic inflammation throughout the body, including the thyroid. Infections and inflammation in the mouth from impacted teeth and dental infections can negatively impact thyroid function, particularly in autoimmune thyroid diseases, such as Hashimoto’s, also known as chronic lymphocytic thyroiditis, and Graves’ disease.

• Systemic Effects: Chronic infections can stress the body, and the inflammation can alter metabolic processes and immune responses that are linked to thyroid functions.
• Chronic Inflammation: Periodontitis is a chronic inflammatory disease. The bacteria and inflammatory byproducts from gum disease can trigger inflammation in other parts of the body, including the thyroid, and may worsen or contribute to thyroid autoimmune conditions.

The Role of Your Dentist and a Thyroid Disorder

Your dentist may be the first to suspect a serious thyroid disorder and aid in early diagnosis. Thus, as part of a health care team, the dentist plays an important role in detecting thyroid abnormalities. Your dentist can avoid possible dental complications resulting from treating patients with thyroid disorders. Modifications of dental care must be considered when treating patients who have thyroid disease, such as stress reduction, awareness of drug side effects or interactions, and vigilance for the appearance of signs or symptoms of hormone toxicity.

Possible Modifications for Dental Procedures

Depending on the exact thyroid condition and its severity, dental procedures may need to be modified. Certain antiseptics, vasoconstrictors, or post-procedure medications may need to be avoided. In extreme situations, dental procedures may need to be delayed if a patient’s blood pressure and pulse rate are too high. Medications to manage secondary conditions of thyroid disease, like heart problems, may affect how you respond to blood clots and anesthesia.

Caring for Your Oral Health with Thyroid Disease

It’s especially critical to properly care for your oral health when you have thyroid disease. Above all, keep your routine cleaning and checkups with your dentist. Be sure to inform your dentist and doctor about your thyroid condition to ensure they can adjust any treatments and create an integrated care plan.

Your at-home oral hygiene should include these activities:

• Brush and Floss Diligently: Brush twice a day and floss daily to remove plaque, which helps prevent gum disease.
• Stay Hydrated: Drink plenty of water to combat dry mouth, a common symptom of thyroid disease that increases the risk of cavities.
• Use Products for Dry Mouth: Consider using a toothpaste and mouthwash specifically designed to help with dry mouth, and consider products with xylitol to stimulate saliva production and moisturize the mouth.
• Manage Dietary Triggers: Minimize sugar intake and avoid or limit alcohol, caffeine, and tobacco, which can worsen dry mouth.
• Schedule Regular Checkups: Visit your dentist at least twice a year for professional cleanings and to check for issues like gum disease.
• Consider Fluoride: Talk to your dentist about fluoride treatments to help prevent cavities.

Contact Hamby Family Dental Center to Schedule a Dental Checkup

Our professional dental team at Hamby Family Dental Center will keep your overall health, including your thyroid health, at the top of mind when you come in for checkups and procedures. We can guide you in keeping your teeth healthy and cavities minimized as we take into account any thyroid issues you may have. Contact us today by calling us at  919-552-2431 or completing the form below.