Asadi-Pooya AA, Emami M, Sperling MR Age of onset in idiopathic (genetic) generalized epilepsies: clinical and EEG findings in various age groups. Seizure. 2012; 21:417-421 https://doi.org/10.1016/j.seizure.2012.04.004
National Institute for Health and Care Excellence. Epilepsies in children, young people and adults. 2025. https://www.nice.org.uk/guidance/ng217 (accessed February 2025)
Balamurugan E, Aggarwal M, Lamba A, Dang N, Tripathi M Perceived trigger factors of seizures in persons with epilepsy. Seizure. 2013; 22:743-747 https://doi.org/10.1016/j.seizure.2013.05.018
González HFJ, Yengo-Kahn A, Englot DJ Vagus nerve stimulation for the treatment of epilepsy. Neurosurg Clin N Am. 2019; 30:219-230 https://doi.org/10.1016/j.nec.2018.12.005
National Institute for Health and Care Excellence. Cannabis-based medicinal products. NG144. 2025. https://www.nice.org.uk/guidance/ng144 (accessed February 2025)
Urolagin SS, Swaroop D, Agrawal C, Dholakia Karalwad MB Management of phenytoin-induced gingival enlargement in a patient with antiphospholipid antibody syndrome: a rare case report. J Indian Soc Periodontol. 2016; 20:561-564 https://doi.org/10.4103/0972-124X.201693
Corrêa JD, Queiroz-Junior CM, Costa JE, Teixeira AL, Silva TA Phenytoin-induced gingival overgrowth: a review of the molecular, immune, and inflammatory features. ISRN Dentistry. 2011; 2011 https://doi.org/10.5402/2011/497850
Candotto V, Pezzetti F, Baj A Phenytoin and gingival mucosa: a molecular investigation. Int J Immunopathol Pharmacol. 2019; 33 https://doi.org/10.1177/2058738419828259
Károlyházy K, Kovács E, Kivovics P, Fejérdy P, Arányi Z Dental status and oral health of patients with epilepsy: an epidemiologic study. Epilepsia. 2003; 44:1103-1108 https://doi.org/10.1046/j.1528-1157.2003.04003.x
Cornacchio ALP, Burneo JG, Aragon CE The effects of antiepileptic drugs on oral health. J Can Dent Assoc. 2011; 71
Beaumont J, Chesterman J, Kellett M, Durey K Gingival overgrowth: part 1: aetiology and clinical diagnosis. Br Dent J. 2017; 222:85-91 https://doi.org/10.1038/sj.bdj.2017.71
Friedlander AH, Cummings JL Temporal lobe epilepsy: its association with psychiatric impairment and appropriate dental management. Oral Surg Oral Med Oral Pathol. 1989; 68:288-292 https://doi.org/10.1016/0030-4220(89)90213-2
Jacobsen PL, Eden O Epilepsy and the dental management of the epileptic patient. J Contemp Dent Pract. 2008; 9:54-62 https://doi.org/10.5005/jcdp-9-1-54
Bellocchio L, Inchingolo AD, Inchingolo AM Cannabinoids drugs and oral health-from recreational side-effects to medicinal purposes: a systematic review. Int J Mol Sci. 2021; 22 https://doi.org/10.3390/ijms22158329
Scully C Medical problems in dentistry, 6th edn. Edinburgh: Elsevier; 2010
Rood JP Local anaesthesia and the medically compromised patient. Dent Update. 1991; 18:330-334
Costa AL, Yasuda CL, Shibasaki W The association between periodontal disease and seizure severity in refractory epilepsy patients. Seizure. 2014; 23:227-230 https://doi.org/10.1016/j.seizure.2013.12.008
Nonato ER, Borges MA Oral and maxillofacial trauma in patients with epilepsy: prospective study based on an outpatient population. Arq Neurpsiquiatr. 2011; 69:491-495 https://doi.org/10.1590/S0004-282X2011000400016
Karolyhazy K, Kivovics P, Fejerdy P, Aranyi Z Prosthodontic status and recommended care of patients with epilepsy. J Prosthet Dent. 2005; 93:177-182 https://doi.org/10.1016/j.prosdent.2004.11.008
Gray D, Barraclough O, Ali Z, Nattress B Modern partial dentures – part 2: a review of novel metal-free materials and innovations in polymers. Br Dent J. 2021; 230:813-818 https://doi.org/10.1038/s41415-021-3068-y
King P, Foster L, Yates R, Newcombe RG, Garrett MJ Survival characteristics of 771 resin-retained bridges provided at a UK dental teaching hospital. Br Dent J. 2015; 218:423-428 https://doi.org/10.1038/sj.bdj.2015.250
Abdullah BJ, Teong LK, Mahadevan J, Jalaludin A Dental prosthesis ingested and impacted in the esophagus and orolaryngopharynx. J Otolaryngol. 1998; 27:190-194
Mawardi H, Alsubhi A, Salem N Management of medication-induced gingival hyperplasia: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol. 2021; 131:62-72 https://doi.org/10.1016/j.oooo.2020.10.020
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
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
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
Register now to continue reading
Thank you for visiting Dental Update and reading some of our resources. To read more, please register today. You’ll enjoy the following great benefits: