The endocrine system and disorders
Common Disorders IX: The endocrine system: Common disorders and their dental
implications.
Describe the anatomy and physiology of the endocrine system;
Recognise and describe common endocrine disorders and their management;
Understand how these may impact on the patient’s oral health;
Understand how these may impact on your approach to treatment;
Develop an understanding of the links between oral health and certain endocrine disorders.
Homeostasis:
The body exists in a constant state of balance.
Using various receptors the body recognises changes to the norm.
When change occurs various systems exist to correct this imbalance via a system known as
negative feedback.
The endocrine system is a group of glands which produce a variety of hormones which are
important in maintaining this homeostasis.
Hormones:
Hormones are chemical messengers.
They are released by cells or glands and have an effect on a different part or parts of the body.
Endocrine hormones are released into the bloodstream.
Exocrine hormones are released into ducts and flow from these to neighbouring cells.
To react to a hormone the cell must have the necessary receptor.
Pineal Gland:
Produces melatonin (aa-based) which is responsible for sleep/wake cycles.
Darkness prompts the pineal gland to start producing melatonin while light causes that
production to stop. This is detected via the optic nerve.
,Peak levels occur at night and make us sleepy, lowest levels occur at noon.
In humans, also seems to co-ordinate the fertility hormones.
Descartes believed it was where the soul was housed.
No particular relevant diseases. But can be effected by patients working shift patterns at night
Do be aware of your own sleep cycles – patients prefer awake practitioners.
Pituitary Gland:
Size of a pea.
Regulates homeostasis.
Also important in puberty and growth.
Hypopituitarism:
Caused by tumours or irradiations of the pituitary gland.
Hormone replacement therapy is a treatment of choice.
Patients may be at risk of adrenal crisis.
Acromegaly:
Caused by hyperfunction of the pituitary, causing an excess of growth hormone.
Most commonly due to a pituitary tumour.
As bones are unable to lengthen once the epiphyses have fused the growth hormone causes
them to thicken and broaden instead.
Treatment of the tumour, followed by management of the symptoms.
This includes monitoring for common complications.
Dental complications are mainly due to the secondary diseases
, Thyroid:
Controls speed of energy use and therefore metabolism.
Controls body’s sensitivity to other hormones.
Dysfunction of the thyroid therefore has widespread and varied effects on the body.
Controls speed of energy use and therefore metabolism.
Controls body’s sensitivity to other hormones.
Dysfunction of the thyroid therefore has widespread and varied effects on the body.
Goitre:
A goitre is an enlarged thyroid gland they may be:
Euthyroid
Hyperthyroid
Hypothyroid
Only require surgery if:
Dyspnoea
Dysphagia
Cosmetic concern
Causes of goitre include
Physiological – e.g. puberty
Drugs – e.g. Carbimazole
Thyroid disease e.g. Graves disease
Common Disorders IX: The endocrine system: Common disorders and their dental
implications.
Describe the anatomy and physiology of the endocrine system;
Recognise and describe common endocrine disorders and their management;
Understand how these may impact on the patient’s oral health;
Understand how these may impact on your approach to treatment;
Develop an understanding of the links between oral health and certain endocrine disorders.
Homeostasis:
The body exists in a constant state of balance.
Using various receptors the body recognises changes to the norm.
When change occurs various systems exist to correct this imbalance via a system known as
negative feedback.
The endocrine system is a group of glands which produce a variety of hormones which are
important in maintaining this homeostasis.
Hormones:
Hormones are chemical messengers.
They are released by cells or glands and have an effect on a different part or parts of the body.
Endocrine hormones are released into the bloodstream.
Exocrine hormones are released into ducts and flow from these to neighbouring cells.
To react to a hormone the cell must have the necessary receptor.
Pineal Gland:
Produces melatonin (aa-based) which is responsible for sleep/wake cycles.
Darkness prompts the pineal gland to start producing melatonin while light causes that
production to stop. This is detected via the optic nerve.
,Peak levels occur at night and make us sleepy, lowest levels occur at noon.
In humans, also seems to co-ordinate the fertility hormones.
Descartes believed it was where the soul was housed.
No particular relevant diseases. But can be effected by patients working shift patterns at night
Do be aware of your own sleep cycles – patients prefer awake practitioners.
Pituitary Gland:
Size of a pea.
Regulates homeostasis.
Also important in puberty and growth.
Hypopituitarism:
Caused by tumours or irradiations of the pituitary gland.
Hormone replacement therapy is a treatment of choice.
Patients may be at risk of adrenal crisis.
Acromegaly:
Caused by hyperfunction of the pituitary, causing an excess of growth hormone.
Most commonly due to a pituitary tumour.
As bones are unable to lengthen once the epiphyses have fused the growth hormone causes
them to thicken and broaden instead.
Treatment of the tumour, followed by management of the symptoms.
This includes monitoring for common complications.
Dental complications are mainly due to the secondary diseases
, Thyroid:
Controls speed of energy use and therefore metabolism.
Controls body’s sensitivity to other hormones.
Dysfunction of the thyroid therefore has widespread and varied effects on the body.
Controls speed of energy use and therefore metabolism.
Controls body’s sensitivity to other hormones.
Dysfunction of the thyroid therefore has widespread and varied effects on the body.
Goitre:
A goitre is an enlarged thyroid gland they may be:
Euthyroid
Hyperthyroid
Hypothyroid
Only require surgery if:
Dyspnoea
Dysphagia
Cosmetic concern
Causes of goitre include
Physiological – e.g. puberty
Drugs – e.g. Carbimazole
Thyroid disease e.g. Graves disease
