Dental Care And Epilepsy

Epilepsy is a disease that occurs in people who have a wide range of environmental, socio-economic, educational, and other factors impacting their healthcare. Unlike non-epileptic people, specific considerations for epileptic patients include the treatment of oral soft tissue side effects of their medication and correcting damage to their teeth that has occurred secondary to seizure trauma.

The treatment planning for dental care must consider the fabrication of a dental prosthesis designed to minimize risk of future damage or displacement of teeth. The patient of epilepsy should also be properly educated and instructed in oral hygiene and provided an understanding of how their oral health impacts their general health. The two primary problems compromising the ability to maintain good dental health for patients with the disease epilepsy are the financial resources to afford good healthcare and, in some patients, mental or physical handicaps which prevent them from being properly managed or to cooperate in a general dental setting.

A thorough consideration of the health of the epilepsy patient's history is the main prerequisite for successful treatment and can prevent many complications. Most of the patients with the disease epilepsy know that they have the disease and are either on medication or know they are vulnerable to seizures. This information should be brought out during their early visit when the health history is taken. If the patient acknowledges they have the disease epilepsy, then the other medical questions are sensible. Some of the epileptic patients may tend to hide their disorder for fear of being refused dental treatment or they consider epilepsy as an embarrassing disease. In this case the information requested on the health history regarding treatment and medications the patient takes should alert the dentist to a possible seizure disorder.

As with all of the patients, the regularity of dental check-ups and prophylaxis appointments should be based on the patient's needs. The goal of this is to reduce and prevent the dental and periodontal disease and diseases of the oral mucosa. The recall and hygiene interval of this condition may be more frequent for epileptic patients due to increased risk for gingival hyperplasia secondary to use of an AED such as phenytoin (Dilantin). During a dental check up it is important to explain to the patient and parents (if applicable) the importance of good oral hygiene and adequate nutrition on their gingival health and general health. It is also a good time to make clear why it is important to use toothpaste and any supplemental fluoride preparations for the prevention of dental decay, especially in those patients suffering from xerostomia.

The physician should keep in mind stress is one of the factors that can trigger a seizure. Appointments with the doctor should be scheduled during a time of day when seizures are less likely to occur, if predictable, and to minimize stress and anxiety during the appointment. Methods such as explaining the dental procedures to the epileptic patient before starting and offering assurance and support during the procedure are always useful. This kind of interaction allows the physician to assess the status of the patient during the procedure and can reduce the patient's worry and tension.

• John Palsson
• 17/02/2009, 8:59 AM
• 0 Comments