Hallman

Beth Hallman DH1

Michelle Cummins
DH 120A: Clinical Dental Hygiene
16 May 2014
Iodine: An Essential Mineral to the Body
The human body is a complex system that, even after thousands of years, is still
largely a mystery. It is clear, however, that in order for the body to function correctly it
must be fueled with the correct foods. Beyond that, these foods must contain essential
vitamins and minerals in the right proportions for the body to function properly. There are
some vitamins that are deemed as non-essential because they are naturally occurring in
the body such as vitamin D, which is synthesized in the skin when it is exposed to
sunlight. There are other vitamins and minerals, however, which are essential, in other
words; the body has no way of receiving them unless they are consumed. Iodine is
considered to be an essential mineral and is crucial in the development and maintenance
of the human body.
Iodine is a naturally occurring element that was first discovered in 1811 by a
French chemist, Bernard Courtois. He poured sulphuric acid on seaweed ash, which then
produced a violet vapor that crystalized to form iodine. This mineral is most abundant in
seawater at 0.05 parts per million, therefore, it is present in sea vegetables such as
seaweed (3). Iodine may also be found in other foods such as shellfish, fish, spinach,
pumpkin, broccoli, chocolate, yogurt, cows milk, eggs, mozzarella cheese and
strawberries (2). In addition to these foods in which iodine naturally occurs, in the
1920s, when the symptoms of iodine deficiency were first being recognized, iodine

Hallman

began to be added to ordinary table salt. According RD McCure in Life Extension

Magazine, The Morton Company was the first to add iodine to salt in 1924, after a
successful public health campaign (4). As opposed to a few decades ago when goiters
were common, goiters caused by iodine deficiency have been practically stamped out of
existence in the United States.
Iodine has a plethora of uses; some of the uses are biological and some that are
commercial. The Royal Society of Chemistry lists iodines commercial uses as involving
pharmaceuticals, photographic chemicals, printing inks and dyes, catalysts and animal
feeds (3). Biologically, iodine plays an essential role in the health and function of the
thyroid gland. One of iodines main functions in the body is to synthesize the thyroid
hormones thyroxine (T4) and triiodothyronine (T3) that are made of the amino acid
tyrosine and a specific number of iodine atoms (depending on the hormone). The
hormones that the thyroid produces control your bodys metabolism, regulating
everything from body temperature and heart rate to glucose consumption and even blood
lipid levels. [In addition] iodine isespecially crucial for brain development in children,
making its deficiency the number one cause of preventable mental retardation
worldwide (4).
As previously hinted at, a deficiency of iodine in a persons diet can lead to
significant negative health effects. Because of iodines role in the function of the thyroid,
a lack of iodine in the body can lead to the swelling of the thyroid gland resulting in what
is known as a goiter. According to whfoods.org, The enlargement of the thyroid results
from overstimulation of the thyroid gland by thyroid stimulating hormone (TSH), as the
body attempts to produce increased amounts of thyroid hormone(5). Some of the other

Hallman

conditions that may be caused by an iodine deficiency are hypothyroidism,

hyperthyroidism, Graves disease, cretinism, and an increase in blood lipids. All of these
conditions are related to the dysfunction of the thyroid gland in response to a lack of
iodine in the blood. Iodine is especially important in the diet of a pregnant or lactating
woman as it is crucial in the brain development of children and can help to prevent
miscarriages. Recent studies have also shown that iodine may play a role in breast health,
stomach health, and cardiovascular health (4). On the opposite side of the spectrum, an
excess of iodine can also cause health problems, although an iodine overdose rarely
occurs from consuming iodine-rich foods alone. Accidental overdose of iodine from
medications or supplements in amounts exceeding one gram may cause burning in the
mouth, throat and stomach and/or abdominal pain, nausea, vomiting, diarrhea, weak
pulse, and coma (5). Ironically, an iodine overdose can manifest itself with the same
symptoms as an iodine deficiency. In an attempt to prevent these symptoms of iodine
toxicity, the Institute of Medicine established the following Tolerable Upper Intake
Levels (TUL) for iodine: 1-3 years: 200 mcg, 4-8 years: 300 mcg, 9-13 years: 600 mcg,
14-18 years: 900 mcg, 19 years and older: 1,100 mcg, Pregnant women 14-18 years: 900
mcg, Pregnant women 19 years and older: 1,100 mcg, Lactating women 14-18 years: 900
mcg, Lactating women 19 years and older: 1,100 mcg (5).
Iodine deficiency is most often manifested in the body through thyroid disorders;
these disorders themselves have many oral manifestations. The most common thyroid
disorders that exhibit oral conditions are hypothyroidism and hyperthyroidism.
Hypothyroidism is a decrease in the function of the thyroid that can manifest itself
systemically with a slower metabolic rate, weight gain, lethargy, intolerance to cold, dry

Hallman

and cool skin, and puffiness of the face and eyelids, as well as others. The blood pressure
appears to be normal, but the heart rate is slow (1). Hypothyroidism is also known as
cretinism when seen in children. Orally, cretinism may be demonstrated by
macroglossia, dysgeusia, delayed eruption, poor periodontal health, altered tooth
morphology and delayed wound healing (1). Hyperthyroidism, however, is an
overproduction of the thyroid hormones, that may result in symptoms including, tremor,
emotional instability, intolerance to heat, sinus tachycardia, marked chronotropic and
ionotropic effects, increased cardiac output (increased susceptibility to congestive heart
failure), systolic heart murmur, hypertension, increased appetite and weight loss (1).
Orally, hyperthyroidism may cause an increased susceptibility to caries, periodontal
disease, enlargement of extraglandular thyroid tissue (mainly in the lateral posterior
tongue), maxillary or mandibular osteoporosis, accelerated dental eruption and burning
mouth syndrome (1). Graves disease is another form of hyperthyroidism that is often
demonstrated with an enlarged thyroid gland, such as a goiter, that is palpable and visible
during the intra/extra-oral exam. If any of these symptoms present themselves during a
routine dental hygiene appointment and the patient shows no history of thyroid conditions
on their medical history it is crucial that the hygienist report these findings to the dentist
who can then refer the patient to an endocrinologist to further evaluate their condition.
When providing care to a patient who presents with hypothyroidism, there are
several things that the clinician needs to be aware of. First, hypothyroidism may cause
prolonged bleeding; therefore, bleeding during the assessments and prophylaxis must be
carefully monitored. Furthermore, this condition can also prolong the healing process so
with reappointments, healing should be assessed with this in mind. Additionally,

Hallman

hypothyroidism can cause cardiac problems, so the patients primary care physician
should be consulted to be sure that no premedication is required before dental treatment
can be carried out. These patients also demonstrate sensitivity to central nervous system
depressants and barbiturates, so these kinds of medications should be used only in
moderation. Finally, the use of surgical antiseptics that contain iodine may also increase
the risk of hypothyroidism and should be avoided (1).
On the other side, patients with hyperthyroidism may also require special
attention from the dental staff. Due to the symptoms of elevated heart rate and blood
pressure demonstrated with hyperthyroidism, an increased duration in pressure put on a
bleeding wound may be necessary to stop bleeding. As with hypothyroidism, patients
with an overactive thyroid may also be at risk for delayed healing in the oral
environment. Analgesics containing ASA (acetylsalicylic acid) and NSAIDS are both
contraindications for patients presenting with hyperthyroidism. Fluoride, though usually
encouraged by dental professionals, may need to be avoided with patients with thyroid
conditions due to antagonistic affects with iodine, which can inhibit the thyroids ability
to properly make hormones (1).
In conclusion, it is crucial for the health of dental patients and people everywhere
to be aware of the vitamins and minerals that their bodies require for proper functioning
and how it can be added to their diets. Iodine is an essential mineral that, when lacking,
has a negative effect on the health and function of the human body. If a patient is lacking
iodine they should be encouraged to add the foods previously discussed into their diets,
or take dietary supplements.

Hallman
Works Cited
(1) Chandna, Shalu and Manish Bathla. Oral Manifestations of Thyroid Disorders and
Its Management. Indian Journal of Endocrinology and Metabolism. Jul 2011;
15(Suppl2): S113S116. WEB. 13 May 2014.
<http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3169868/>
(2) Darby, Michele Leonardi and Margaret M. Walsh. Dental Hygiene: Theory and
Practice. St. Louis, Missouri: Saunders, Elsevier Inc., 2010. PRINT.
(3) Periodic Table: Iodine. Royal Society of Chemistry. 2011. WEB. 13 May 2014.
<http://www.rsc.org/periodic-table/element/53/iodine>
(4) Piccone, Nancy. The Silent Epidemic of Iodine Deficiency. Life Extension
Magazine. Life Extension Magazine, October 2011. WEB. 13 May 2014.
< http://www.lef.org/magazine/mag2011/oct2011_The-Silent-Epidemic-ofIodine-Deficiency_01.htm>
(5) Worlds Healthiest Foods. George Matiljan Foundation. WEB. 13 May 2014.
< http://www.whfoods.com/genpage.php?tname=nutrient&dbid=69>