Original Article Oral health status in epileptic children Taskin Gurbuz 1 and Huseyin Tan 2 Departments of 1 Pedodontics and 2 Pediatric Neurology, Atatürk University, Faculty of Medicine, Erzurum, Turkey Abstract Background: The aim of the present study was to evaluate the oral hygiene status and dental treatment r children with epilepsy. Methods: The treatment group consisted of 211 children with epilepsy (120 boys and 91 girls, 4–15 year 7.85 1 2.98 years). The control group consisted of healthy children, matched by age and gender. Clinic patients were obtained from hospital records. Clinical examinations were conducted, under standard li buccal mirror, a dental probe and air drying to evaluate caries experience and to record the periodonta child. Statistical analysis was performed using c 2 test, Fisher exact test and anova. Results: The number of decayed and missing teeth, the degree of abrasion and periodontal indexes were worse in patients with epilepsy, compared to the control group (P < 0.001). Gingival enlargement was documented in 42% of patients on valproate monotherapy compared to only in 16% of patients on phenobarbital. Dental caries and halitosis were the most common oral disorders. Generalized tonic–clonic seizures often cause minor or traumatized anterior teeth. Conclusions: Epileptic children are at an increased risk of developing caries and gingivitis compared with hea subjects. Key words caries, children, epilepsy, gingival status, oral hygiene. Epilepsy is a common chronic neurologic disorder that affects 1–3% of the population, and almost 10% of the population will have one ormore seizures at some time in their lives. 1 The epilepsies form an array of more or less discrete epilepsy syn- dromes, characterized by age of onset, hereditary factors, seizure types, electroencephalogram (EEG) abnormalities, and progno- sis. 2 The current emphasis in epilepsy treatment is to improve quality oflife, notonly by suppressing seizure, butalso by minimizing the side-effects of medications. 3 Both the condition and its medical management can affect oral health. Prevention of oral disease and carefully planned dental treatment are essential to the well-being of people with epilepsy. Children younger than 15 yearsconstitute a large group among epileptic individuals, and a considerable proportion of them also have mental and motor deficits. 4,5 These patients are at risk for oral health due to their poor self-care and the side-effects of anticonvulsant treatment: in particular, the use of phenytoin and phenobarbital can be associated with gingival enlargement. 6,7 Patients with epilepsy can be at increased risk of fracture because enzyme-inducing anti-epileptic drugs (AED; e.g.,phenytoin, phenobarbital, carbamazepine) alter the metabolism and clear- ance of vitamin D and have been associated with osteopenia and osteomalacia. 8 To our knowledge, few reports have been pub- lished on the oral hygiene and dental treatment requiremen adults and children with epilepsy. 9–11 Understanding of epilepsy and seizures raises awareness the disorder’s impact on patients’ general medical and psyc logicalhealth. Dentaltreatment of patients with epilepsy and seizures should be carried out by dentists who are knowledg aboutthese disorders. 12 The medical literature contains little information on the influence of epilepsy in dental care.Most existing studies focus on phenytoin-induced gingival hyperp In almostall aspects of oralhealth and dental status, the condition of patients with epilepsy is significantly worse tha of age-matched groups in the general (non-epileptic) popula- tion. 13 Furthermore, patients who have poorly controlled epile and who experience frequent generalized tonic–clonic seizures exhibitworse oral health in comparison with patients who are better controlled or only have seizures that do notinvolve the masticatory apparatus. 13 Patients living with epilepsy have special needs during de treatment. The purpose of the present study was therefore to determine whether epilepsy has a specific effect on oral hea and dental treatment needs. Methods This cross-sectional study was performed in the Department Pediatric Neurology, Faculty of Medicine, and Department of Pedodontics, Faculty ofDentistry, Atatürk University, during 2006–2007. A total of 442 subjects, 211 on AED and 211 hea Correspondence: Taskin Gurbuz, DDS, PhD, Atatürk Universitesi, Dis Hekimligi Fakultesi, Pedodonti Ana Bilim Dali,Erzurum, Turkey. Email: gurbuzt25@yahoo.com Received 28 February 2008; revised 8 July 2009; accepted 7 September 2009. Pediatrics International (2010) 52, 279–283 doi: 10.1111/j.1442-200X.2009.02965.x © 2010 Japan Pediatric Society