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Tabitha Campbell

Jody Williams

DHY 315

8/12/18

Dental Treatment Considerations: Epileptic Children

The World health Organization defines epilepsy as “a chronic affection of multiple

etiologies that is characterized by recurring episodes of paroxysmal brain dysfunction caused by

a sudden neurological discharge” (WHO). The condition usually develops in childhood and is

diagnosed after an individual has had at least two unprovoked seizures (NCBI). Effective home

care is crucial, oral hygiene is often overlooked and neglected in children suffering epilepsy.

When oral hygiene aid is not provided at home and dental care is not pursued children effected

by this condition commonly suffer gross decay, as well as traumatic tooth fracturing. Loss of

primary dentition before normal exfoliation times may cause a spacing issue for upcoming

permanent dentition, leading to possible malalignment or malocclusion and a need for corrective

orthodontic treatment.

When treating these children in the dental office special considerations need to be made

In an effort to reduce stress and anxiety in the patient it is advised to schedule appointments

during a part of the day in which seizures are not as likely to occur. Nitrous Oxide, or general

anesthesia may be necessary for effective care. Certain types of lights may trigger seizure

episodes, to reduce the chance of overhead lights, or operator lights inducing a seizure dark

glasses must be provided to these patients (NCBI).

It is important to have an up to date medical history prior to delivery of care. Monitoring

intake of pre- procedural intake of antiepileptic drugs is also important, many of the prescriptions
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for those with epilepsy cause oral side effects such as xerostomia, and gingival enlargement

(NCBI). Phenytoin is one common drug that can cause gingival enlargement. Gingival

hypertrophy can make proper oral hygiene difficult to maintain. The gingiva can swell over the

crown of the tooth making plaque removal challenging. Often times a gingivectomy is necessary

to restore proper gingival contour and make effective oral home care easier to achieve. The

dentist or hygienist may recommend a chlorohexidine gel or rinse to these patients for antiseptic

plaque reduction purposes. (epilepsy foundation) These chlorohexidine gels and rinses may help

improve oral health status by means of plaque reduction resulting in a reduction of gingival

inflammation and associated gingivitis.

It is important to realize that epileptic children may suffer several accompanying medical

conditions that need to be considered when providing care and in treatment planning. It may be

beneficial to take a hands-on approach when teaching these children about effective home care,

by having these patients demonstrate their technique and providing helpful technique

modifications they are able to learn more effectively. Involving the child’s guardian in the home

care review may prove beneficial as well. To provide these medically compromised patients with

the best oral care the hygienist must be educated and informed.
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Works Cited

World Health Organization, World Health Organization, www.who.int/.

“What Is Epilepsy?” Epilepsy Foundation, 21 Jan. 2014, www.epilepsy.com/learn/about-

epilepsy-basics/what-epilepsy

Joshi, Sourabh Ramesh, et al. Advances in Pediatrics., U.S. National Library of

Medicine, 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC3793425/.