Gingival Enlargement in Children Treated With Antiepileptics

Abstract

This study was conducted to determine the occurrence, severity, and risk factors of gingival enlargement in children treated with valproate and other nonvalproate antiepileptic drugs. A cross-sectional study was carried out in which data obtained from 68 epileptic children under treatment were compared with those from 50 controls. A structured questionnaire was used to collect data on patients' demographics, dental and oral hygiene practices, and medication history. Gingival enlargement, gingival index, plaque index, and probing depth were measured to assess periodontal health. The chi-square and Fisher exact tests were used in statistical analysis. In case of significance, a detailed chi-square analysis was carried out to determine the origin of the difference. Patients in both the valproate and nonvalproate groups showed significantly higher gingival enlargement, gingival index, plaque scores, and pocketing (P < .001 and P < .01, respectively) than the control group. In the valproate group, the duration of the treatment had a significant effect on gingival enlargement (P < .001) but not on gingival index, plaque index, and probing depth values (P > .05). Toothbrushing was most frequent in the control group (P = .000) and more frequent in the valproate group than the nonvalproate group (P = .024). Our study showed significant differences regarding gingival enlargement in children treated with valproate. These findings illustrate that epileptic children on valproate are at risk of periodontal problems.

Epilepsy and Oral Health

“…Bleeding as a potential side effect should be discussed with patients and their families in preparation for surgery (Acharya & Bussel, 2000). According to Tan et al, VPA can be associated with side-effects in gingival tissue in children by a mechanism attributable to the drug rather than oral hygiene or inflammation (Tan et al, 2004). Those findings are consistent with the present results.…”

Gingival overgrowth, congenital generalized hypertrichosis, mental retardation and epilepsy: case report and overview

“…The generalized, tonic-clonic seizures had been treated for 14 months with sodium valproate, which has been proven to induce GO in children. GO increases in severity with the duration of treatment, but promptly regresses after its interruption (Tan et al, 2004). Although the age at the onset of GO in our patient was unknown, antiepileptic treatment had been changed in topiramate, which has no obvious gingival effect, long before the time of our observation, while GO persisted.…”

Patients with epilepsy may have an increased risk of tooth loss

“…However, lesser-known and probably more important influences on the patient's oral health status are increased parafunctional behavior, which may damage oral structures, 5 and epilepsy treatment-related influences, eg, druginduced xerostomia 6 or periodontal problems. 7 The authors provide interesting insight into the prosthodontic status of this special population. The article may help to demystify epilepsy's assumed effects on oral health and the patient when the authors conclude that only a segment of this population needs modified treatment strategies compared with those of general dental patients.…”