Those suffering from thyroid conditions may experience recurrent gum bleeding, easy bruising, and chronic fatigue. Hypothyroid patients have capillary blood supply alterations in gum tissues. Those suffering from thyroid issues have enhanced periodontal bone loss as tooth-supporting alveolar bone is less sensitive to hormonal signals.
Periodontitis is a set of inflammatory conditions affecting the periodontium, i.e., the tissues that surround and support the teeth. Periodontitis involves progressive loss of the alveolar bone around the teeth, and if left untreated, can lead to the loosening and subsequent loss of teeth. Periodontitis is caused by microorganisms that adhere to and grow on the tooth’s surfaces, along with an over-aggressive immune response against these microorganisms. A diagnosis of periodontitis is established by inspecting the soft gum tissues around the teeth with a probe (i.e., a clinical examination) and by evaluating the patient’s X-ray films (i.e. a radiographic examination), to determine the amount of bone loss around the teeth.
Chronic generalized periodontitis (CGP) contributes to endocrine dysfunction with cortisol level reduction and free thyroid hormones increase, enforcing prooxidant processes with multiple iron content increase.
Patients with long standing hypothyroidism may have increased subcutaneous mucopolysaccharides due to decrease in the degradation of these substances. The presence of excess subcutaneous mucopolysaccharides may decrease the ability of small blood vessels to constrict when damaged or cut and may result in increased bleeding from infiltrated tissues, including mucosa and skin. Local pressure for an extended time will probably control the bleeding from the small vessels adequately.
Patients suffering from Hypothyroidism also have gingival microcirculation with a reduction in the diameter of capillaries, as well as a greater number and tortuosity of capillary loops. Inflammatory complications of dental implantations and free thyroxin in oral fluid is associated with thyroid insufficiency.
Thyroid diseases may affect the status of periodontal diseases, especially in hypothyroid conditions. The duration from disease onset to treatment of thyroid disorders may be critical, since uncontrolled thyroid disease may result in destruction of the periodontium. Periodontal therapies, including dental implant placement, appear to be safe with no increase in treatment failure, so long as the status of the thyroid gland is controlled.
Oral Squamous Cell Carcinomas (SCC) have a relatively high rate of abnormal findings in the thyroid gland that can be detected by US. Scans that include the thyroid gland should be performed when surveying cervical lymph nodes for metastasis during US examination. Particular attention should be paid to thyroid gland-related diseases in older men who have oral cancer and to thyroid gland abnormalities if patients had oral SCC in the floor of the mouth or of the maxillary gingiva.
Flossing, brushing or especially dental scaling can easily create bleeding. Many dentists claim this is normal and insignificant in terms of regular dentistry. If you experience oral bleeding you should be concerned, especially if you are suffering from an autoimmune condition. This opens a two-way street for blood to escape, and for bacteria to enter the blood stream. The blood stream provides access to all of the organs and tissues of the body while the bacteria (influenced by chemotaxis) looks for lodging.
Biting something hard like almonds, raw crunchy veggies or any hard food flushes these bacteria – if present – to the gingival crevice where they are liberated into the lymphatic drainage or into the blood circulation when chewing food or gum.If an infection is not able to establish drainage through the skin surface or into the oral cavity, it may spread diffusely through fascial planes of the neck’s soft tissue. Once the infection descends into the submandibular space, it may extend to the lateral pharyngeal space, and then to the retro-pharyngeal space. From here, it may reach the thyroid gland.
The damage caused to the gland results in the release of a conspicuous quantity of thyroid hormones, thus causing a thyrotoxic pattern: temperature, cutaneous pallor, excessive perspiration, tremor, tiredness, weight loss, increased appetite, and tachycardia.
Additionally, the thyroid gland’s edema caused difficulty swallowing (dysphagia) and speaking (dysphonia) commonly seen with thyroid gland enlargement. After dental treatment consisting of ultrasonic scaling, PerioProtect and appropriate anti-inflammatory and antibiotic therapy determined by dental PCR testing, administration of oral beta-blockers and corticosteroid therapy may be performed to counteract thyrotoxicosis in order to prevent recurrences. A root canal may be necessary, once the thyrotoxicosis had been resolved.