Thyroid disorders. Part I: hyperthyroidism.

The significant thyroid disorders that may be found in dental patients are presented in a series of 3 articles. This article (part I) deals with hyperthyroidism, part II with hypothyroidism and thyroiditis, and part III with neoplastic lesions of the thyroid. The signs and symptoms, laboratory tests used to diagnoses hyperthyroidism, and the medical management of patients with hyperthyroidism are presented in this paper. The dental management of patients with hyperthyroidism is discussed in detail. The dentist, by detecting the early signs and symptoms of hyperthyroidism, can refer the patient for medical diagnosis and treatment and avoid potential complications of treating patients with uncontrolled disease. These complications include the rare thyrotoxic crisis (thyroid storm) that may be precipitated by dental treatment, acute infection, or trauma in the patient with uncontrolled hyperthyroidism. Also, the use of epinephrine or other pressor ammines can cause a hypertensive crisis in the patient with uncontrolled hyperthyroidism. Patients will benefit from the early detection and referral by reducing the risks of the medical complications such as hypertension, cardiac arrhythmias, and congestive heart failure.