Thyroid hormone has a major impact on many areas of the body including the oral cavity. It is one of the key factors for individual wellbeing. Thyroid disorders have become a major health burden in India. It affects approximately one in ten adults. Oral health can be strongly impacted by thyroid function. Dry mouth, a common side effect of hypothyroidism, which is an underactive thyroid, raises the risk of tooth decay, gum disease, and poor breath. Additionally, it may result in a swollen tongue, swallowing issues, and a diminished sense of taste. An accelerated rate of bone loss in the jaw from hyperthyroidism, an overactive thyroid, can cause tooth loss. Additionally, it may lead to an enlarged thyroid gland, which can make it difficult to open one’s mouth wide and produce a tightening of the throat. Maintaining excellent oral health requires maintaining normal thyroid function.

Understanding the difference

When the thyroid is underactive and not producing enough hormone it is called hypothyroidism. On the contrary unregulated production of thyroid hormones is called hyperthyroidism.

Insufficient levels of thyroid hormone is responsible for a slower metabolic rate, weight gain, lethargy, intolerance to cold, dry and cool skin, puffiness of the face and eyelids as the major symptoms. Such patients may also have a slower heart rate despite normal blood pressure.

Excess of thyroid hormone is recognized by tremors, heat intolerance, increased blood pressure, increased heart rate, increased susceptibility to heart failure, increased appetite, and weight loss. 

Thyroid and oral health

Excess or deficiency of thyroid hormones can adversely affect the mouth. Dental problems for people suffering from thyroid disorders are also related to specific age groups. For instance, middle-aged women and women during the menopause phase often complain of a burning sensation on the tongue or lips.

Patients with hypothyroidism usually encounter enlarged tongue (macroglossia), altered taste sensation (dysgeusia), delayed eruption of teeth, poor gum health, altered tooth shapes, long winding recovery from mouth sores and delayed wound healing.

Those with hyperthyroidism are more prone to tooth decay, periodontal disease, enlargement of extra glandular thyroid tissue, dry mouth, burning sensations in the mouth, inability to eat spicy food, faster and early tooth eruption, and vague jaw pain due to weak jawbones.

Can thyroid problems cause teeth problems?

BLEEDING GUMS

Thyroid patients often experience puffy and bleeding gums. Delayed wound healing not only leads to discomfort in patients but also increases the likelihood of an infection.

MACROGLOSSIA

A large tongue can cause a number of problems like difficulty in chewing, swallowing, speaking and even breathing in certain individuals. While sleeping an enlarged tongue may drive a thyroid patient to snore or breathe with an open mouth. Open mouth and mouth breathing causes the oral cavity to become dry causing dry mouth when you wake up the next morning.

ALTERED TASTE

This causes a patient to taste food in a different way than they usually do. Such patients may avoid certain food groups essential to health. This causes further deterioration of overall health.

GUM DISEASE

The imbalance of the thyroid hormones can cause poor gum healing leading to future gum-related dental problems. The bacterial load of the oral cavity increases dramatically and may cause swollen or bleeding gums and even an increased risk of heart disease and stroke. 

DRY MOUTH

This is a very common oral manifestation among thyroid patients. The decreased saliva in the mouth can cause canker sores, tooth decay and even difficulty in swallowing. It also weakens the tooth over time. This is because saliva contains calcium in traces which helps the tooth mineralize and make them strong.

TOOTH DECAY

People with overactive thyroid may have tooth cavities, sensitive teeth that hurt on sudden temperature changes and even pain in the jaw. A decayed tooth may cause bad breath which has negative social implications in a person’s life.

IMPROPER TOOTH DEVELOPMENT

Children with thyroid issues may have unusual gaps in teeth growth, crowded teeth, enlarged gums extending between the teeth, and pain or weakness in the jaw.

OSTEOPOROSIS OF THE JAW

Abnormal levels of thyroid hormone may affect the body’s ability to maintain healthy bone density through the remodeling process. This may cause bone loss which in turn may cause tooth loss.

Do thyroid patients need regular dental checkups?

Treating the hormonal imbalance may help alleviate some of the oral problems. But consulting a dentist for the dental ailments will result in a faster remedy for the same. A dental professional will treat the symptoms and recommend changes in the oral hygiene routine based on the problems faced by an individual.

• Your dentist may prescribe you a non alcoholic mouthwash and a mint-free or a toothpaste that doesn’t cause burning sensations for dry mouth.
• Consume low salt diet and avoid dry foods in case you are suffering from dry mouth. Avoid alcoholic and caffeine drinks. It may exacerbate their condition. 
• Increase the fluid intake and keep the oral cavity moist. Drink plenty of water. 
• Xylitol products have proven to be very helpful in thyroid patients with dry mouth and caries. It not only reduces the intake of unhealthy sugars, which cavity causing bacteria love, but also reduces the bad bacteria in the mouth.

Maintenance and treatment of the various oral issues may ensure a healthy smile and reduce the risk of developing serious conditions later on.

The bottom line

The thyroid gland is responsible for homeostasis in the body. Any thyroid dysfunction can wreak havoc and affect various parts of the body including the oral cavity. Such individuals have many oral complications like tooth decay, deteriorating gum health, and dry mouth to name a few. A comprehensive treatment for both dysfunctions of the gland and dental issues is needed.

Highlights

• Thyroid gland plays a major role in maintaining the overall health of an individual. Its dysfunction can lead to many problems in the body as well as dental issues.
• Hypothyroidism is deficiency of thyroid hormone in the body, whereas hyperthyroidism is the excess of thyroid hormone in the body.
• Some common oral problems are dental decay, gum disease, dry mouth, altered taste sensation and enlarged tongue.
• Oral problems may be an early warning sign of thyroid dysfunction.
• A good oral hygiene is the way to go about it.
•  Regular check-ups with a dentist is essential to keep the symptoms at bay and avoid any complications due to negligence.