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Managing patients with epilepsy in primary care: an update

From Volume 52, Issue 3, March 2025 | Pages 186-192

Authors

Theo Tindall

BDS, Foundation Dentist, MyDentist Aglionby Street, Carlisle

Articles by Theo Tindall

Ewen McColl

BSc(Hons), BDS, MFDS, FDS RCPS, MCGDent, MRD RCS Ed, MClinDent, FDS RCS(Rest Dent), FHEA, FDTF(Ed), , BSc (Hons), FCGDent, FDTFEd, FFD RCSI

BSc (Hons), BDS, FDS RCPS, FCGDent, MRD RCS Ed, MClinDent, FDS RCS(Rest Dent), FDTFEd, FFD RCSI, FHEA, Head of School, Director of Clinical Dentistry, Peninsula Dental School, University of Plymouth

Articles by Ewen McColl

Email Ewen McColl

Charlotte Curl

BDS(Hons), FDS RCS(Eng) DSCD RCS(Eng), PgDipClinEd FHEA

BDS(Hons), FDS RCS(Eng), DSCD RCS(Eng), PGDip Clin Ed, FHEA, Consultant in Special Care Dentistry, King's College Hospital NHS Foundation Trust, London

Articles by Charlotte Curl

Debbie Miller

BSc Nursing (Epilepsy care), RNMH, RN Child, Epilepsy Clinical Nurse Specialist, King's College Hospital NHS Foundation Trust, London

Articles by Debbie Miller

Abstract

Epilepsy is a common neurological condition that affects approximately 630,000 people in the UK. It is caused by disordered bursts of electrical activity in the brain, which affect the way it works. It is an often-misunderstood condition, with many dental professionals assuming patients with epilepsy have exclusively tonic-clonic seizures. There are two groups of seizures: generalized and focal, with multiple types within those categories. Every dental practice will have patients with epilepsy, and it is imperative to know how to manage each of the types of seizures if one were to happen in the dental chair. Patients with epilepsy are likely to be on at least one drug that can have oral side effects, which can increase risks of caries and periodontal disease. It is thus important that dental team members are cognizant of the complications associated with these drugs in order to optimise patient care.

CPD/Clinical Relevance: Dental professionals should be aware of different types of seizures, know what questions to ask patients with epilepsy and know the relevance to treatment planning.

Article

Epilepsy is one of the most common neurological conditions worldwide with approximately 630,000 people living with epilepsy in the UK and approximately 80 new diagnoses made every day.1 It is caused by disordered bursts of electrical activity in the brain, which affect the way the brain functions.

Despite its frequency, the presentation of epilepsy is often misunderstood, with the focus on patients having tonic-clonic or, as previously known, grand-mal seizures, often referred to as fits. Although our understanding of epilepsy is often based around patients having tonic-clonic seizures, there are several different types of seizures, which are divided into two broad categories: generalized and focal.2

Epilepsy symptoms begin in childhood 75% of the time, most commonly before adolescence.3,4 People with learning disabilities are more likely to have epilepsy, with around 32% of people with a mild–moderate learning disability having the condition; 20% of those with epilepsy have a learning disability.5

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