Neurology
Dental Management of Patients with Epilepsy
Confirm seizure control; minimise triggers
Confirm the patient has taken medication and seizures are controlled. Minimise flashing lights and stress; know the seizure first-aid plan.
Emergency vs routine management
If EMERGENCY — what to do
- • Seizure: protect from injury, do not restrain or put anything in the mouth, note the time.Ref: Resuscitation Council UK. Medical emergencies and resuscitation — Standards for dental practice, 2020 (updated 2023)
- • Seizure > 5 min: buccal midazolam 10 mg (adult) and call emergency services.Ref: NICE NG217 — Epilepsies in children, young people and adults, 2022
If ROUTINE — what to do
- • Confirm seizure control and that medication was taken; avoid triggers (bright lights, stress).Ref: Little JW, Miller CS et al. Dental Management of the Medically Compromised Patient, 10th ed., Elsevier 2023
- • Phenytoin → gingival overgrowth; valproate → possible bleeding (check platelets before surgery).Ref: Little JW, Miller CS et al. Dental Management of the Medically Compromised Patient, 10th ed., Elsevier 2023
Clinical precautions
- • Confirm medication compliance & recent control
- • Minimise triggers (light, stress, fatigue)
- • Be prepared to manage a seizure
At a glance by procedure
Initial assessment before lab results or timing details are entered.
| Procedure | Initial assessment |
|---|---|
| Examination / radiographs | MODIFY / CAUTION Confirm seizure control; minimise triggers |
| Supragingival scaling / polish | MODIFY / CAUTION Confirm seizure control; minimise triggers |
| Deep scaling / subgingival RSD (subgingival calculus) | MODIFY / CAUTION Confirm seizure control; minimise triggers |
| Root canal treatment | MODIFY / CAUTION Confirm seizure control; minimise triggers |
| Simple extraction (1–3 teeth) | MODIFY / CAUTION Confirm seizure control; minimise triggers |
| Surgical / bony extraction | MODIFY / CAUTION Confirm seizure control; minimise triggers |
| Implant placement | MODIFY / CAUTION Confirm seizure control; minimise triggers |
References
- Epilepsy — dental management
- Resuscitation Council UK. Medical emergencies and resuscitation — Standards for dental practice, 2020 (updated 2023)
- NICE NG217 — Epilepsies in children, young people and adults, 2022
- Little JW, Miller CS et al. Dental Management of the Medically Compromised Patient, 10th ed., Elsevier 2023
Related guides
This guide supports — and does not replace — professional clinical judgment. Always consider the individual patient and consult the treating physician when indicated.