Epilepsy and dental health
While the subject of dental health should concern everyone, it is of particular importance to those who regularly take medication including many children and adults with epilepsy.
Some anti-epileptic drugs and other medications can cause dental problems. Symptoms such as bad breath, or gums being sore, swollen or red, may indicate a need to pay closer attention to dental health practices.
What is dental health?
In general, it is a combination of good dental hygiene habits, including regular visits to the dentist, and effective communication between the person and their dentist and doctor. Proper dental care is necessary to help prevent dental decay and gum disease.
Why is dental health important for people with epilepsy?
Dental complications have been closely associated with the use of Dilantin, a commonly prescribed anti-epileptic drug, while anecdotal evidence suggests that other medications may also cause problems in some people.
It is not yet fully understood why Dilantin causes dental problems. What is known, however, is that Dilantin can produce gingival hyperplasia, a condition which results in painful, swollen, red gums. This is more common among children who are on this medication.
Other problems which have sometimes been associated with long-term use of Dilantin include coarsening of facial features, extra body hair growth (often in women) and acne (most common in teenagers).
If Dilantin has been introduced in high doses at an early age, the position of the teeth and supporting bone structure, and the development of the child's skull, can all be affected to varying degrees. Therefore it is very important to pay close attention to teeth and gums.
How can dental health be improved?
The following suggestions will help prevent problems and ensure that good dental health is achieved.
All children should be examined by a dentist after their first tooth appears.
Dental care program
Discuss your situation with your dentist and doctor. They can help you work out a suitable dental care program which includes regular dental checkups.
Dentists are trained to monitor the development of teeth and to treat problems which may include teeth growing out of alignment. Working in consultation, your dentist and doctor should be able to tell you whether a dental problem is related to anti-epileptic medication or some other cause.
Proper dental habits
This means putting your dental care program into practice, including regular brushing and careful removal of food pieces to prevent bacteria building up. It is the bacteria, collecting in the mouth, which causes the problems.
Bacteria leads to infection which can result in gum disease and other problems. Use dental floss and if a toothbrush is not available at lunchtime, rinse your mouth vigorously with water.
Don't forget poor dental habits can increase the chances of gum tissue overgrowth which makes biting and eating difficult. It is often painful and looks unsightly. This overgrowth may sometimes require oral surgery.
The dentist needs to be aware of the type of medication prescribed, including dosage levels and any experiences of side effects or interactions between drugs. Anti-epileptic drugs, in the form of syrup, may also cause dental problems in some children.
Diet and lifestyle
Consider carefully the effects of diet and lifestyle. Generally speaking, foods which are best for overall health are best for dental health.
Aim for regular, healthy and well-balanced meals, avoiding crash diets and junk food. A healthy diet will include those foods which are nutritional and which contribute towards the development of healthier teeth and gums.
Foods such as raw vegetables and fruit, wholemeal bread and milk are recommended. Sugary cakes and pastries, sweets, biscuits, syrup, jam, honey, white bread, chewing gum, soft drinks, icy poles and ice creams should only be eaten in moderation as these are the types of food which encourage tooth decay.
Regular dental checkups
A checkup with the dentist is recommended every six (6) to twelve (12) months.
If teeth have been broken, the jaw fractured or the face bruised as a result of a fall during a seizure, medical assistance should be sought immediately.
You should also seek medical help if fragments such as food have been swallowed or inhaled, while the jaw was clenched during a seizure.
Falling can sometimes cause problems to soft and hard oral tissues. People who experience drop attacks (both tonic and atonic) are more likely to sustain dental injuries than others.
Remember: epilepsy and dental care both require regular monitoring. Preventive dental care is directed towards the prevention of dental decay and gum disease. This is part of a comprehensive lifelong dental care program.
For more information on epilepsy and dental health consult:
- your own dentist,
- the Dental Emergency Service at the Royal Dental Hospital of Melbourne
telephone 03 9341 0222,
- Department of Health and Community Services - Dental Health Services
telephone 03 9868 7888
- Epilepsy Foundation of Victoria.
Reference Panel: Prof F. Vajda (Austin Hospital); Dr T. Markowitz (Box Hill Community Health Centre); Dr V. Amarena (Dental Board of Victoria); Dr S.Y. Liow; Ms A. Fundak; and the Dental Hygienists' Assoc. of Aust. (Vic Branch).