Epilepsy and oral care

Epilepsy is caused by a change in brain electrical activity that can result in a seizure. Seizures can vary in strength from an absence (which may be hard for somebody else to notice) to a very obvious seizure (resulting in the person falling to the floor, going stiff and jerking).

There are over 600,000 known epileptics in the UK. Some have the condition their entire life while others may acquire it after a stroke, severe head injury or brain infection. 

So how can Epilepsy affect teeth?

There are many ways in which epilepsy can affect teeth:

Medication/Xerostomia:

A common medication for treating epilepsy is the anti-epileptic drug Carbamazepine. One of the common side effects of this drug (and others used to treat Epilepsy) is Xerostomia or dry mouth. Saliva substitutes and stimulants can be used to relieve the side effects of Xerostomia. Talk to your pharmacist or dentist to find the most suitable saliva substitute or stimulant.

Trauma:

Epileptic seizures often result in trauma to the head, face and teeth. The severity of the trauma can range from split lips, lacerated tongue to multiple fractured teeth or facial fractures.

Limitations on treatment:

Patients with epilepsy may not be suitable for certain prostheses e.g.dentures. If a denture fractures or becomes dislodged during a seizure, it becomes a choking risk and a potential airway hazard. For this reason, dentists may not recommend a removable prosthesis. Similarly, adhesive bridges can come loose or fall off during a seizure, again posing an inhalation risk.

So what can be done?

• Well maintained epilepsy to reduce the risk of seizures with regular medication checks
• Excellent oral hygiene
• Regular dental visits with planning for supportive therapy and knowledge how to quickly access emergency dental care if needed
• Saliva replacements if required.

Once somebody has fully recovered from a seizure, assess the mouth to see if any obvious damage has occurred. If a minor cut to the cheeks or lips is present, then rinse gently with warm salt water at regular intervals. If the teeth have been affected or are loose, arrange an emergency dental appointment. If a tooth looks loose or like it will fall out do not remove it. Keep it in the socket and
the mouth closed and access an emergency dental appointment as soon as possible. If the tooth has come out completely, do not rinse it or put it in cold water. Do not allow the tooth to dry out, store in milk if possible. Bring it with you to the dentist as quickly as possible.

Sometimes the teeth can be replaced in the socket and splinted in place often resulting in the tooth being maintained if you act quickly enough.