The drug category chosen is endocrine drugs. This category of drugs acts on the endocrine system of the body. Endocrine medicines are medications that target a dysfunctional endocrine pathway. The endocrine system is made up of glands and chemical messengers known as hormones. The endocrine system is responsible for controlling growth and development, tissue function, metabolism, and reproduction. Hormones have an effect on practically every cell in the body because they travel through the bloodstream and connect to specialized receptors.
There are eight main glands in the body that are part of the endocrine system, including the pituitary, adrenal, thyroid, and pancreatic glands. This system has an impact on mood, sexual function, metabolism, and growth and development. One may have an endocrine disease or problem if their hormone levels are abnormally high or low. When the body does not react to hormones as it should, endocrine diseases and disorders can also arise.
Some of the disorders of the endocrine system include glucose homeostasis disorders, such as diabetes, type 1 and 2; thyroid disorders, for example, goiter and hyperthyroidism. Another disorder is calcium homeostasis disorders and metabolic bone disease such as osteoporosis, rickets, and osteomalacia. Pituitary gland disorder is also another common disorder of the endocrine system, it causes diseases such as the Cushing’s disease and pituitary tumors. Another disorder is the adrenal gland disorder that causes diseases such as Addison’s disease and congenital adrenal hyperplasia. . Sex hormone disorders are also disorders of the endocrine system, it causes diseases such as Turner’s syndrome, ovarian and testicular failure. Additionally, tumors of the endocrine system are yet another disorder of the system, the disorder causes Carcinoid syndrome and multiple endocrine neoplasia.
The cornerstones of endocrinology treatment involve replacing hormone deficits and controlling hypersecretion of hormones. Improving quality of life and lowering long-term morbidity and mortality linked to hormone hypo- or hypersecretion are the ultimate goals of treatment. However, the drugs and hormones used to treat endocrine disorders may have an effect on the dental aspect of the body. It is important for an orthopedist to be fully aware of a patient’s endocrine history so as to provide appropriate and timely treatment that will not negatively impact on the patient’s dental health. The main endocrine disorders that have an effect on dental health are diabetes mellitus, vitamin D deficiency, and sexual hormone imbalance.
Over time, there has been a brief rise in the incidence of gingivitis without a corresponding shift in plaque levels. Girls are more likely than boys to develop gingivitis, with a mean age of 12 years and 10 months for the condition’s peak experience compared to 13 years and 7 months for boys. A study found a favorable correlation between increases in gingival inflammation and elevated testosterone in boys and elevated estradiol and progesterone in girls. This is important for an orthopedist to keep in mind when handling dental matters of pubescents.
Since 1, 25 dihydroxyvitamin D, the active form of vitamin D, targets the cells known as ameloblasts and odontoblasts, it plays a crucial role in the production of enamel, dentin, and oral bone. A key risk factor for dental caries and periodontal disease is developmental abnormalities that can arise from a deficiency in vitamin D throughout the tooth development process. One possible explanation for these results could be enamel hypoplasia, a developmental abnormality that arises from a vitamin D shortage.
Dental caries is a multifactorial disease that also has a decreased saliva flow rate; diabetes mellitus is characterized by a decreased salivary buffering capacity. Dental carries has risk factors that include oral cariogenic bacteria, additionally, patients with diabetes have higher concentrations of cariogenic bacteria, especially Streptococcus mutans, and a higher percentage of the diabetic population has high concentrations of these bacteria. It is, therefore, anticipated that persons with diabetes would have a greater incidence and prevalence of dental caries.
Numerous research investigations have indicated a considerable rise in the prevalence, severity, and development of periodontal disease among people with diabetes. Moreover, at follow-up, significant periodontal disease is linked to poor metabolic control and other problems related to diabetes in patients with diabetes at baseline. Advanced Glycation End Products (AGEs) are produced as a result of diabetes and can both directly and indirectly aggravate inflammation, including periodontitis. According to research and tests, diabetes-related periodontal tissue damage and an exacerbated inflammatory response are caused by the interaction between AGEs and their receptor RAGEs (AGE-RAGE). Results indicate that in patients with childhood-onset diabetes, periodontal disease may begin very early in life and may become more noticeable as children grow into teens.
In conclusion, it is evident that there is a link between endocrine disorders and dental diseases; thus, it is crucial to comprehend the link so as to better manage both endocrine disorders and dental diseases without negatively impacting the other. Understanding the underlying pathophysiology of these conditions can sometimes explain why they co-occur, as in the case of diabetes mellitus and periodontal disease. In other situations, however, co-occurring risk factors, like socioeconomic status and carbohydrate intake, can explain why both conditions manifest clinically together.
References
KIRK, J. M., & RUTTER, M. M. (2021). Endocrine System. CHARGE Syndrome, 195.
Lloyd, R. V. (2023). Endocrine pathology. In Pathology: Historical and Contemporary Aspects (pp. 127-144). Cham: Springer International Publishing.
Saminsky, M. (2017). Periodontal Disease and Dental Caries among Children and Adolescents Suffering from Endocrine Disorders – A Literature Review.15(2), 165–172. https://doi.org/10.17458/per.vol15.2017.sam.periodontaldiseasedental
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