Title : Dental health in persons with epilepsy: A neglected crisis
Abstract:
Background: Persons with epilepsy are in general considered to have poor dental hygiene which can be contributed by severity of epilepsy, ignoring oral health issues or the medications used. A continuing need exists for better understanding the effects of antiepileptic medication on oral health. Several studies have shown the effects of older antiepileptic, especially Phenytoin, on oral health. But studies exploring oral side effects of newer AEDs are lacking.
Methods: A cross-section study was done in which 69 persons with epilepsy on treatment were compared with 33 controls. A structured questionnaire was used to collect data on demographics, dental and oral hygiene practices, and detailed medication history including older and newer antiepileptic drugs. A routine dental examination along with plaque, gingival, DMFT and DMFS indices were assessed, and the data was statistically analyzed.
Results: Patients on polytherapy as well as on older AEDs were more prone to oral side effects with significantly higher gingival index, plaque index and calculus, as compared to patients on monotherapy and newer AEDs. Gingival hyperplasia was common in patients taking PHT alone as compared to patients taking folic acid along with PHT (p <0.05). Gingival hyperplasia was also seen in patients on VPA, but no significance was found (p -1.28).
Conclusion: Older AEDs especially PHT and VPA, can be associated with significant oral side effects. But newer AEDs can be considered safe in relation to the oral health.
Audience Take Away Notes:
- Persons with epilepsy have a compromised oral health, the etiology of which is multifactorial
- This study provides information on oral health status of persons with epilepsy and the effect of antiseizure medications on oral health
- Data regarding oral side effects of newer ASMs are lacking
- This study highlights the effect of older as well as newer ASMs on oral health
