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Management of Epileptic Patient in an Orthodontic Clinic.

Sashi Bhushan Ekka, Rajesh Balani, Chandresh Shukla, Sahil Agarwal, and Karthik Swamy

Seizure disorders are the most common serious chronic neurological condition. This review is intended to update the orthodontist regarding seizure disorders including etiology, medical and surgical management, impact on dental health, potential for altering orthodontic treatment planning and delivery, and guidelines for management of seizures in the orthodontic office. It is estimated that there are 55,00,000 persons with epilepsy in India, 20,00,000 in USA and 3,00,000 in UK. The majority of patients can be managed medically so that they remain free of seizures. Contemporary management may include medications, surgery, an implanted nerve-stimulation device, and/or a ketogenic diet. Considerations for the orthodontist planning treatment for a patient with a seizure disorder are specific details about seizure onset, frequency, and type, behavior during seizures, duration, triggers, recovery period, medical management, and compliance. Patients with epilepsy and a malocclusion should have a comprehensive orthodontic evaluation. Adverse side effects of Anti-Epileptic Drugs (AEDs) and past dental trauma should be researched by the orthodontist and reviewed as part of patient informed consent. The practitioner and staff should be prepared to recognize and respond appropriately when a patient has a seizure in the orthodontic office.