Most folks think of epileptic seizures as the uncontrollable jerking and stiffening of the arms and leg, or someone “swallowing” their tongue. But sudden collapse and loss of consciousness are also symptoms. And so is a temporary state of confusion, an uncontrollable episode of blinking, and even the opposite of that—a staring spell or almost catatonic gaze. All of these carry with them immediate risk to one’s safety. However, there are additional symptoms that can carry longer-term health issues, including oral and dental ones.
A study from 2014 in the journal “Seizure” showed a high correlation between periodontal disease—specifically gingivitis and periodontitis—and seizure severity. “From these results, it seems that seizures may be an important feature determining the occurrence of oral health status,” the researchers said. “Epilepsy patients need to focus more on their oral health and quality of oral hygiene.”
What is epilepsy?
Epilepsy is a neurological condition, a nervous disorder wherein the brain undergoes abnormal activity. Thankfully, it’s rare. Only 1% of the population has it. But it’s a matter of high stakes that sometimes can be controlled by anti-epileptic drugs (AEDs) and sometimes not so much. According to the Epilepsy Society, the condition can be to many different underlying causes, such as:
- Genetics—both inherited and non-inherited (a new change in the person’s genes)
- Structural change in the brain—brain injury, infection (like meningitis), stroke, or tumor
- Tuberous sclerosis—a rare condition that causes growths in organs including the brain
- Neurofibromatosis—a genetic condition that can cause growths on the nerves
How can one manage epilepsy?
The first thing to understand is that it takes a village. This is not just a medical issue. This is not just a dental issue. Your doctor, your dentist, and your loved ones are all going to play a role in your management of epileptic seizures.
Knowledge is critical
There are good reasons for every single question we ask you when you arrive at our office for a teeth cleaning, a full dental exam, or a procedure. For instance, one’s dentures can break or create a choking hazard during a seizure. That means if we know you experience seizures or have a family history of them, or if you had a traumatic brain injury or stroke, then we’ll recommend fixed prosthetics in most cases. If nighttime seizures are in your health history, then we may want to fit you with a mouthguard, making sure it’s one that cannot cause a choking incident.
Hygiene is critical
During a dental exam, we will closely evaluate any patient with epilepsy for gingival hyperplasia (enlarged gums) as well as dry mouth. Both of these conditions make a patient higher risk for gum disease and tooth decay. So it’s important for people living with epilepsy to be one step ahead of the issues that often arise.
But being one step ahead doesn’t start in the dentist’s chair. It happens at home by doing the following things regularly:
- Brush morning, day and night with fluoride toothpaste
- Floss every day
- Eat healthy foods and healthy amounts of food; keep your weight down
- Stimulate saliva production by using mints or lozenges with xylitol
Talk about trauma
It only figures that someone who has had multiple seizures over a lifetime will experience injury to teeth and tongue. But the head, neck and jaw also can take a beating. So it’s important to talk to your dentist about past episodes and injuries.
Chances are your doctor has put you on an AED, such as phenytoin, phenobarbital, or carbamazepine. And that’s appropriate since seizures are not to be taken lightly. The bad news is those drugs alter the metabolism, specifically in how your body processes vitamin D. Long story short, your bones risk fracture not just because of the seizures but of the drugs that help prevent them, too.
To minimize the risk of fractures, talk to your health team about calcium and vitamin D supplements.
What if I have a seizure while at the dentist?
A good dentist and his or her staff are well trained for handling a seizure emergency. What’s just as critical is what you should expect after the seizure is over. Here’s a recommended list of things to do and not to do:
- To do—Talk to your dentist so he or she can evaluate your level of consciousness and clarity
- To do—Make sure your dentist has contacted a friend or family member if you arrived alone
- To do—Let your dentist do a brief oral examination for any injuries
- Not to do—Do further dental treatment that day
- Not to do—Leave the office before your level of awareness is not 100% back to normal
The other thing in the “not to do” list: Avoid the dentist’s office. We understand you may be a little scared, but we know how to be a part of the prevention solution. And we’re committed to putting you at ease each step of the way.