Antiepileptic drugs and oral health

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Epilepsy affects between 40-70 per 100,000 of the population in the developed world.  Antiepileptic drugs (AEDs) in particular phenytoin (PHT) is associated with gingival hyperplasia(GH) . The aim of this review was to explore the effects of all AEDs on oral health.

The authors searched PubMed, EMBASE the Cochrane library and bibliographies of relevant articles. They included retrospective or prospective cohort studies that included patients with all types of epilepsy taking AEDs, as well as case series of ≥ 10 cases. Study selection was conducted independently by two reviewers.

15 studies were included The AEDs assessed were PHT, carbamazepine (CBZ), phenobarbital (Pb) and valproate (VPA).

They found

  • 16%–94% of patients taking PHT  had gingival hyperplasia
  • Patients taking valproate, carbamazepine or phenobarbital also had gingival hyperplasia.
  • Alveolar bone loss occurred in patients taking carbamazepine or PHT.
  • no published studies of newer-generation AEDs.

The authors concluded

Although several studies examined the effects of PHT on oral health, none have studied those of the newer generation of AEDs. Studies exploring oral side effects of AEDs are needed.

CornacchioALP,. Burneo,JG ,Aragon CE The Effects of Antiepileptic Drugs on Oral Health. J Can Dent Assoc 2011;77:b140

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Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

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