World Journal of Dentistry

Register      Login

VOLUME 14 , ISSUE 7 ( July, 2023 ) > List of Articles


The Impact of Hyperthyroidism on Dental Caries in relation to Salivary Constituents among Women: A Case Control Study

Eman H Kadhom, Nada Jafer MH Radhi

Keywords : Chloride, Dental caries, Electrolytes, Hyperthyroidism, Salivary flow rate, Potassium, Potential of hydrogen

Citation Information : Kadhom EH, Radhi NJ. The Impact of Hyperthyroidism on Dental Caries in relation to Salivary Constituents among Women: A Case Control Study. World J Dent 2023; 14 (7):586-591.

DOI: 10.5005/jp-journals-10015-2251

License: CC BY-NC 4.0

Published Online: 01-09-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Aim: The aim of this study was to evaluate the impact of hyperthyroidism on dental caries among women regarding the salivary potential of hydrogen (pH), salivary flow rate (SFR), salivary chloride (Cl), and potassium (K). Materials and methods: A case control comparative study design was used in the present study; the sample size was 90 females between the ages of 25 and 45. The study population was divided into two groups; the case group included 45 participants. Which has a history of hyperthyroidism, while the control group included 45 healthy females. The clinical examination was performed according to the instructions of the World Health Organization (WHO) 2013. The saliva was collected in order to determine the SFR, pH, and electrolyte concentrations. Salivary K and Cl were measured using the atomic absorption spectrophotometry method and the colorimetric method, respectively. Results: The caries experience in the hyperthyroid group was higher compared to the healthy group but with no significant difference. Salivary pH and flow rate was lower among the hyperthyroid group compared to the healthy group, but there was no statistically significant difference. Electrolytes were higher in the study group than in the control group, with a significant difference. The correlation between salivary electrolytes and caries experience was nonsignificant. Conclusion: The present study revealed that patients with hyperthyroidism had greater levels of caries experience when compared to the healthy group, and that was associated with a decrease in SFR and pH. As a consequence, patients with hyperthyroidism require special care for their dental health. Clinical significance: The medical history evaluation is extremely important for oral health and has significantly influenced oral health. Therefore, it is important to recognize the possible consequences of hyperthyroidism on oral health. Dental healthcare practitioners must be aware of the oral and systemic manifestations of the hyperthyroidism. The risk of dental caries increased as the SFR decreased among these patients, in addition to changes in salivary pH and electrolytes, so patients with hyperthyroidism have a greater need for dental care.

  1. Strieder TG, Prummel MF, Tijssen JG, et al. Risk factors for and prevalence of thyroid disorders in a cross-sectional study among healthy female relatives of patients with autoimmune thyroid disease. Clin Endocrinol 2003;59(3):396–401. DOI: 10.1046/j.1365-2265.2003.01862.x
  2. Canaris GJ, Manowitz NR, Mayor G, et al. The Colorado thyroid disease prevalence study. Arch Intern Med 2000;160(4):526–534. DOI: 10.1001/archinte.160.4.526
  3. Penman ID, Ralston SH, Strachan MW, et al. Davidson's Principles and Practice of Medicine. E-Book. 23rd ed. Elsevier Health Sciences; 2022.
  4. Fadhil M, Razaq S, Al-Kareem A, et al. Evaluation the correlation between IL-17 level and autoimmune antibodies in hypo and hyper thyroidisms Iraqi patients. Iraqi J Sci 2019;60(9):1967–1976. DOI: 10.24996/ijs.2019.60.9.9
  5. Babu NV, Patel PB. Oral health status of children suffering from thyroid disorders. J Indian Soc Pedodont Prevent Dent 2016;34(2):139. DOI: 10.4103/0970-4388.180443
  6. Feitosa DdS, Bezerra BdB, Ambrosano GMB, et al. Thyroid hormones may influence cortical bone healing around titanium implants: a histometric study in rats. J Periodontol 2008;79(5):881–887. DOI: 10.1902/jop.2008.070466
  7. Buket A, Tumen DS, Celenk S, et al. Dental treatment way of congenital hypothyroidism: case report. J Int Dent Med Res 2008;1(1):34–36.
  8. Dixit PS, Ghezzi EM, Wagner-Lange LA, et al. The influence of hypothyroidism and thyroid replacement therapy on stimulated parotid flow rates. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol 1999;87(1):55–60. DOI: 10.1016/S1079-2104(99)70295-7
  9. Koczor-Rozmus A, Zwirska-Korczala K, Sadlak-Nowicka J, et al. Evaluation of salivary gland function in women with autoimmune thyroid diseases. Wiad Lek 2003;56(9-10):412–418.
  10. Mariani LH, Berns JS. The renal manifestations of thyroid disease. J Am Soc Nephrol 2012;23(1):22–26. DOI: 10.1681/ASN.2010070766.
  11. Zaichick V. Comparison between bromine, calcium, chlorine, iodine, potassium, magnesium, manganese, and sodium contents in normal thyroid and Riedel's struma. J Biotechnol Bioinform Res 2021;9(6):2–6. DOI: 10.22159/ijms.2021.v9i6.42883
  12. Schwarza C, Leichtleb AB, Arampatzisc S, et al. Thyroid function and serum electrolytes: does an association really exist. Swiss Med Wkly 2012;142:W13669 DOI: 10.4414/smw.2012.13669
  13. Kumara H, Krishna M, Vishwanath H. The electrolytes imbalance between hypothyroidism and hyperthyroidism. Inter J Cur Res 2016;8(5):31031–31033.
  14. Mittal S, Bansal V, Garg SK, et al. The diagnostic role of saliva: a review. Clin Exp Dent 2011;3(4):e314–320. DOI: 10.4317/jced.3.e314
  15. García-Godoy F, Hicks MJ. Maintaining the integrity of the enamel surface: the role of dental biofilm, saliva and preventive agents in enamel demineralization and remineralization. J Am Dent Assoc 2008;139:25S–34S. DOI: 10.14219/jada.archive.2008.0352
  16. Fejerskov O, Nyvad B. Is dental caries an infectious disease? Diagnostic and treatment consequences for the practitioner. Nordic Dent 2003:141–151.
  17. Cochrane N, Cai F, Huq N, et al. New approaches to enhanced remineralization of tooth enamel. J Dent Res 2010;89(11):1187–1197. DOI: 10.1177/0022034510376046
  18. Kadhem DJ, Al Haidar AH. Remineralization of dentine caries using moringa oleifera based nano-silver fluoride: a single-blinded, randomized, active-controlled clinical trial. Dent Hypothes 2022;13(3):82–85. DOI: 10.4103/denthyp.denthyp_57_22
  19. Chong PH, He Q, Rao P, et al. The interindividual variation of salivary flow rate and biochemistry in healthy adults: influence of black tea consumption. J Function Foods 2021;82:104516. DOI: 10.1016/j.jff.2021.104516
  20. World Health Organization. Oral health surveys: basic methods. World Health Organization; 2013. ISBN: 978-92-4-154864-9.
  21. Tenovuo J, Legerlof F. Saliva. In: Thylstrup A, Fejerskov O, editors. Textbook of Clinical Cariology. Munksgaard; Copenhagen: 1994. ISBN: 8716109163, 9788716109163.
  22. Osailan S, Pramanik R, Shirlaw P, et al. Clinical assessment of oral dryness: development of a scoring system related to salivary flow and mucosal wetness. Oral Surg Oral Med Oral Pathol Oral Radiol 2012;114(5):597–603. DOI: 10.1016/j.oooo.2012.05.009
  23. Haswell S. Atomic Absorption Spectrometry: Theory, Design and Application (Analytical Spectroscopy Library, vol. 5). Elsevier Science, Hull; 1991. ISBN: 9780444882172.
  24. Boulpaep EL, Boron WF, Caplan MJ, et al. Medical physiology: a cellular and molecular approach. 2009.
  25. Guyton AC, Hall JE. Textbook of medical physiology: Saunders Philadelphia 1986.
  26. Ali LK. The effect of chronic renal failure on thyroid hormones. Iraqi J pharm Sci 2010;19(1). DOI: 10.31351/vol19iss1pp65-68
  27. Sembulingam K, Sembulingam P. Essentials of medical physiology: JP Medical Ltd; 2012.
  28. Zahid TM, Wang B-Y, Cohen RE. The effects of thyroid hormone abnormalities on periodontal disease status. J Inte Acad Periodontol 2011;13(3):80–85.
  29. Pinto A, Glick M. Management of patients with thyroid disease: oral health considerations. J Am Dent Assoc 2002;133(7):849–858. DOI: 10.14219/JADA.ARCHIVE.2002.0299
  30. Namani RRG, Laxmi Narayana Sripuram S. A study of serum electrolytes in thyroid patients attending a tertiary care hospital. European J Molecul Clin Med 2022;9(3):855–863.
  31. Kaur J, Ahemad N, Gupta A. Changes in the electrolyte profile of patient having hypothyroidism. J Med Sci Clinical Res 2014;2(4):633–637.
  32. Park CW, Shin YS, Ahn SJ, et al. Thyroxine treatment induces upregulation of renin-angiotensin-aldosterone system due to decreasing effective plasma volume in patients with primary myxoedema. Nephrol Dial Transplant 2001;16(9):1799–1806. DOI: 10.1093/ndt/16.9.1799
  33. Ismail-Beigi F, Edelman IS. The mechanism of the calorigenic action of thyroid hormone: stimulation of Na++ K+-activated adenosinetriphosphatase activity. J Gen Physiol 1971;57(6):710–722. DOI: 10.1085/jgp.57.6.710
  34. Shirota T, Shinoda T, Yamada T, et al. Alteration of renal function in hyperthyroidism: increased tubular secretion of creatinine and decreased distal tubule delivery of chloride. Metabolism 1992;41(4):402–405. DOI: 10.1016/0026-0495(92)90075-l
  35. Al-Rubbaey Y. Oral health status and dental treatment needs in relation to salivary constituents and parameters among a group of patients with thyroid dysfunction. J Baghdad College Dent 2010;22(1):105–108.
  36. Meshaikhy RBA, Rawi NAA. Assessment of dental caries experience among patients with thyroid disorders attending different hospitals in Baghdad city/Iraq. J Res Med Dent Sci 2020;8(5):37–43.
  37. Al-Naif FAA, Al-Aswad FD. Oral manifestation biochemical and IgA analysis of saliva in hyperthyroid (Grave's disease) patients (comparative study). J Baghdad College Dent 2013;25(1):82–86.
  38. Turner MD, Ship JA. Dry mouth and its effects on the oral health of elderly people. J Ame Dent Assoc 2007;138:S15–S20. DOI: 10.14219/jada.archive.2007.0358.
  39. Al-Tamimi HK, Al-Rawi NA. Age-related changes with selected salivary physical properties and caries experience among healthy adult men. Int J Med Res Health Sci 2018;7(9):52–58.
  40. Tanaka M, Matsunaga K, Kadoma Y. Correlation in inorganic ion concentration between saliva and plaque fluid. J Med Dent Sci 2000;47(1):55–59.
  41. Marya C. A textbook of public health dentistry: JP Medical Ltd; 2011.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.