Hypothyroidism and hyperthyroidism can impact dental treatment. For patients with hyperthyroidism, epinephrine and other vasopressors used in dental procedures should be used cautiously as they can overstimulate the cardiovascular system and potentially cause issues like cardiac arrhythmias. When local anesthetics with vasoconstrictors must be used for hyperthyroid patients, the least concentrated epinephrine solution should be chosen and the smallest effective volume injected, and aspiration should be performed before injection.

20. Hypothyroidism

22. Impaction
molar

30. DENTAL CONSIDERATION • HYPERTHYROID –
Epinephrine & other vasopressors should be used with caution –
Vasopressors stimulate the cardiovascular system & can precipitate
cardiac dysrhythmias, tachycardia, & thyroid storm in hyperthyroid
patients whose cardiovascular system have already been sensitized
DENTAL CONSIDERATION • HYPERTHYROID –
However, LA with vasoconstrictors may be used when the following
precautions are taken: • Used the least-concentrated effective solution of
epinephrine (1:200,000 is preferred to 1:100,000 which is preferred to
1:50,000) • Injecting the smallest effective volume of
anesthetics/vasopressors • Aspiration prior to any injection