A Parent’s Guide to Dental Care for Children with Seizures and Epilepsy
Some of the uncontrolled movements during a seizure happen in the mouth. Children may clench their jaw and teeth and/ or drool and froth while having a seizure.
Do not put anything in your child’s mouth. He or she cannot swallow their tongue. If you try to force something in to your child’s mouth during a seizure, you may hurt your child or yourself.
Children with seizures or epilepsy need to see a pediatric dentist regularly.
A child should have his/her first dental visit no later than 12 months of age. Your child’s dentist will recommend how often he or she should go to the dentist.
Children with seizures or epilepsy can have special oral problems.
There is a risk of breaking his or her teeth during an episode; children may break their teeth more than once.
Medicines used to manage seizures, such as phenytoin, may cause your child’s gums to overgrow.
Prepare your child for a visit to the dentist:
Make sure your child takes his/ her medicine on schedule.
Make sure he or she has a good night’s rest before the appointment.
Questions to ask your child’s dentist:
Can my child wear sunglasses during the dental appointment?
Yes, absolutely! If the dentist does not offer sunglasses, ask for them at every appointment. Dental chair lights are very bright and may cause a seizure in a child with a history of seizures.
Can you numb my child’s teeth?
Yes. Usually, the dentist will use a local anesthetic called lidocaine with epinephrine to numb your child’s teeth. This has been found to be safe and effective for children with seizures.
Can my child get the laughing gas if they are scared?
Maybe. Laughing gas (nitrous oxide) is safe for most children with a history of seizures. Your child’s dentist may talk to your child’s neurologist before giving your child laughing gas.
Can my child be sedated for dental treatment?
Yes. Children with a history of seizures can be sedated if they are scared. Children with seizures should not be sedated with meperidine; it can make it more likely for your child to have a seizure.
Do my child’s medicines affect the teeth?
Sometimes they do. Sugar is sometimes added to cover up the bitter taste of the medicine. Taking frequent doses of sweet medicine can make your child more likely get cavities.
The medicine may make your mouth dry and not have enough spit. Having a dry mouth creates bacteria that can cause cavities.
Dry mouth also makes plaque and tartar build up faster which can lead to gum disease.
It is important to try to prevent cavities since the medicine used to prevent seizures cannot be changed.
How frequently should my child see a dentist for check-ups?
It depends. Some children may need dental check-up every six months, while others may need to see the dentist more frequently. It depends on his or her risk of getting cavities or other dental problems.
Should my child get a mouth guard?
Yes. A mouth guard can be useful to protect your child’s teeth during a seizure.
Does my child need prescription fluoride products?
Maybe. The dentist will decide based on a dental exam and x-rays.
How can I prevent cavities in my child?
Brush your child’s teeth every morning and every night with a soft toothbrush.
Use toothpaste with fluoride in it and has the ADA seal of approval on the tube.
Floss after brushing at night.
Drink fluoridated water.
Do not drink juices, sodas, or sports drinks often.
Stay away from foods that have added sugar. In-between meal snacks should not be sweet treats.
Questions your child’s dentist might ask you:
Who is your child’s neurologist? How can I get in touch with him or her?
What medicines does your child take? What are the dosages? What time of day does your child take medicine?
Does your child have any drug and food allergies?
What type of seizures does your child have?
How often does your child have seizure episodes? When was the last one?
What are the known triggers for your child’s seizures?
How do you keep your child safe during a seizure episode?
Has your child had any complications or problems during or after dental treatment in the past?
Is your child afraid of going to the dentist?
Questions you should ask your child’s neurologist:
Does my child need any extra protection while receiving dental care?
Is there anything the dentist should do differently for my child?
Children with a history of seizures can get cavities, just like children who do not have seizures. Dental cavities are preventable by ensuring a healthy, low-sugar diet and regular brushing and flossing.
How to find a pediatric dentist:
American Academy of Pediatric Dentistry: www.aapd.org
American Board of Pediatric Dentistry: www.abpd.org
Additional Information on Seizures: https://medlineplus.gov/seizures.html
Note: The information you see describes general oral health information for children with seizures, but it does not apply to everyone. This information is not medical advice. Please contact a healthcare provider if your child has a medical problem. If you think your child may have a medical emergency, please call your child’s doctor or an emergency number immediately.
Text by Priyanshi Ritwik, DDS, MS
Edited by Julie Schiavo, MLIS, AHIP