Large tongue is common in

Oral manifestations of hypothyroidism : Childhood hypothyroidism known as cretinisim is characterized by thick lips, large protruding tongue (macroglossia), malocclusion and delayed eruption of teeth. Thickening of the lips and macroglossia is due to increased accumulation of subcutaneous mucopolysaccharides i.e., glycosaminoglycans due to decrease in the degradation of these substances. The long-term effects of severe hypothyroidism on craniofacial growth and dental development have also included impaction of the mandibular second molars. This seems to be caused by a dissociation of ramus growth and failure of normal resorption of the internal aspect of the ramus, resulting in insufficient space for proper eruption of these teeth. The common oral findings in hypothyroidism include the characteristic macroglossia, dysgeusia, delayed eruption, poor periodontal health, altered tooth morphology and delayed wound healing.Before treating a patient who has a history of thyroid disease, the dentist should obtain the correct diagnosis and etiology for the thyroid disorder, as well as past medical complications and medical therapy. Reference: GHAI Essential pediatrics, 8th edition