3 Damaging Effects of Antiepileptic Drugs on Oral Health

Last Updated on: 10th June 2024, 09:08 am

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Written by

Q.F. Nayibe Cubillos Morales

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Medically Reviewed by

Dr. Gustavo Assatourians D.D.S

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The Side Effects of Antiepileptic Drugs on Oral Health?

Epilepsy is a chronic, non-communicable brain disease in which seizures are generated. According to the WHO, this is the most common neurological disorder. About 50 million people in the world suffer from it. 

Epilepsy can lead to clenching the jaws and grinding the teeth, among other effects. We have a comprehensive guide about bruxism and epilepsy that can help you understand the connection between the two.

With proper treatment, most people can live without seizures. However, to achieve this goal, some medications are prescribed that, while fulfilling their basic function can engender side effects on oral health.

 

What are Antiepileptic Drugs?

Antiepileptics are drugs widely used in the treatment of seizure disorders (such as epilepsy), neuropathic pain, and psychiatric disorders. They act on the central nervous system, so their chronic consumption can have multiple side effects, including drowsiness, dizziness, and loss of balance. In some cases, they can generate side effects on the gastrointestinal system and the oral cavity. This is a problem because these treatments are usually lifelong or long-lasting, implying the need to deal medically with the adverse effects of the medication.

antiepileptic-drugs-on-oral-health

 

What are the Most Used Antiepileptic Drugs?

The most frequently prescribed antiepileptic drugs are:

 Carbamazepine

 Phenytoin

 Lamotrigine

 Sodium valproate

 Gabapentin

 Clonazepam

 Lorazepam

 Diazepam

 Phenobarbital

 

Oral Complications of Antiepileptic Drugs

As mentioned, antiepileptic drugs are effective in treating various diseases, but prolonged use can have side effects on the patient’s oral health.

1. Gingival hypertrophy or enlargement

swollen-gums

This is one of the most common oral complications associated with the long-term use of antiepileptic drugs. It manifests as an increase in the size of the gums, which can affect both aesthetics and oral function.

Although it is usually painless, patients may experience difficulty speaking, chewing, and swallowing, as well as gum bleeding and changes in tooth positions. An increase in the size of the gums also generates retention of food debris and bacteria on the surface of the teeth. Drugs linked to this condition include phenytoin, carbamazepine, and sodium valproate. To understand more signs and symptoms of gum disease, click here.

2. Xerostomia

Xerostomia, hyposalivation, or dry mouth, is another common oral complication associated with the use of antiepileptic drugs. Patients may experience decreased saliva production, which can cause dental caries, periodontal disease, and a predisposition to lacerations of the oral mucosa. Xerostomia can also cause problems swallowing food and taste disturbances.

3. Hematopoietic disorders

The hematopoietic system is responsible for producing blood cells. Some antiepileptic drugs have been shown to alter the production of these cells, affecting coagulation and causing lesions in the gums and mucosa.

 

Can Antiepileptic Drugs cause Cavities?

Antiepileptic drugs can cause caries indirectly by decreasing salivary flow. Saliva is essential to protect teeth from caries since it cleans surfaces, maintains an optimal pH, and helps to constantly remineralize dental tissue. Therefore, patients with xerostomia or decreased salivation are more prone to developing caries.

 

Oral Health Considerations in Patients with Epilepsy

If you suffer from epilepsy, the following tips may be helpful:

 Schedule your appointments at a time when seizures are unlikely.

 Tell your dentist about the type and frequency of seizures.

 Do not stop anticonvulsant medications if the treating physician has not indicated it.

 Tell your dentist what triggers your seizures so he can take preventive measures, such as wearing dark glasses or eye masks with stress management techniques.

 Although it is not commonly required, the use of conscious sedation is an option for patients for whom dental care generates a high level of anxiety; You can request it if you need it.

 Make sure that the health professional adapts the consultation to your needs. If this does not happen, it is advisable to look for another service provider.

 If you require the use of prostheses, if possible they should not be removable to avoid choking during seizures.

 If the use of removable dental prostheses is unavoidable, opt for metal prostheses to avoid the risk of fracture.

visit-dentist

 Attend dental check-ups every six months.

If you require more information on dental health in patients with epilepsy, you can consult our post on bruxism and epilepsy.

 

Conclusion

 Antiepileptic drugs are used to treat various diseases in addition to seizure disorders.

 Although antiepileptics are effective, they can induce side effects or complications in the oral cavity.

 It is important that both the patient and the dentist are aware of these complications to prevent and treat them effectively.

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References

1. Aragon, C. E., & Burneo, J. G. (2007). Understanding the patient with epilepsy and seizures in the dental practice. Journal (Canadian Dental Association), 73(1), 71–76.

2. Cornacchio, A. L. P., Burneo, J. G., & Aragon, C. E. (2011). The effects of antiepileptic drugs on oral health. Journal (Canadian Dental Association), 77, b140. https://jcda.ca/article/b140

3. Dry mouth. (Feb 1, 2011). Mayoclinic.org. https://www.mayoclinic.org/diseases-conditions/dry-mouth/diagnosis-treatment/drc-20356052

4. Epilepsy. (s/f). Who.int. https://www.who.int/news-room/fact-sheets/detail/epilepsy

5. Gallo, C., Bonvento, G., Zagotto, G., & Mucignat-Caretta, C. (2021). Gingival overgrowth induced by anticonvulsant drugs: A cross-sectional study on epileptic patients. Journal of Periodontal Research, 56(2), 363–369. https://onlinelibrary.wiley.com/doi/10.1111/jre.12828

6. Joshi, S. R., Pendyala, G. S., Saraf, V., Choudhari, S., & Mopagar, V. (2013). A comprehensive oral and dental management of an epileptic and intellectually deteriorated adolescent. Dental research journal, 10(4), 562–567.

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