Hypothyroidism Dental Management — ORE Part 1 MCQ

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EasyHuman Disease & Dental ManagementHypothyroidism Dental ManagementORE Part 1

A patient with well-controlled hypothyroidism, treated with levothyroxine, attends for routine dental treatment. Which is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Provide routine care after confirming that treatment is stable

Explanation lettering: D = shown as A · E = shown as B · B = shown as C · C = shown as D · A = shown as E

**A is correct.** In a patient whose hypothyroidism is well controlled on established levothyroxine replacement, routine dental treatment can proceed normally. The relevant check is that the condition and treatment are stable, alongside the usual medical history and medication review. The UK levothyroxine SmPC describes dose titration and monitoring to correct thyroid deficiency; its cautions principally concern initiation of replacement in patients with significant cardiovascular disease, advanced age, or severe long-standing hypothyroidism. B is inappropriate because well-controlled hypothyroidism alone does not require universal avoidance of adrenaline-containing local anaesthetic. C is wrong because hypothyroidism is not an indication for antibiotic prophylaxis. D is unnecessary in stable disease. E is also incorrect: no automatic 50% local-anaesthetic dose reduction is indicated solely because a patient takes stable levothyroxine.

Reference: Electronic Medicines Compendium. Levothyroxine 50 micrograms/5 ml Oral Solution: Summary of Product Characteristics, sections 4.2 and 4.4, 2024. https://www.medicines.org.uk/emc/product/12323/smpc