Behavioral and Dental Management of a Pediatric Patient Diagnosed with Autoimmune Encephalitis: A Case Report

Background

This is a case report presenting the behavioral and dental management of a 9-year-old child recently diagnosed with autoimmune encephalitis, seizure disorder, and psychosis and treated with anticonvulsant and antidepressant medications. In this case, seizure semiology was presented as eye blinking during the attack, and the child was usually not conscious. It is absorbed by itself and associated with a post-sleeping attack that lasts for minutes.

Case description

Parents presented to the pediatric dental clinic with a chief complaint of decayed teeth that needs to be restored. The child has mixed dentition and is diagnosed with anterior crossbite and single posterior crossbite. The child was cleared by the pediatric neurologist and psychiatrist and had no contraindications to dental treatment under local anesthesia. The child's treatment was completed on the dental chair without any seizure attacks, and the patient's chief complaint was resolved.

Conclusion

Pediatric dentists should be educated about dental precautions and consider drug interactions when treating children with autoimmune encephalitis. Various types of non-pharmacological behavior guidance techniques and pharmacological methods of behavior management techniques can aid in the behavioral management of children with psychosis.

How to cite this article

Alowi WA, Baghlaf K. Behavioral and Dental Management of a Pediatric Patient Diagnosed with Autoimmune Encephalitis: A Case Report. Int J Clin Pediatr Dent 2023;16(2):416-419.

Sociodemographic factors associated with the level of knowledge about management of epileptic patients in Peruvian dental students: a cross-sectional study under a multivariable analysis

BACKGROUND

Epilepsy is a chronic neurological disease that could indirectly affect oral health, and it is necessary for dentists to be familiar with the specific needs of patients with epilepsy. Therefore, aim of the present study was to assess the factors associated with the level of knowledge about management of epileptic patients in Peruvian dental students.

METHODS

This analytical, observational, cross-sectional and prospective study assessed 312 dental students from a Peruvian university during February to April 2022. A validated questionnaire of 20 closed multiple-choice questions was used to measure the level of knowledge about dental management in epileptic patients. A logit model was used to assess the influence of variables: gender, age, year of study, marital status, place of origin and area of residence, with the level of knowledge in dental students considering a significance level of p < 0.05.

RESULTS

Of the total, 28.8%, 36.2% and 34.9% had a poor, fair and good level of knowledge, respectively, about the dental treatment of epileptic patients. On the other hand, it was observed that being a woman (OR = 0.44, CI 0.26-0.75) and being a third year student (OR = 0.39, CI 0.21-0.74) and fourth year student (OR = 0.43, CI 0.23-0.89) constituted a protective factor against poor knowledge about the dental management of epileptic patients, while being from the capital city constituted a risk factor. Finally, age, marital status and the students' area of residence were not considered influential factors (p > 0.05).

CONCLUSION

Most of the students showed a poor and fair level of knowledge about the dental management of epileptic patients, with gender, academic year and place of origin being influential factors. It is advisable that authorities and teachers in the dental profession organize recurrent training programs on the care of patients with chronic diseases requiring special attention, since knowing general concepts, pharmacological management and dental care of epileptic patients will allow future dentists to develop competencies to improve and implement good quality care protocols for this group of patients.

The Knowledge and Awareness of Medical Emergencies and Management among Dental Students

Background:

Every dentist should anticipate being confronted with a medical emergency (ME), and one should always be ready to treat the most catastrophic ones.

Aim:

This study aimed to assess the knowledge of dental clinical students of Tamil Nadu in the ME understanding and management to create awareness toward patient care.

Methodology:

A total of 768 dental students, including final-year students and residents from different colleges, took part in the questionnaire-based cross-sectional study. The selection of study participants was by the convenience sampling method. The questionnaire contained thirty closed multiple-choice questions to assess their knowledge of MEs. Microsoft Office Excel software was used for compiling the answers. The descriptive analysis of the data is exhibited in graphs.

Results:

The majority of participants were mindful of the vital signs; only 55% of the participants know the importance of checking their respiration rate. The knowledge of identifying MEs such as anaphylaxis was 91%, and only 27%–37% of the respondents knew to identify angina, transient ischemia, and lidocaine toxicity. Approximately 15%–40% of the respondents only knew the management of angina, cardiac arrest, hyperventilation, respiratory obstruction, and seizure. Only 10% agreed that the best office emergency kit should be prepared by themselves. Roughly 78% of the respondents were conscious of the patient's referral whenever necessary and aware of state dental acts.

Conclusion:

This study reflects a significant need for training in executing ME among dental students who are to transmute into future dental professionals.

Assessment of oral health status of children with epilepsy: A retrospective cohort study

BACKGROUND

Epileptic children are liable to experience oral health problems either due to the disease itself or medications administered to control the condition.

AIM

We aimed to investigate caries experience, gingival health and oro-facial traumatic injuries in a sample of epileptic Egyptian children.

DESIGN

A retrospective cohort study was conducted from September 2016 to April 2017 using data from medical records in Children Hospital at Ain Shams University. Dental examination was performed for 100 epileptic children and 80 healthy subjects who matched in age, gender, and socio-economic status. Caries experience was measured using the decayed, missing and filled teeth (DMFT or dmft) index and gingival index (GI) of Loe and Sillness was used to determine gingival health status. Oro-facial injuries were assessed using the WHO classification of trauma. Quantitative data were presented as mean, SD, and 95% CI values. Qualitative data were presented as frequencies and percentages and the significance level was set at P ≤ 0.05.

RESULTS

The mean ± SD GI for epileptic children was significantly higher (1.16 ± 0.42) than that of healthy children. (1.01 ± 0.11) Healthy subjects had significantly lower mean dmf index scores 2.2 ± 2.6 compared to epileptic subjects where mean dmf scores were 4.1 ± 2.1. No significant difference, however, was detected between the two groups regarding caries experience in permanent dentition or incidence of oro-facial injuries.

CONCLUSIONS

Epileptic children are highly burdened with gingival problems and liable to develop dental caries especially in primary dentition. Oral traumatic injuries, however, are not common complications if seizure attacks are well controlled.