Dental Status and Oral Health of Patients with Epilepsy: An Epidemiologic Study

Abstract

Summary: Purpose: We performed a dental survey of epilepsy patients to examine their oral health by statistical means and to provide a guide for the dental treatment of these patients. Methods: We first set up four “dental” subgroups of epilepsy patients, based on the types of seizures, seizure frequency, and mental state. One hundred one patients underwent a survey concerning their dental, medical, and epilepsy histories, followed by a dental examination. Indexes quantifying oral hygiene, the number and condition of the remaining teeth, periodontium, and the degree of prosthetic treatment were measured. An age‐matched control group of general (nonepilepsy) population underwent an identical dental examination. Statistical comparison was performed between the patient and the control groups and between subgroups of epilepsy patients. Results: In almost all aspects of oral health and dental status, patients with epilepsy showed a significantly worse condition compared with the control group. Comparison of the subgroups of epilepsy patients revealed that the most severe findings concern patients who have poorly controlled epilepsy, especially those who have frequent generalized tonic–clonic seizures. Conclusions: The observed difference probably results from a combination of factors such as the effect of the seizures themselves, socioeconomic conditions, and the negative attitude of dentists. We recommend that the planning of dental treatment of such patients should start with the assessment of their disease and determination of the “dental” subgroup to which they belong. For each subgroup, specific recommendations for interventions are given.

Assessment of oral health status of children with epilepsy: A retrospective cohort study

“…Parents of all study participants were interviewed using a structured detailed standardized questionnaire constructed from similar studies to match the objectives of the study. Data on age, gender, number of siblings and parents’ level of education and employment were collected.…”

“…Some anti‐epileptic drugs (AEDs) are known to have side effects with direct negative impact on oral health condition. Phenytoin, for instance, causes gingival hyperplasia and this has been observed in 50% of patients taking this medication for 3 months . There is controversy, however, regarding caries experience in epileptic patients.…”

Epilepsia: condutas na prática odontológica

“…Em geral, pacientes com epilepsia e com crises regulares tendem a ter um baixo nível socioeconômico, provavelmente devido ao preconceito quando procuram emprego. E o baixo poder socioeconômico está relacionado com a saúde bucal deficiente, indicadas, quando necessárias, aplicações de flúor, profilaxias profissionais frequen- tes e tratamento periodontal, além do uso de saliva artificial nos casos de xerostomia 11,[13][14][15] . O cirugião-dentista deve conhecer algumas interações medicamentosas perigosas, que podem impedir a absorção do antiepilético, como a eritromicina, as penicilinas, o metronidazol, a aspirina e o ibuprofeno, descritas detalhadamente na Tabela 2 16,17 .…”

Epilepsy and Oral Health

“…In almost all aspects of oral health and dental status, the condition of patients with epilepsy is significantly worse than age-matched groups in the general (nonepileptic) population (Karolyhazy et al, 2003). Furthermore, patients who have poorly controlled epilepsy and experience frequent generalized tonic-clonic seizures exhibit worse oral health in comparison with patients who are better controlled or only have seizures that do not involve the masticatory apparatus (Karolyhazy, et al, 2003). The number of decayed and missing teeth, the degree of abrasion and periodontal indexes are significantly worse in patients with epilepsy.…”

“…The medical literature contains little information on the influence of epilepsy in dental care. Patients who have epilepsy have been shown to have significantly worse dental condition than the general population (Karolyhazy, et al, 2003). The disease may affect the dental status and oral health of patients in several ways.…”