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Authors: John Morgan, Bonnie F. Zimble

Epilepsy/Seizure Disorders:

Summary

Special Care in Dentistry
John Morgan, DDS
Tufts University School of Dental Medicine, 2008


Table: Epilepsy (Seizure Disorder)

In summary, epilepsy, or seizure disorder, is an often-misunderstood condition that usually requires few, if any, special treatment modifications by dentists. Dentists should be prepared to treat the infrequent seizure that may occur in the chair. A positive dental experience will assist the patient with seizure disorder in overcoming the social stigma attached to the condition.  

DEFINITIONS AND SYMPTOMS

MAJOR ORAL CONDITIONS WHICH MAY OR MAY NOT BE PRESENT

PREVENTION AND TREATMENT

MEDICATIONS

Brain disorder in which the normal pattern of neuronal activity becomes disturbed 

Seizures may be triggered by external stimuli such as:

Stress

Anxiety

Pain

Sensory overload

Patient may also experience:

Strange sensations, emotions or behavior

Loss of Consciousness

 Convulsions

 Muscle spasms

Gingival hyperplasia associated with Dilantin

Uncontrolled clenching

Strict daily oral hygiene regimen starting at an early age 

Toothbrushing skills should be adapted to the individual’s abilities and strengths 

Fractured teeth and gaps in between teeth should be repaired to prevent injury to oral tissues during a seizure 

Routine exams and prophylaxis

 Mouth props may be needed in the event that a patient has a seizure during treatment 

Surgery to remove excessive gingival tissue when indicated

Altering anti-convulsant medications to reduce the incidence of gingival hyperplasia 

Use of mechanical toothbrushes 

Use of oral antimicrobial agents 

Fluoride therapy

 

Seizure medication such as phenytion (Dilantin) may cause gingival hyperplasia

Valporic acid (Depakene) and carbamezapine (Tegretol) may cause excessive bleeding 

Sucrose based medications may increase susceptibility to dental caries

 

 Source:

 National Institute of Neurological Disorders and Stroke