Asthma

Orthodontics should be performed only on asthmatic patients who are asymptomatic or whose symptoms are well controlled. To minimize the risk of an attack, the patient's appointment should be in the late morning or the late afternoon. Orthodontist needs to be aware of the potential for dental materials and products to exacerbate asthma. These items include dentifrices, fissure sealants, tooth enamel dust (during interproximal slicing) and methyl methacrylate. Therefore, fixed appliances and bonded retainers without acrylic are preferable.

Oxygen and bronchodilator should be available during treatment. Dental local anesthetics with vasoconstrictors should be used with caution in asthmatic patients, as many vasoconstrictors contain sodium metabisulfite, a preservative that is highly allergenic.14 Anxiety is a known ‘asthma trigger', so the orthodontist should reduce the stress level of the patient. (Source: different Articles)

Thyroid Disease

Orthodontic therapy requires minimal alterations in the patient with adequately managed thyroid disease. Patients with histories of hyperthyroidism should be carefully evaluated to determine the level of medical management, and they should be treated in a way that limits stress and infection. Medications such as epinephrine and other vasopressor amines should be given with caution in patients with treated hyperthyroidism, although the small amounts are used in dental anesthetics. Patients with hypothyroidism require careful consideration due to the potential for excessive sedation. (Source: different Articles)

Thank you very much for your valuable answer. But i was talking about hypothyroidism not hyperthyroidism.

Why not?

In todays world of emerging technical improvements, i cannot see any reason to refuse ortho treatment in such patients.

There are 2 important considerations:

1. History of allergies...do not use any materials which may cause allergic reactions and bring on an attack of asthma.

2. If the hypothyroidism is long-standing, an o.p.g. X-ray to check the density of bone is a must, followed up with a bone scan, if indicated.

Besides, go easy with patients having both these conditions.

Take time to explain and detail the procedure properly.do not say "dont worry, it is a simple procedure, and wont pain at all."

these patients are hyper-everything..they worry a lot and may be very nervous.

Also do their work slowly and see that they are v comfortable.there should be no anxiety or apprehension in the patient's mind.

I agree with Dr. Havewala, take care using NiTi arches or coils and even try to use nickel free brackets! Good luck ;)

Thank you all...