Authors
Jithin Georgea, Jayakumari Nandanaa, Thania Elizabeth Pidiyancherila, Lakshmi Priyaa, Ramshekhar N Menona, Ashalatha Radhakrishnana
aR. Madhavan Nayar Centre for Comprehensive Epilepsy Care, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
Abstract
Background and Objective: Epilepsy is a common neurological disorder with significant disabilities. Persons with epilepsy is considered to have poor dental hygiene. It is due to multifactorial causations. Studies regarding the attitude of neurologists and dentists and knowledge of patients is limited.
Methods: This is a questionnaire based cross sectional study of patients diagnosed with epilepsy treated in Sree Chitra Tirunal Institute of Medical Sciences and Technology. Attitude and practice of neurologists and dentists towards the dental health issues in persons with epilepsy were studied via an online questionnaire.
Results: A total of 111 dentists, 106 neurologists and 82 patients were enrolled in the study. Out of the 106 neurologists, 73 (68.9%) opined that a person with epilepsy has increased risk of dental health issues, while 22.6% opined same risk compared to normal population. The opinion of neurologists regarding fitness for dental procedures: 57.1 % gives fitness only in controlled epilepsy while 33.3 % opined that they give fitness for all cases regardless of control of epilepsy. 40.6% opined that refractory epilepsy has a link to periodontal diseases. Among dentists, 17.6 % dentists refer to alternate higher centre, if patient had seizures in the past. 80.9 % ask for history of seizures, in their dental patient in their consulting room, while 19.1 % does not ask. 46.8% of dentists ask for history of antiseizure medications when they see an oral pathology, while 13.8% does not ask for such history, and 39.4% ask only if he has history of seizures. Most dentists (34.9%) opined that anxiety was the most common issue faced during the procedure in persons with epilepsy and 24. 8% opined gum bleeding as the major issue. Out of 82 persons with epilepsy, 78 believes in keeping the mouth clean is essential while 4 were unaware. 24 people opined they experience nervousness while on dental chair, and 10 people fear being there and 46 have no such difficulties. 27 people takes preventive measures if they notice a dental caries to prevent further decay, 18 will wait and watch, 34 will consult dentist at the earliest, while a single person answered that he would ask the neurologist for his/her opinion.
Conclusion: The neurologists should give importance in enquiring the dental health problems and should advise for routine dental health check-ups for persons with epilepsy. In addition, dentists should be educated in doing emergency measures during a seizure episode and should not defer patients from doing dental procedures due to history of seizures.
Keywords: Epilepsy, Dental issues, Knowledge, Attitude, Practice