Table 3.81.

Key considerations for dental management in hyperthyroidism (see text)

	Management modifications*	Comments/possible complications
Risk assessment	2	Thyroid storm; fainting; possibly lymphopenia and bleeding tendency
Appropriate dental care	2	Behaviour control; delay elective dental treatment until the patient rendered euthyroid
– Local anaesthesia	1	Reduce epinephrine dose
– Conscious sedation	1	Avoid benzodiazepines
– General anaesthesia	3/4	Arrhythmias
Patient access and positioning
– Access to dental office	0
– Timing of treatment	0
– Patient positioning	0
Treatment modification
– Oral surgery	2
– Implantology	2
– Conservative/Endodontics	1
– Fixed prosthetics	1
– Removable prosthetics	1
– Non-surgical periodontology	2
– Surgical periodontology	2
Imaging	1	Alveolar osteoporosis
Hazardous and contraindicated drugs	2	Avoid benzodiazepines and povidone-iodine

^*0 = No special considerations. 1 = Caution advised. 2 = Specialised medical advice recommended in some cases. 3 = Specialised medical advice mandatory. 4 = Only to be performed in hospital environment. 5 = Should be avoided.