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Károlyházy K, Vass AF, Csillik A, Schmidt P, Márton K. Is temporomandibular joint involvement more frequent in patients with epilepsy? A clinical study. J Prosthet Dent 2024; 131:626-632. [PMID: 35725662 DOI: 10.1016/j.prosdent.2022.03.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 03/20/2022] [Accepted: 03/21/2022] [Indexed: 10/18/2022]
Abstract
STATEMENT OF PROBLEM Epileptic seizures may affect the stomatognathic system via transmission of an increased load to the dentition and the temporomandibular joint (TMJ), resulting in temporomandibular joint dysfunction (TMD). PURPOSE The purpose of this clinical study was to assess whether TMD was more prevalent in patients with epilepsy than in those without epilepsy. MATERIAL AND METHODS A total of 107 participants diagnosed with epilepsy and 100 healthy controls were enrolled in the study. Those with epilepsy were divided according to their dental manageability into 3 subgroups: mild group, moderate group, and severe group. Following general, dental, and TMJ-related history, the range of maximal mouth opening (MMO), laterotrusion, possible deviation and deflection, and presence of crepitation and clicking was recorded, as suggested by the diagnostic criteria for temporomandibular diseases (DC/TMD). Pressure pain threshold (PPT) was also measured by using a pressure algometer on 3 points bilaterally. RESULTS Incidence of TMJ complaints was not significantly different between the control (30%) and the group diagnosed with epilepsy (33%); however, the number of complaints experienced was significantly higher in the epilepsy group (C: 3%, E: 16% had 3 or more complaints; P<.001). Joint clicking was significantly more prevalent in the entire epilepsy group (P=.012) and in the mild group (P=.004) than in controls. Crepitation and joint pain were not significantly more common in the epilepsy group. Maximal mouth opening, laterotrusion, and the ratio of restricted mouth opening did not differ significantly in the epilepsy group. Deflection occurred significantly more often in the epilepsy subgroups (mild and moderate groups; P<.001), and the extent of deflection was also significantly higher in all the epilepsy subgroups (P<.001) than in controls. Regarding the pressure pain threshold, significant difference was observed in the severe group at the left masseter muscle points M1 (P=.046) and M2 (P=.028) compared with controls. CONCLUSIONS All parameters typical of TMD could be found frequently in patients with epilepsy. Because of the seizures and the consequent joint overload, the TMJ involvement was more common or more serious in those diagnosed with epilepsy. Outcomes of this study support the assumption that epilepsy is a risk factor for the development of TMD.
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Affiliation(s)
- Katalin Károlyházy
- Associate Professor, Department of Prosthetic Dentistry, Faculty of Dentistry, Semmelweis University, Budapest, Hungary
| | - Andrea Fanni Vass
- Assistant Professor, Department of General Dental Preclinical Practice, Faculty of Dentistry, Semmelweis University, Budapest, Hungary.
| | - Anita Csillik
- Assistant Lecturer, Department of Neurology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Schmidt
- Vice-Director, Department of Prosthetic Dentistry, Faculty of Dentistry, Semmelweis University, Budapest, Hungary
| | - Krisztina Márton
- Associate Professor and Head of Department, Department of General Dental Preclinical Practice, Faculty of Dentistry, Semmelweis University, Budapest, Hungary
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Ari K, Hussain SZM, Mohammad AW, Nassif R. A Prolonged History of Denture Impaction for 12 Weeks In Situ. Cureus 2022; 14:e26002. [PMID: 35859950 PMCID: PMC9288201 DOI: 10.7759/cureus.26002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2022] [Indexed: 11/06/2022] Open
Abstract
Foreign body ingestion has serious consequences if left untreated. Impacted dentures for a prolonged period can lead to life-threatening complications. Therefore, prompt diagnosis and immediate intervention are lifesaving. Our patient presented to his local accident and emergency department after having swallowed his dentures during a meal. Initial investigations and workup detected no abnormalities and he was discharged back to the community. Twelve weeks following ingestion, he had developed dysphagia and weight loss which prompted an urgent referral for oesophago-gastro-duodenoscopy (OGD). This identified the dentures impacted within the upper oesophagus and initial attempts at removal were unsuccessful, therefore he required hospital admission for alternative feeding in the interim. A joint procedure with the Ear, Nose and Throat and upper gastrointestinal surgeons was carried out to successfully remove the dentures endoscopically. The patient made an immediate recovery, resuming his normal oral diet with appropriate follow up after discharge. It is suspected our patient had an impacted denture for a period of 12 weeks without sustaining any life-threatening complications, which makes this case rather unique. This case highlights the importance of thorough and careful clinical history taking and examination.
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Magata N, Tanoue N, Ayuse T, Ayuse T. A prospective clinical evaluation of fixed dental prostheses made of metal alloys in patients with cerebral palsy. Clin Exp Dent Res 2020; 7:561-567. [PMID: 33314696 PMCID: PMC8404493 DOI: 10.1002/cre2.378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 11/18/2020] [Accepted: 11/24/2020] [Indexed: 11/10/2022] Open
Abstract
Background In general, the prevalence of caries and other oral and dental issues is increased in patients with disabilities, such as those with cerebral palsy. Providing appropriate dental treatment at a primary dental clinic for patients with cerebral palsy and intellectual disability, among other conditions, is challenging. Objective The objective of this study was to evaluate the longevity and investigate the related prognostic factors of fixed prostheses in patients with cerebral palsy. Methods The records of 36 cerebral palsy patients were used for collecting and analyzing data. A total of 155 prostheses made from metal alloys were finally included in this study. Annual failure rates were calculated; patient‐ and tooth‐related variables associated with prosthesis failure were assessed by a multivariate Cox‐regression analysis and frailty models to introduce random effects. Results The 10‐year prosthesis survival rate was 62% and the 20‐year survival rate was 36%. In terms of prosthesis‐related variables, the type of prosthesis had a significant effect, and the hazard ratio of fixed partial dentures was 2.32 times that of single‐unit crowns. In terms of patient‐related variables, the presence of epilepsy had a significant effect on survival, and the hazard ratio for comorbid epilepsy was 3.76 times that for those without comorbid epilepsy. Conclusions Our findings suggested that fixed prostheses placed in patients with cerebral palsy might have a particularly low survival rate in cases with comorbid epilepsy. It might also be important to consider the type and/or design of the prosthesis carefully to ensure a better prognosis.
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Affiliation(s)
- Nobuaki Magata
- Division of Clinical Physiology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Naomi Tanoue
- Department of Special Care Dentistry, Nagasaki University Hospital, Nagasaki, Japan
| | - Terumi Ayuse
- Department of Special Care Dentistry, Nagasaki University Hospital, Nagasaki, Japan
| | - Takao Ayuse
- Division of Clinical Physiology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Gawlak D, Łuniewska J, Stojak W, Hovhannisyan A, Stróżyńska A, Mańka-Malara K, Adamiec M, Rysz A. The prevalence of orodental trauma during epileptic seizures in terms of dental treatment - Survey study. Neurol Neurochir Pol 2017; 51:361-365. [PMID: 28711375 DOI: 10.1016/j.pjnns.2017.06.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 02/14/2017] [Accepted: 06/19/2017] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Epilepsy is one of the most common neurological disorders. Seizures that occur during attacks may lead to head injuries. It is crucial to establish proper prophylactic management against trauma occurrence, as nowadays prevention is not sufficient. AIM Assessment of the frequency of head and intraoral trauma during epileptic seizures and to evaluate factors that may predispose to injuries. MATERIAL AND METHODS The questionnaire was carried out among 106 patients with epilepsy. Survey conducted questions regarding development of the disease and occurrence of orodental and head trauma. Results were statistically analyzed with the chi-square test (p<0.05). RESULTS 52.4% of subjects admitted the occurrence of oral trauma during epileptic seizures. The most common were lips, tongue or cheeks injuries. 18% patients suffered from tooth crack and 17% from tooth fracture. 50% of respondents suffered from head trauma during seizures: 41% patients reported bruises, 39% burns, 37% wounds, 10% nose fractures, 7% eye socket trauma and 3% skull crack. 14.1% of respondents experienced dentist refusal to undertake treatment, while 4% of patients had epileptic attack during dental procedures. CONCLUSIONS Dental trauma is common result of epileptic seizures. It is necessary to implement prophylactic management to prevent hard and soft tissues injuries, for example by using custom-made mouthguards. Moreover, specially designed dental programs for this group of patients should be provided.
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Affiliation(s)
- Dominika Gawlak
- Department of Prosthetics, Medical University of Warsaw, ul. Nowogrodzka 59, 02 - 006 Warsaw, Poland.
| | - Joanna Łuniewska
- Students' Scientific Association at the Department of Prosthetics, Medical University of Warsawul. Nowogrodzka 59, 02 - 006 Warsaw, Poland
| | - Wiktoria Stojak
- Students' Scientific Association at the Department of Prosthetics, Medical University of Warsawul. Nowogrodzka 59, 02 - 006 Warsaw, Poland
| | - Anahit Hovhannisyan
- Students' Scientific Association at the Department of Prosthetics, Medical University of Warsawul. Nowogrodzka 59, 02 - 006 Warsaw, Poland
| | - Anna Stróżyńska
- Students' Scientific Association at the Department of Prosthetics, Medical University of Warsawul. Nowogrodzka 59, 02 - 006 Warsaw, Poland
| | - Katarzyna Mańka-Malara
- Department of Prosthetics, Medical University of Warsaw, ul. Nowogrodzka 59, 02 - 006 Warsaw, Poland
| | - Marcin Adamiec
- Department of Oral Surgery, Medical University of Warsawul. Nowogrodzka 59, 02 - 006 Warsaw, Poland
| | - Andrzej Rysz
- Department of Neurosurgery, Medical University of Warsaw, ul. Banacha 1a, 02-097 Warsaw, Poland; Department of Neurology, Medical University of Warsaw, ul. Banacha 1a, 02-097 Warsaw, Poland
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Schöpper M, Ludolph AC, Fauser S. Dental care in patients with epilepsy: a survey of 82 patients and their attending dentists and neurologists in southern Germany. Int Dent J 2016; 66:366-374. [PMID: 27590164 DOI: 10.1111/idj.12251] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION The current study assessed the knowledge and attitudes of dentists and neurologists, and of their patients with epilepsy, in the catchment area of an outpatient clinic for epilepsy in southern Germany. METHODS One-hundred patients with epilepsy were asked to complete questionnaires about their dental treatment. Attitudes of their attending dentists and neurologists were also assessed. RESULTS Patients with epilepsy: The questionnaires were returned by 82% of patients. Of these, 84% regularly (once or twice a year) sought out a dentist, 79% reported their epilepsy to the dentist, 6% were refused treatment by a dentist because of their epilepsy, 10% had already experienced a seizure while at a dental office and 52% wished for more detailed information pretreatment. Dentists: Although 97% treated patients with epilepsy, 21% believed that their equipment was inappropriate for treating a patient experiencing seizures. The majority were not familiar with interactions between antibiotics/analgetics and anti-epileptic drugs. Short-term general anaesthesia was preferred for critical patients by 70% of dentists, 70% recommended dental ceramic for prosthetic reconstruction of anterior teeth and 64% would not recommend use of a removable denture. Neurologists: Sixty-two per cent were asked for advice by their patients, 71% knew about particular risks and interactions between antibiotics/analgetics and anti-epileptic drugs, 8% would stop valproic acid before extensive dental intervention and 92% recommended general anaesthesia in critical patients (uncooperative patients, patients with learning difficulties, and patients with frequent generalised tonic-clonic or complex partial seizures). DISCUSSION In general, patients were satisfied with their dental treatment. Regarding the clinician's role, however, dentists need to know more with respect to treating patients with seizures. Beyond that, it would be desirable for neurologists to take more time to answer their patients' questions regarding dental care.
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Affiliation(s)
- Malin Schöpper
- Department of Neurology, University Hospital Ulm, Ulm, Germany
| | | | - Susanne Fauser
- Department of Neurology, University Hospital Ulm, Ulm, Germany.,Epilepsy Center Bethel, Krankenhaus Mara I, Bielefeld, Germany
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Wang Y, Peng J, Li Y, Luo H, Huang G, Luo S, Yin X, Song J. Association between tooth loss and risk of oesophageal cancer: a dose-response meta-analysis. SPRINGERPLUS 2016; 5:1020. [PMID: 27441139 PMCID: PMC4938834 DOI: 10.1186/s40064-016-2711-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 06/29/2016] [Indexed: 12/31/2022]
Abstract
Many epidemiological studies have found that tooth loss is associated with susceptibility to oesophageal cancer. However, a definitive answer is yet to be discovered, and the findings are inconclusive. We performed a meta-analysis to assess the relationship between tooth loss and oesophageal cancer risk. We searched PubMed and Embase databases to screen eligible studies up to June 2015. Nine observational studies (eight articles) involving 2604 patients and 113,995 participants were included in the meta-analysis. The combined odds ratio for tooth loss and oesophageal cancer was 1.53 (95 % CI 1.02-2.29) for the high versus lowest teeth loss categories. However, inconsistent results were detected in the stratified and sensitivity analysis. In dose-response analysis, the summary odds ratio for each one tooth loss increment was 1.01 (95 % CI 1.00-1.02). The current evidence, based solely on six case-control studies and three cohort studies, suggests that tooth loss is a potential marker of oesophageal cancer. However, no firm conclusion can be drawn at this time that tooth loss may play a causal role in development of oesophageal cancer. Additional large-scale and high-quality prospective studies are required to evaluate the association between tooth loss and risk of oesophageal cancer.
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Affiliation(s)
- Yadong Wang
- Department of Oral and Maxillofacial Surgery, Guizhou Provincial People's Hospital, Guizhou, 550002 China
| | - Juxiang Peng
- Department of Orthodontics, Stomatology Hospital of Guiyang, Guizhou, 550002 China
| | - Yan Li
- Department of Oral and Maxillofacial Surgery, Guizhou Provincial People's Hospital, Guizhou, 550002 China
| | - Hong Luo
- Department of Oral and Maxillofacial Surgery, Guizhou Provincial People's Hospital, Guizhou, 550002 China
| | - Guanglei Huang
- Department of Oral and Maxillofacial Surgery, Guizhou Provincial People's Hospital, Guizhou, 550002 China
| | - Siyang Luo
- Department of Oral and Maxillofacial Surgery, Guizhou Provincial People's Hospital, Guizhou, 550002 China
| | - Xinhai Yin
- Department of Oral and Maxillofacial Surgery, Guizhou Provincial People's Hospital, Guizhou, 550002 China
| | - Jukun Song
- Department of Oral and Maxillofacial Surgery, Guizhou Provincial People's Hospital, Guizhou, 550002 China
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Boopathy V, Bakshi SS, Balasubramanian P, Dakshinamoorthy S. Neglected partial denture in the lower oesophagus presenting after 7 days. BMJ Case Rep 2015; 2015:bcr-2015-211400. [PMID: 26424822 DOI: 10.1136/bcr-2015-211400] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Accidental ingestion of a denture is an acute emergency, and the denture is usually removed on the same day it is discovered. We present a patient who had a seizure while asleep, during which his denture broke; he accidentally swallowed a major part of it, which had a clasp attached. He was unaware that he had ingested the denture, since he was asymptomatic, but he started developing symptoms after 5 days and presented to us on the eighth day of ingestion. With much difficulty, the impacted section of the denture in the distal oesophagus was removed with the combined effort of flexible endoscopy and a rigid oesophagoscopy. Post-procedure, the patient developed mediastinitis, which was managed conservatively; he is doing well on follow-up.
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Affiliation(s)
- Vinoth Boopathy
- Department of Medical Gastroenterology, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
| | - Satvinder Singh Bakshi
- Department of ENT, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
| | - Padhmini Balasubramanian
- Department of Radiology, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
| | - Suganthy Dakshinamoorthy
- Department of Medical Gastroenterology, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
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Er K, Yildirim M, Taşdemir T, Akca M, Abidin I. Electrophysiological evidence on epileptiform activity enhanced by electrical stimulation of teeth in rats. Neurol Res 2014; 36:673-8. [PMID: 24620974 DOI: 10.1179/1743132813y.0000000311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
The aim of this study was to evaluate the possible effects of electrical stimulation (ES) of tooth on penicillin-induced epileptiform activity in rats. Experiment was realized on 24 adult male Sprague Dawley rats. Rats were assigned three groups [stimulation group (SG), penicillin group (PG), and penicillin+stimulation group (PSG)]. In SG, ES was only applied. Ten pulses of electrical current were delivered to the teeth for a duration of 2 milliseconds at 1-second intervals from a stimulator. Currents were applied in the range of 40-240 μA with 40 μA steps. Electrocorticography (ECoG) recordings were taken before and after ES. In PG, ECoG recordings were taken before and during the injection of penicillin. In PSG, after epileptiform activity was induced, ES was applied and ECoG recordings were taken as in SG. All the data were analyzed with Student's t test. Applied currents did not cause any epileptiform activity in SG. When the PSG was compared with the PG it was seen that the spike frequency of epileptiform activity increased in a statistically significant way after application of 240 μA (P < 0·05). On the other hand current application caused an increase in the spike amplitude of the PSG compared with the amplitude of the PG, but it was not statistically significant. We concluded that ES of tooth with high current can trigger epileptiform activity in rats. For this reason, further research is required to evaluate the effects of ES of tooth for pulp testing on epileptic human subjects and antiepileptic drug users.
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The association between periodontal disease and seizure severity in refractory epilepsy patients. Seizure 2014; 23:227-30. [PMID: 24456623 DOI: 10.1016/j.seizure.2013.12.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 12/09/2013] [Accepted: 12/26/2013] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Periodontal diseases are common in most populations and affect people at all socioeconomic levels. Evidence suggests that patients with epilepsy actually have higher risks of dental disease and increased oral health needs, but the frequency and consequences of poor controlled seizures on dental and periodontal health have not been reported before. We aimed to assess the impact of seizure frequency on periodontal status and oral hygiene in a sample of epilepsy patients. METHODS One hundred and nine consecutive patients treated for epilepsy at the outpatient clinic of our University Hospital were invited to take part in an oral examination to determine their periodontal disease status, together with a control group. In addition, seizure frequency and use of medication were documented. RESULTS In logistic regression model, patients were significantly more susceptible to bad oral hygiene, gingivitis and periodontitis that controls (p<0.001); seizure frequency was significantly related to bad oral hygiene (p=0.010), gingivitis (p<0.001) and periodontitis (p<0.001). Tooth brushing habits and presence of caries were associated with oral health in patients group. CONCLUSION Our study found a significant positive correlation between periodontal disease and seizure severity. Epilepsy patients need to focus more on their oral health and quality of oral hygiene.
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Seizure-related injuries and hospitalizations: self-report data from the 2010 Australian Epilepsy Longitudinal Survey. Epilepsy Behav 2013. [PMID: 23201608 DOI: 10.1016/j.yebeh.2012.10.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
AIM To examine self-report data on seizure-related injuries and hospitalizations. METHOD We analyzed data from the 2010 Australian Epilepsy Longitudinal Survey, distributed to registrants on the Australian Epilepsy Research Register. 343 responses were received (55% response rate), providing insight into experiences of living with seizures. This article examines self-report data on injuries related to seizures and hospitalizations. RESULTS 64% of those reporting injuries required hospital treatment. Respondents with seizure-related injuries had significantly earlier seizure onset, with risk of injury related to myoclonic and atonic seizures and currently taking 3 or more AEDs. Soft tissue injuries were the most frequently reported (85%), with 27% indicating facial injuries. CONCLUSIONS The high rate of hospitalizations largely for soft tissue injuries suggests that access to more appropriate care was not available. Further research into care-seeking behavior by Australians suffering injury following seizure is required. Additionally, awareness of injury risks is important for appropriate self-management of epilepsy.
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Mehmet Y, Senem Ö, Sülün T, Hümeyra K. Management of Epileptic Patients in Dentistry. ACTA ACUST UNITED AC 2012. [DOI: 10.4236/ss.2012.31008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
BACKGROUND The aim of the present study was to evaluate the oral hygiene status and dental treatment requirements in children with epilepsy. METHODS The treatment group consisted of 211 children with epilepsy (120 boys and 91 girls, 4-15 years old, mean age 7.85 + or - 2.98 years). The control group consisted of healthy children, matched by age and gender. Clinical features of the patients were obtained from hospital records. Clinical examinations were conducted, under standard light, using a plane buccal mirror, a dental probe and air drying to evaluate caries experience and to record the periodontal health of each child. Statistical analysis was performed using chi(2) test, Fisher exact test and anova. RESULTS The number of decayed and missing teeth, the degree of abrasion and periodontal indexes were significantly worse in patients with epilepsy, compared to the control group (P < 0.001). Gingival enlargement was documented in 42% of patients on valproate monotherapy compared to only in 16% of patients on phenobarbital. Dental caries and halitosis were the most common oral disorders. Generalized tonic-clonic seizures often cause minor oral injuries and traumatized anterior teeth. CONCLUSIONS Epileptic children are at an increased risk of developing caries and gingivitis compared with healthy subjects.
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Affiliation(s)
- Taskin Gurbuz
- Department of Pedodontics, Atatürk University, Faculty of Dentistry, Erzurum, Turkey.
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Abstract
Patients who have developmental disabilities and epilepsy can be safely treated in a general dental practice. A thorough medical history should be taken and updated at every visit. A good oral examination to uncover any dental problems and possible side effects from antiepileptic drugs is necessary. Stability of the seizure disorder must be taken into account when planning dental treatment. Specific considerations for epileptic patients include the treatment of oral soft tissue side effects of medications and damage to the hard and soft tissue of the orofacial region secondary to seizure trauma. Most patients who have epilepsy can and should receive functionally and esthetically adequate dental care.
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Affiliation(s)
- Miriam R Robbins
- Department of Oral and Maxillofacial Pathology, Radiology and Medicine, New York University College of Dentistry, 345 East 24th Street, Clinic 1B-Room 114S, NY 10010, USA.
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