What do I need to Know about Going to the Dentist as an Epileptic?
If you have teeth you will need to go to the dentist at some point in your life. If you are an epileptic, there are important precautions you need to take such as taking the medication regularly and getting plenty of sleep.
Are epileptic patients more likely to get dental problems than normal people?
The answer to this is yes. While epileptic patients can get dental problems like dental caries and dental infections, their anti-seizure medication also causes problems.
Phenytoin (Dilantin) is an anti-seizure medication that can cause an overgrowth of your gums which is cosmetically unpleasant. Hence, patients may require dental procedures like laser excision or electrosurgery to remove the excess gum.
Sodium valproate (Depakote) comes in liquid or sprinkle forms, and they have a very high concentration of sugar. If you take it at night and sleep immediately after, without brushing, the high sugar concentration can enhance the bacteria that dissolves the enamel in teeth causing caries and plaque. Therefore, it is very important to brush your teeth and wash your mouth after taking Depakote. This must also be done diligently in children.
Carbamazepine (Tegretol) can reduce the production of saliva in the mouth. Saliva is constantly cleaning the teeth and therefore, reduction of saliva can cause dental caries as well as dry mouth.
Can I undergo dental surgery as an epileptic?
Yes, you can! But there are precautions you need to take, and we will elaborate further on them now.
Can I undergo emergency dental surgery as an epileptic?
Yes, if you have a dental emergency like an infection or a broken tooth, you can go for dental surgery. Since you have no time for preparation, it is important to be on regular medication.
What do I need to know when undergoing an elective procedure?
There is no specific time to go for a procedure since your last seizure. It varies from individual to individual. Planning is important to avoid getting seizures during your dental procedure.
What do I need to do before my procedure?
The most important thing is to take your medication regularly as prescribed by your doctor.
Make sure you get at least 8 hours of good sleep, so your brain is calm and not prone to excitation. Avoid any triggers that can induce a seizure.
Consult your neurologist before the procedure for expert advice.
Always bring someone who can drive you back in case of an emergency.
What will happen during my visit?
Inform your dentist that you are an epileptic and about your medication and your emergency treatment plan.
Your dentist will perform the surgery in a shorter time as a longer procedure time puts you at risk of seizures.
Can I get numbing if I have epilepsy?
Again, the answer is yes. Local anaesthesia with Lidocaine is recommended and considered safe for epilepsy. However, when administering Lidocaine, if it is mistakenly injected into an artery or vein, it can cause seizures. Your dentist will take great care not to inject the local anaesthetic into a blood vessel.
Conscious sedation may be required in children with autism, cerebral palsy, or developmental delay, to get them to stay still. Nitrous oxide is considered safe for this purpose in epileptics.
What happens if I get a seizure during my dental procedure?
The worst possible outcome is getting a seizure during the dental procedure. If this happens there are protocols in place to make sure you get through the seizure safely.
- Firstly, and most obviously, your dentist will immediately abort the procedure if you start fitting.
- Then your dentist will remove all objects in your mouth because they could cause injury.
- Your dentist will also remove any sharp instruments in your surrounding that could potentially harm you during your seizure.
- You will not be restrained during your seizure, but your dentist will make sure you don’t fall out of your chair and get injured.
- Your dentist will time your seizure- About 95% of the seizures will resolve on their own in around 2 minutes. If your seizure lasts for over 5 minutes, it is called status epilepticus, and this is an emergency. Your dentist will administer rescue medication via the nasal, oral, or rectal route. If available, they will go for intramuscular midazolam or intravenous lorazepam. Then they will call emergency services for help.
- After your seizure, you can be confused and agitated. Your family can calm you down and re-orient you with your surroundings.
In conclusion, if you take precautions such as being on regular medication, getting plenty of sleep, and being prepared for an emergency, you can safely undergo dental procedures as an epileptic.