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      Undetected hypothyroidism: A rare dental diagnosis

      case-report

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          Abstract

          Thyroid dysfunction is the second most common glandular disorder of the endocrine system, which may rear its head in any system in the body including the mouth. The oral cavity is adversely affected by either an excess or deficiency of thyroid hormone. Childhood hypothyroidism known as cretinism is characterized by thick lips, large protruding tongue (macroglossia), malocclusion and delayed eruption of teeth. Neonatal screening for congenital hypothyroidism is not performed in all countries and not every affected patient might be determined by neonatal screening alone. The dentist by detecting the early signs and symptoms of hypothyroidism can refer the patient for medical diagnosis and treatment and avoid potential complications of treating patients with uncontrolled disease. Herein, we present a case of undetected hypothyroidism in a 13-year-old female patient based on dental features by oral medicine specialists.

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          Most cited references18

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          Management of patients with thyroid disease: oral health considerations.

          The thyroid gland and its hormones play an important role in the regulation of growth, development and metabolic functions of the body. Thyroid diseases include a group of conditions that can affect the delivery of dental care. The authors conducted a MEDLINE search of the medical and dental literature concerning thyroid disease and its management published between 1980 and 2000. The authors found eight published articles concerning this topic in the dental literature; a few of the articles specifically addressed thyroid disease and dental care. They reviewed the medical literature within the scope of provision of dental care. The oral health care professional can play a role in the screening of dental patients who have undiagnosed thyroid disease. In addition, to treat patients who have thyroid disease, a thorough understanding of the many related pathological conditions, as well as the signs and symptoms that can occur, is needed. Specific dental treatment protocols for these patients are not found in the medicodental literature published between 1980 and 2000. As part of a health care team, the dentist plays an important role in detecting thyroid abnormalities. Modifications of dental care must be considered when treating patients who have thyroid disease.
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            Psychometric evaluation of a new questionnaire measuring treatment satisfaction in hypothyroidism: the ThyTSQ.

            There is a clinical impression of dissatisfaction with treatment for hypothyroidism among some patients. Psychometric properties of the new ThyTSQ questionnaire are evaluated. The questionnaire, measuring patients' satisfaction with their treatment for hypothyroidism, has two parts: the seven-item ThyTSQ-Present and four-item ThyTSQ-Past, measuring satisfaction with present and past treatment, respectively, on scales from 6 (very satisfied) to 0 (very dissatisfied). The questionnaire was completed once by 103 adults with hypothyroidism, age (mean [SD]) 55.2 [14.4], range 23-84 years (all treated with thyroxine). Completion rates were very high. Internal consistency reliability was excellent for both ThyTSQ-Present and ThyTSQ-Past (Cronbach's alpha = 0.91 and 0.90, respectively [N = 102 and 103]). Principal components analyses indicated that the seven items of the ThyTSQ-Present and the four items of the ThyTSQ-Past could be summed into separate Present Satisfaction and Past Satisfaction total scores. Mean Present Satisfaction was 32.5 (7.8), maximum range 0-42, and mean Past Satisfaction was 17.5 (6.1), maximum range 0-24, indicating considerable room for improvement. Patients were least satisfied with their present understanding of their condition, mean 4.2 (1.7) (maximum range 0-6), and with information provided about hypothyroidism around the time of diagnosis, mean 3.9 (1.8) (maximum range 0-6). The ThyTSQ is highly acceptable to patients with hypothyroidism (excellent completion rates), and has established internal consistency reliability. It will assist health professionals in considering psychological outcomes when treating people with hypothyroidism, and is suitable for clinical trials and routine clinical monitoring.
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              Newborn screening in India: current perspectives.

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                Author and article information

                Journal
                J Oral Maxillofac Pathol
                J Oral Maxillofac Pathol
                JOMFP
                Journal of Oral and Maxillofacial Pathology : JOMFP
                Medknow Publications & Media Pvt Ltd (India )
                0973-029X
                1998-393X
                May-Aug 2014
                : 18
                : 2
                : 315-319
                Affiliations
                [1 ] Department of Oral Diagnosis, Oral Medicine and Dental Radiology, College of Dental Science, Ahmedabad, Gujarat, India
                [2 ] Department of Oral Diagnosis, Oral Medicine and Dental Radiology, Ahmedabad Dental College and Hospital, Gandhinagar, Gujarat, India
                Author notes
                Address for correspondence: Dr. Sonal B Dudhia, 1-D, Shantiniketan-2, Nr. Hirabag Railway Crossing, Ambawadi, Ahmedabad-380 006, Gujarat, India. E-mail: sonaldudhia@ 123456rediffmail.com
                Article
                JOMFP-18-315
                10.4103/0973-029X.140922
                4196309
                8eb1fc86-a2bc-41f7-b73f-ad7bffdb13c9
                Copyright: © Journal of Oral and Maxillofacial Pathology

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 09 December 2013
                : 07 July 2014
                Categories
                Case Report

                Pathology
                childhood hypothyroidism,dental anomalies,dental diagnosis,oral manifestations
                Pathology
                childhood hypothyroidism, dental anomalies, dental diagnosis, oral manifestations

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