Having epilepsy can affect our oral health in a number of ways.
The medications we use can cause Gingival hyperplasia which is a common and mild form of gum disease which causes irritation, redness and swelling of our gingiva (the part of our gum around the base of our teeth). Gingival overgrowth can prevent proper care of our teeth and gums and it can cause pain when chewing and eating. It can also look unsightly when the growth of the gums completely covers a tooth or teeth.
It may be possible to change the medications that are causing Gingival hyperplasia with the support of your neurologist or GP, but a visit to the dentist to discuss treatment options such as gingivectomy (the removal of gum tissue) will help to treat the problem. Removing plaque that has hardened into tartar may also be recommended.
If Gingival hyperplasia is left untreated then it can lead to more serious gum disease known as periodontitis, which is when the gum infection damages the soft tissue and destroys the bone that supports the teeth. By practicing good oral hygiene (i.e. flossing between your teeth, brushing your teeth at least twice a day with a soft toothbrush, using fluoride toothpaste, and using a mouthwash) will help to maintain good gum health.
Other recommendations for good oral health are:
- eating a good balanced healthy diet that is low in sugary or acidic foods
- avoiding smoking and tobacco products, and
- visiting your dentist or dental hygienist at least every six months.
People who experience tonic clonic seizures are at risk of damaging their teeth, cheek, lip, jaw or tongue during a seizure. It is not possible to prevent these injuries.
Please follow the guidelines in our EWCT first aid poster to know how to help someone having a tonic clonic seizure.
The tongue is a moveable set of eight muscles that allows us to speak, eat, drink, taste, chew, swallow and defend our mouths against germs. It is anchored to the floor of our mouth and so we cannot swallow it during a seizure. However, if we were to have a seizure on our back, the tongue would flop back and block the airwave and we would not be able to breathe until we are rolled into the recovery position. At that point, the tongue would flop forward allowing us to breathe.
Nothing should ever go into the mouth during a seizure with the mistaken belief that a person is swallowing their tongue. Any foreign object going into the mouth at that time could badly injure a person’s teeth or jaw.
We cannot stop tongues being badly bitten either during a seizure. Tongues that are badly bitten will require stitching.
To prevent bitten tongues some people may consider wearing properly fitted mouth guards which are used by those who teeth grind but not for epilepsy. However, these mouth guards present two potentially serious hazards for those with tonic clonic seizures. They are
(a) A mouth guard becoming loose during a seizure which may then block the airway; and
(b) mouth guards, which are made of silicone or plastic, disintegrating or breaking down during forceful biting and being accidentally swallowed or breathed down into the lungs. These particles would not show up on imaging and be hard to remove.
It is recommended that mouth guards are not used for tonic clonic seizures, especially for those people who have seizures during sleep.
A visit to your dentist
On a first visit to see your dentist, or dental hygienist, it is important that you tell them about your epilepsy and what it may look like. Your EWCT advisor can help minimize any anxiety you may have by writing up an epilepsy action plan which can then be shared.
All dental health professionals are taught about the many types of seizures and how to respond in the event of a seizure or emergency. They understand your anti-seizure medications and triggers such as anxiety, stress and bright lights. They will do their best to make sure that your experience sitting in the dentist chair is a positive one.Disclaimer: this fact sheet is for education purposes only. Please consult your doctor or other health professional for advice regarding your epilepsy.