Epilepsy: dental considerations

For the medical management of epilepsy, see Epilepsy and seizures.

In dental practice, first-aid management of a seizure is outlined here.

For patients with epilepsy, assess the stability of their condition, including how frequently seizures occur and what triggers them. At each appointment, check that the patient has taken their usual medication because omission of doses can cause seizures.

Avoid stressful extended procedures. Consider the use of a mouth prop to prevent the patient from biting the operator’s fingers or instruments if a generalised seizure occurs during treatment.

Some antiepileptic drugs (phenytoin, sodium valproate, carbamazepine and barbiturates) can cause gingival enlargement (gingival hyperplasia). Gingival enlargement can be minimised with good oral hygiene; however, extensive gingival enlargement requires specialist management.