MON-616 Potential Relationship between Hypothyroidism and Periodontal Disease Severity

Abstract

Introduction: Hypothyroidism is an endocrine disorder having autoimmune and inflammatory etiologies. There is evidence that periodontal disease might be influenced by a variety of systemic inflammatory conditions in a bidirectional manner, including diabetes, cardiovascular disease, adverse pregnancy outcomes, and osteoporosis.1 Consequently, we hypothesized that the severity of periodontitis also might be influenced by hypothyroidism. Methods: IRB approval was obtained prior to initiation of this study. To test our hypothesis, records of patients referred to a faculty periodontal practice during the 20-year period from 1996-2015 were reviewed (N=1093). Inclusion criteria included the presence of chronic, generalized moderate-to-severe periodontitis (stage III to IV; grade B to C).2 Exclusion criteria were diabetes, smoking, systemic steroids, hormonal supplementation unrelated to thyroid disease, and non-thyroid autoimmune disease. After applying those criteria, 538 patients were considered for further analysis. Periodontal disease severity was measured by calculating the percent of teeth with probing depths ≥5 mm or ≥6 mm. The presence of hypothyroidism was determined by review of patient medical history for use of prescription medication(s) for thyroid hormone supplementation. Significance was measured via analysis of variance and independent sample t-tests calculated using IBM SPSS Statistics v25. Results: Patients with hypothyroidism had more teeth with greater probing depths, implying more severe periodontal disease. Specifically, 61.4% of teeth from periodontitis patients with hypothyroidism had periodontal probing depths ≥5 mm, vs. 48.1% of teeth in periodontitis patients without hypothyroidism (27.7% increase, mean difference= 13.3%, 95% confidence interval= 7.9%-18.8%, P=5E-06). Similarly, the prevalence of probing depths ≥6 mm was 36.2% in periodontitis patients with hypothyroidism, vs. 28.2% for periodontitis patients without hypothyroidism (28.4% increase, mean difference= 8.0%, 95% confidence interval= 3.1%-12.9%, P=0.002). Conclusions: Our data indicate that the prevalence of moderate to advanced periodontitis might be influenced by hypothyroidism. Prospective and retrospective studies are currently underway to determine whether hypothyroidism might be associated with systemic or inflammatory changes that might affect periodontal disease progression. Studies measuring the relationship of hypothyroidism on less severe forms of periodontitis also are in progress. Collectively, our data suggest that periodontists should consider thyroid disease, and endocrinologists should consider clinical history or signs of periodontal disease, as a component of patient evaluation.