Your Thyroid and Dental Healthby Mary Shomon Patient Advocate
Many people aren’t aware that the thyroid gland — which controls your body’s metabolism — and your dental health are connected in several important ways. Thyroid disease can manifest in various dental and oral symptoms. And some dental diagnostic and treatment procedures can have an impact on your thyroid. Before your next visit to the dentist, learn more about this critical relationship.
The effects of your thyroid on dental health
Thyroid problems in general are associated with an increased risk of several dental and oral health issues, including:
Dry mouth, known as xerostomia, which can cause accelerated tooth decay and cavities
Burning mouth syndrome, which causes a burning pain in the mouth
Sjogren's syndrome, an autoimmune disease that causes a dry mouth
Dysgeusia, a change in the sense of taste
Slow eruption or irregular growth of teeth in children
Accelerated tooth decay and increased cavities
Greater risk of gum and oral infections, including swollen and bleeding gums
Temporomandibular Joint (TMJ) syndrome
An enlarged or swollen tongue, known as macroglossia, which can cause problems with speaking, eating, swallowing, and sleeping
Enlarged salivary glands
Degraded enamel on your teeth
Hyperthyroidism — an overactive thyroid — is associated with:
Rapid decay in your molars
Teeth are extremely sensitive to temperature changes
Increased risk of cavities
Increased risk of gum disease
More rapid eruption of teeth in children
Bone loss in the jaw
What should you do?
If you or your child have unusual patterns of tooth eruption or decay, dry mouth, or any of the above dental/oral health symptoms — and you haven’t yet been diagnosed with thyroid disease — some experts suggest that you ask for a complete thyroid examination and screening. Diagnosis and proper treatment of a previously undetected thyroid condition could be helpful in resolving your dental or oral health problems.
If you have a thyroid condition, be sure to mention this to all your dental health professionals, so they can include it in your medical record and take this into account in diagnosis and treatment of any dental issues. Keep in mind, however, that optimal thyroid treatment is always a critical first step in resolving any thyroid-related conditions or complications.
Dental health product risks
Be aware that some of the chemicals used in dental treatments and dental care products can negatively affect thyroid function.
BPA: Most composite material used to fill dental cavities contains derivatives of a chemical known as bisphenol A (BPA). BPA is an endocrine disruptor that can have adverse effects on your endocrine and thyroid function. Before you have a filling, be sure to ask your dentist if the composite material includes BPA and ask for one of the BPA-free composites currently available.
Triclosan:Triclosan is an endocrine-disrupting chemical found in many oral health products, including plaque-fighting toothpaste, mouthwashes, and oral rinses, as well as other self-care products. Consider checking labels and choose triclosan-free toothpaste and other dental and oral products for home use. You should also ask your dentist if any products used during a dental visit contain triclosan and ask for alternatives.
Fluoride: The topic of fluoride treatment, and toothpaste and dental products that contain fluoride, is controversial. Dental health organizations promote the use of fluoride to help reduce the risk of cavities. Opponents of fluoride point to the harmful effects of exposure to the chemical, which in the past was used as an antithyroid treatment for hyperthyroidism.
Fluoride is added to many public water supplies in the United States, as well as a variety of dental products. Research has shown that fluoride is an endocrine disruptor, and exposure at higher levels may be associated with an increased risk of hypothyroidism. If you want to reduce your exposure to fluoride, consider using only fluoride-free toothpaste and mouth rinses, and pass on fluoride treatments during your dental visits.
Dental X-rays and your thyroid
The thyroid gland is very sensitive to radiation, which is a known risk factor for thyroid cancer. Several research studies have shown that your risk of thyroid cancer increases if you have multiple dental X-rays. While an occasional dental X-ray is not considered risky, the risk goes up with the number of lifetime X-rays. Having up to four X-rays doubles the risk of thyroid cancer — compared to someone who has never had a dental X-ray. Having five to nine dental X-rays puts you at four times the risk, and the risk is five times higher for people who have had 10 or more dental X-rays in a lifetime.
You may want to limit the number of dental X-rays you receive. For example, you can refuse your dentist’s request for routine X-rays, and agree to an X-ray only if you have a specific problem that clearly warrants it. You can also discuss with the orthodontist how to limit the number of X-rays your child will receive if he or she is getting braces.
One practical way to protect yourself — and your children — is to always insist on wearing a thyroid collar when having a dental X-ray. A thyroid collar is a lead collar placed around your neck that shields your thyroid from radiation. While many dentists are still not aware of the concerns and don't have lead collars available for patients, the American Dental Association recommends using a thyroid collar during dental X-rays. You can also read the comprehensive recommendations regarding shielding during dental X-rays issued by the American Thyroid Association.
If your dentist doesn't have one (and he or she should!), you can purchase an inexpensive one yourself for use during appointments with the dentist and orthodontist. If you work in the dental field, you should also make sure that you are not exposed to extra radiation. Some dental professionals routinely wear a thyroid collar when administering any dental X-rays.