Hyperthyroidism (Graves Disease) Fact Sheet
Dan Boboia, DDS
What is it?
A hypermetabolic state that results from excess synthesis and release of thyroid hormone from the thyroid gland. This comes as a result of a disruption of the homeostatic mechanisms that normally adjust hormone secretion to meet the needs of peripheral tissues.
Epidemiology
0.5 – 1% in general population
Etiology
The cause is unknown; it results from the presence in plasma of an abnormal thyroid stimulator called the long acting thyroid stimulator or LATS; an immunoglobulin or family of immunoglobulins directed against the TSH receptor mediates thyroid over-stimulation
Graves Disease
- Most common form of hyperthyroidism
- Thyroid gland over activity
- Autoimmune disease
- 5 x more common among women than men
- Associated with eye disease (Graves opthalmia) and skin lesions (dermopathy)
Hyperthyroidism
- XS intake of thyroid hormones
- Pituitary gland tumor (xs TSH secretion)
- Adenoma
- Toxic Multinodular Goiter
- Thyroiditis
- XS Iodine intake
- Metastatic thyroid cancer
Complications / Signs / Symptoms
- Osteoporosis
- Atrial fibrillation
- Hypertension
- CHF
Thyrotoxic crisis:
- Extreme restlessness, nausea, vomiting, abdominal pain
- Fever, profuse sweating, tachycardia, cardiac arrhythmias, pulmonary edema,
- Stupor, coma
- Severe hypotension
- Death
Diagnosis
- Symptoms: rapid heart rate, intense fatigue, inability to tolerate a hot environment, irritability, nervousness
- Physical signs: weight loss, tachycardia, hand tremors, xs sweating
- Blood Tests: high levels T3 and T4 low level of circulating TSH
- Diagnostic scan: RAIU—radioactive iodine uptake test
Medical Treatment
- Antithyroid drugs
- Radioactive Iodine
- Thyroidectomy
Oral Findings
- Osteoporosis involving alveolar bone
- Dental caries and periodontal disease appear more rapidly in these patients
- Teeth and jaws develop more rapidly
- Premature loss of deciduous teeth with early eruption of permanent teeth
- Euthyroid infants of hyperthyroid mothers have been reported with erupted teeth at birth
- Damaged salivary gland (secondary to radioactive iodine)
