A dental exam uncovers undetected hypothyroidism in a 13-year-old girl

A dental exam uncovers undetected hypothyroidism in a 13-year-old girl

They say a picture is worth a thousand words. It’s one thing to read the list of over 300 hypothyroidism symptoms, but it’s another thing to see actual photos of the symptoms. When people dismiss your thyroid symptoms as all in your head as if they are imaginary symptoms you’ve made up in your mind (like anyone would make up these horrible symptoms), remember this: hypothyroidism can rear its ugly head in any part of the body. And that includes the mouth.

Hypothyroidism symptoms obvious in photos

A case study titled “Undetected hypothyroidism: A rare dental diagnosis” was published in the Journal of Oral and Maxillofacial Pathology in 2014. A 13-year-old girl came to the out-patient Department of Oral Medicine and Radiology in India with maligned teeth as the chief complaint. However, she presented with these obvious physical symptoms of hypothyroidism that had gone undetected. The dental plans were put on hold until a complete medical evaluation was performed.

  • Overweight (she gained abnormal weight after 9 years of age)
  • Short stature
  • Hoarseness of voice
  • Dry, cool skin
  • Stubby hands
  • Poor muscle tone
  • Puffy face
  • Broad, flat nose
  • Thick lips

A dental exam uncovers undetected hypothyroidism in 13-year-old girl

Overweight, short-stature

A dental exam uncovers undetected hypothyroidism in 13-year-old girl

Stubby hands

A dental exam uncovers undetected hypothyroidism in 13-year-old girl

Puffy face; broad, flat nose and thick lips

A dental exam uncovers undetected hypothyroidism in 13-year-old girl

Thick lips, macroglossia (large tongue) and spacing between incisors

  • Large, protruding tongue
  • Delayed shedding of deciduous teeth (baby teeth)
  • Delayed eruption of permanent teeth
  • Malocclusion (misaligned bite)
  • Over-retained deciduous canine
  • First and second molars in all four quadrants of the jaw
  • Only central and lateral permanent insiders and first permeant molars were erupted in all four quadrants
  • Retarded bone age in skull
  • Retarded bone age in hand-wrist

A dental exam uncovers undetected hypothyroidism in 13-year-old girl

Photograph of PA skull radiograph showing over-retained deciduous and unerupted permanent teeth

A dental exam uncovers undetected hypothyroidism in 13-year-old girl

Photograph of hand-wrist radiograph showing retarded bone age

Blood tests were taken and her TSH was found to be sky high at 153.46.

She was prescribed thyroxine sodium tablets by an endocrinologist. After five months of treatment, her clinical features of hypothyroidism visibly improved.

A dental exam uncovers undetected hypothyroidism in 13-year-old girl

Five month post-treatment photograph showing loss of excessive weight and puffy face

A dental exam uncovers undetected hypothyroidism in 13-year-old girl

Five month post-treatment photograph showing improvement in stubby hands

 Reference:

Sonal B. Dudhia and Bhavin B. Dudhia. Undetected hypothyroidism: A rare dental diagnosis. Journal of Oral and Maxillofacial Pathology. 2014 May-Aug;18(2):315-319.

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About Dana Trentini

Who knew that little butterfly-shaped thyroid gland at the base of my neck could affect my life so completely? I founded Hypothyroid Mom in memory of the unborn baby I lost to hypothyroidism. Winner of two 2014 WEGO Health Activist Awards: Health Activist Hero & Best In Show Twitter. Hypothyroid Mom is for information purposes only and should not be considered a substitute for consulting your physician regarding medical advice pertaining to your health. Hypothyroid Mom includes Affiliate links including the Amazon Services LLC Associates Program. Connect with me on Google+