Relationship Between Hypothyroid Disease and Periodontitis
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PART IBackground The potential association between periodontitis and a variety of immunologic and inflammatory conditions provides a foundation for a possible relationship between hypothyroidism and periodontitis. A scoping review was performed to categorize and evaluate the existing literature regarding the potential relationship between those conditions.Methods We used a modified approach to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) by searching five databases in addition to the grey literature. Keywords for both periodontal disease and hypothyroidism in the title and abstract fields, including subject terms from the database thesaurus when possible, were used to search the existing literature for publications relevant to evaluation of the thyroid-periodontitis relationship. No date or language restrictions were applied.Results The authors screened 847 unique publications from an initial search September 4th, 2018, and a supplemental search on April 26th, 2019, which, after applying inclusion and exclusion criteria, yielded 29 publications (28 full-length papers and one abstract), which were further analyzed for relevance and applicability. Most of the included papers were cross-sectional studies (n= 14), with five of them being retrospective chart reviews. Only one retrospective cohort study, one intervention study, three case-control studies, two review papers, three case reports, and four animal studies, were identified after review of the literature, in addition to one abstract. However, following critical analysis, only three papers and one abstract were used to further assess the hypothyroid-periodontitis relationship.Conclusions There are very few high-quality studies describing the potential association between hypothyroidism and periodontitis, with most of the available literature consisting of retrospective cross-sectional studies and chart reviews. In general, and among the included papers with the fewest confounding factors, a positive relationship between hypothyroidism and periodontitis was found. Further well-controlled, prospective clinical and immunologic studies will be required to confirm that relationship, to measure the strength of any association with disease severity, to establish causality, and to establish the role of either disease in the pathogenesis of the other. PART IIBackground Western New York State (WNY) generally is considered to have a high prevalence of hypothyroidism (HT), but there are insufficient corroborating data. Materials and methods Records of 2,297 periodontal maintenance patients ≥35 years old were reviewed for HT and thyroid hormone supplementation. Results HT prevalence in the WNY population was 15.0%, and 22.6% among females. HT prevalence in a comparable 2011-2012 NHANES dataset was 7.0%, and 10.1% among females. The WNY population exhibited a higher HT prevalence per age decile subgroup, compared to NHANES. Conclusions Our results suggest that HT prevalence in WNY is substantial, and should be considered during patient evaluation.