Epilepsy and Dental Management

Flashcards about epilepsy and dental care

What is the definition of Epilepsy?

Any irritation to the brain may cause a seizure. Recurring seizures are called Epilepsy.

How is Epilepsy detected?

Electroencephalogram (EEG) test, abnormal electric activity or magnetic resonance imaging (MRI), and reveal small scarring in the brain.

Name three Versatile EEGs

Diadem EEG, Neuroheadband EEG, Bhbrain

What are some potential causes of seizures?

Brain injury at birth or later, inherited, or idiopathic (not known).

What can cause seizures in children around 2 years old?

Brain defects, chemical imbalance, or high fevers.

What are the characteristics of a simple partial seizure?

Abnormal sensation, movements, or psychic abnormalities without loss of consciousness.

What are the symptoms of a complex partial seizure?

Person loses touch with surroundings, staggers, moving arms and legs purposeless, resists help, meaningless sounds uttered, confusion for several minutes, followed by recovery

What happens during a convulsive seizure (grand mal or tonic-clonic seizure)?

Abnormal electrical discharge spreads to other parts of brain, causing convulsion, muscle spasm and jerking, head turning intensely to one side, clenching teeth, may bite tongue, temporary loss of consciousness.

What is Status epilepticus and why is it dangerous?

A medical emergency involving wide spread electrical discharge and non-stop seizure; convulsions, intense muscle contractions; can lead to death.

Describe Primary-Generalized epilepsy.

electrical discharge over wide area of brain, wide brain malfunction; convulsion of body; severe muscle spasm and jerking of body.

What are the signs of a Petit mal (absence) seizure?

Staring into space, fluttering eyelids, and twitching facial muscles without loss of consciousness.

What are some oral cavity indications of seizures?

Bruxism of teeth, bitten tongue, scars of bitten lips or cheeks, fractured teeth.

What is Dilantin hyperplasia?

Gingival overgrowth due to antiepileptic medication (Dilantin hyperplasia) or (phenytoin-induced hyperplasia).

Where does gingival overgrowth typically occur in the mouth?

The overgrowth is more at facial and proximal/interdental than at lingual area and may also occur at edentulous areas and around dental implants.

What are the clinical features of gingival overgrowth in the oral cavity?

Enlargement of interdental papillae with signs of inflammation; tissue becomes fibrotic, pink, and stippled with a mulberry appearance.

What are the effects of gingival overgrowth/Hyperplasia?

Poses dental biofilm control problem, may interfere with mastication, may alter tooth eruption, may interfere with speech, may cause serious esthetic concerns.

What are the complicating factors of Gingival overgrowth?

Dental Biofilm/plaque and Gingivitis

What are factors contributing to gingival overgrowth?

Mouth-breathing, overhanging and other defective restorations, large carious lesions, calculus and other biofilm - retaining factors.

What are the Treatment Methods of Gingival Overgrowth?

Surgical Treatment( Gingivectomy or Periodontal flap) and Nonsurgical Treatment(Scaling, polishing overhangs, placing or replacing restorations, and removing calculus).

What rinse prevent return of gingival enlargement?

Chlorhexidine gluconate (0.2% 10ml/100ml bds) rinses.

What information should you obtain regarding the patient's medical history?

Enquire about recent seizures, medications taken and effectiveness of it, adherence to treatment. Type of seizure, severity and duration.

What other types of information should you obtain from the patient?

Age at onset of seizures, precipitating factors/Causes, Frequency of seizures. History of injuries, including oral injuries, broken teeth, tongue lacerations.

What are the basic elements of the patient approach to a patient with seizures?

Provide a calm, reassuring atmosphere and treat with patience and empathy.

What should be done prior to and at the start of Phenytoin Therapy?

Accurate biofilm control programme and complete scaling are introduced in preparation for phenytoin therapy.

What is the dental management for Slight or mild gingival overgrowth?

Nonsurgical treatment, including frequent thorough scaling.

What is the dental management for Moderate gingival overgrowth?

Weekly biofilm instruction and scaling, reevaluation of the tissue to determine whether further procedures are needed.

What is the dental management for Severe fibrotic overgrowth?

Initial scaling and biofilm control are carried out to prepare the mouth for perio surgery.

What are appropriate maintenance appointment intervals?

1,2, or 3-month plans based on severity of enlargement and patient's ability to maintain oral health.

What are the main components of prevention when treating a patient with a seizure disorder?

Daily biofilm removal and fluoride therapy, the use of pit and fissure sealants, and dietary control.

What should be ensured if a patient requires an extraction or conservative treatment?

Ensure that the medication was taken in the morning and observe patient for onset of seizures.

What are the objectives of emergency care?

Prevention of body injury and accidents related to the oral structures.

What is the emergency procedure when a convulsion occurs?

Terminate procedure, call for assistance, protect the patient from injury, position patient, lower chair and tilt to supine, raise feet.

What should be done After seizure /Postictal phase?

allow the patient to rest, talk to the patient in a low, reassuring tone, check oral cavity for trauma to teeth or tissues.

What is Status Epilepticus?

Defined as one or more seizures that lasts longer than 30 minutes. Emergency medical assistance must be sought immediately

What are the Stages of Epilepsy?

Aura(warning stage), Tonic stage(patient loses consciousness), Clonic phase(convulsion), Recovery phase(Patient regains consciousness).