Cautions and Considerations for Thyroid Patients Receiving Dental Care

Dentist and dental assistant looking in patient's mouth
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You may not think that a visit to the dentist has anything to do with your thyroid health, but there are actually four particular areas where there is a crucial connection between your thyroid health and dental tests, treatments, and products.

Dental Care Considerations for People With Compromised Thyroid Health

Here are some considerations to be aware of when it comes to receiving services and using dental care product.

Some Dental Composites Contain BPA

There's a chance that porcelain composites used to fill your cavities contain bisphenol A (BPA), a known endocrine disruptor.

Dr. Irineo Marvin Pantangco of the Center for Natural Dentistry in Encinitas California is a dentist with BPA on his radar. Dr. Marvin describes himself as "a holistic dentist with a passion for a natural approach to dental care." Dr. Marvin has shared that the BPA-free composites he uses on his patients include Diamond Lite, Grandio, and Admira.

Action Point: You may want to ask your dentist which composites he or she is using, and request or insist on a BPA-free product.

Triclosan Is an Ingredient in SomeToothpastes and Mouthwashes

BPA isn't the only endocrine disruptor you're likely to encounter during a session in the dentist's chair. Triclosan, for instance, is an ingredient of some plaque-fighting toothpastes, mouthwashes, and mouth rinses.

Action Point: Ask your dentist if any of the product he/she is using contain triclosan, and ask for a substitution.

Also, choose triclosan-free products for use at home. (Dr. Ben Kim has a helpful list of other dental and household products containing triclosan.)

Multiple Dental X-Rays Are Linked to Thyroid Cancer

Another issue that you are likely to encounter is the dental x-ray. Even many dentists are not aware that the risk of thyroid cancer increases with multiple exposures to dental x-rays.

Some doctors have a "policy" of requiring a panel of x-rays once a year, even if you have good dental health and no signs of disease or problems. Children are often subjected to multiple dental x-rays, especial when going through orthodontia.

Action Points: You may want to refuse to have standard/scheduled x-rays, and agree to x-rays only for diagnostic purposes when there are symptoms or signs of a problem.

You can also ask your dentist to have a thyroid collar — a lead collar that they can place around a patient's neck — on hand, to protect the thyroid from radiation during an x-ray. This is especially important for children, whose thyroid glands are especially susceptible to radiation exposure.

The Controversy Over Fluoride Use in Thyroid Patients

The biggest concern for thyroid patients may be the issue of fluoride.

Many water supplies in the U.S. are fluoridated, and many dentists recommend fluoride treatments and fluoride toothpaste for their patients, especially children, to help prevent cavities. More recently, dentists are also offering fluoride varnish and gel as desensitizing agents.

Many people are not aware that in the first half of the 20th century, fluoride was used medically as an anti-thyroid drug, to slow down thyroid function in patients with an overactive gland.

Fluoride was found to be effective at suppressing or reducing thyroid function, according to research, and the dose needed to reduce thyroid function was low — 2 to 5 mg per day over a period of months. Some scientists estimate that people today who are living in communities with fluoridated water supplies have a range of exposure of 1.6 to 6.6 mg/day.

Action Points: If you are concerned about fluoride, you also may want to find out how much fluoride is in your water supply. The CDC database ​My Water's Fluoride can help you discover the fluoride levels in your county.

If you are particularly concerned, you can stop drinking fluoridated water, and choose a non-fluoridated bottled water. Some people choose to install a reverse osmosis or distillation unit for their home drinking water, or a whole-house unit for drinking, bathing, and washing clothes.

You can also choose toothpaste, mouthwashes and other dental products without fluoride, and be particularly careful that children do not be allowed to swallow products containing fluoride.

This isn't easy, as more than 95 percent of toothpastes contain fluoride, but a few fluoride-free brands include Jason, The Natural Dentist, and Organix-South, which are available at health food stores and online. Tom's of Maine does make a fluoride-free toothpaste, but they also make one with fluoride, so if you choose this brand, check the label carefully.

Infant Dental Health and Fluoridated Water

If you have a formula-fed infant, be aware that the Centers for Disease Control (CDC) has issued a warning against overuse of infant formula that is reconstituted with fluoridated water.

According to the CDC, if that is an infant's only source of nutrition, "there may be an increased chance for mild dental fluorosis. To lessen this chance, parents can use low-fluoride bottled water some of the time to mix infant formula; these bottled waters are labeled as de-ionized, purified, demineralized, or distilled."

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