Diagnosis of Dental Diseases in Children with Epilepsy
Keywords:
epilepsy, children, dental caries, gingival enlargement, antiepileptic drugs, oral hygiene, oral fluid, dental diagnosisAbstract
Background: Children with epilepsy are at increased risk of dental diseases because of the disease itself, the side effects of long-term antiepileptic therapy, comorbid neuropsychiatric disorders and difficulties in maintaining oral hygiene and cooperating during dental treatment. Aim: To summarise current evidence on the prevalence and structure of dental diseases in children with epilepsy and on the methods used for their diagnosis, and to propose a diagnostic algorithm for dental examination of this group. Methods: A narrative review of clinical, epidemiological and laboratory studies indexed in PubMed, Scopus, Google Scholar and eLIBRARY was carried out; quantitative results of comparative clinical studies were extracted and presented in tables and figures. Results: In a study of 100 children with epilepsy and 80 healthy controls, the mean dmf score was 4.1 versus 2.2 and the gingival index 1.16 versus 1.01. Among 107 children and adolescents aged 6–18 years, those taking antiepileptic drugs had higher DMFt (6.80 vs 4.65), CPITN (1.68 vs 0.96) and OHI-S (2.50 vs 1.53) scores. Drug-induced gingival enlargement, gingival bleeding in patients taking valproate, dental trauma during seizures and changes in the composition and antioxidant properties of oral fluid are additional diagnostic targets. Conclusion: Dental examination of children with epilepsy should include a structured medical history, index assessment of caries, hygiene and periodontal status, evaluation of drug-related oral effects and, where possible, analysis of oral fluid, and should be coordinated with the child’s neurologist.
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