Oral physician: A portal to systemic health through oral health – A case of hypothyroidism and review of literature

Improvement in Oral Health and Compliance in a Child with Congenital Hypothyroidism. Case Report

“…At first it was considered to place reversed crowns to correct the anterior crossbite (14), nevertheless, the excessive overjet didn't allow it. For operatory procedures, local anesthesia was achieved with one cartridge of lidocaine with epinephrine, previously corroborated that the patient didn't have any heart disease and limiting anesthetic dose according to patients weight (4).…”

“…The patient was identified to have a metabolic anomaly as he entered to the dental clinic, because of his characteristic physical features (short stature, brachycephalic skull, facial edema) (8), and the medical record answered by his mother confirmed the presence of CH. It is mandatory to be informed about the medical status of patients with endocrine alterations, and basal values must be known in order to recognize a status of hypotension, hypothermia or bradycardia (4). Also, pediatric dentists should encourage patients' follow-up with an endocrinologist.…”

“…Congenital hypothyroidism (CH) is the most common endocrine disease in pediatric population (2), originated by an inappropriate development of thyroid gland in the most of the cases (3), with a diminished availability of thyroid hormones in tissues and impacting in body metabolism (4). Early detection of CH is accomplished through newborn screening tests, and it has been identified a global prevalence of approximately 1:4,000 newborns with CH.…”

“…Thyroid hormones act as regulators of bone metabolism and skeletal maturity through endochondral ossification (6). In children with CH, growth pattern could be delayed and be manifested as short stature, brachycephaly and open cranial sutures (4,7,8). • Patient cooperation.…”

“…• General health status. A lack of an adequate HRT in children with CH could trigger cardiovascular, respiratory, gastrointestinal and neuromuscular affections (4). So, adherence to medical treatment should be assured in order to avoid complications during dental appointment (2).…”