Experiences and Challenges faced by Orthodontists while Treating Epileptic Orthodontic Patients: A Qualitative Study

Authors

  • Sadia Naureen
  • Huma Ghazanfar Kiani

DOI:

https://doi.org/10.51985/JBUMDC2023287

Keywords:

Epilepsy, Gingival hyperplasia, Orthodontist, Seizure.

Abstract

Objective: This study aimed to explore the experiences and challenges faced by orthodontists in treating patients with epilepsy.

 

Study Design and Setting: This was a qualitative study conducted in the Orthodontic Department at Rawal Institute of Health Sciences, Islamabad.

 

Methodology: The study period was almost three months from 4th August 2023 to 30th October 2023. Purposive sampling was done and 11 orthodontists with a minimum of 10 years of clinical experience, who had treated at least one patient with epilepsy in the past 5 years, were selected for an interview. Interviews were conducted in person or virtually, and a topic guide was used. Verbatim transcripts were analyzed using framework methodology, with triangulation techniques to minimize bias.

 

Results: All orthodontists were aware of their patients' epilepsy diagnoses, but none knew the specific type. The implementation of the orthodontic treatment strategy was less than optimal. Ceramic brackets were not used in any case. Limited single-arch treatments were preferred by orthodontists in some cases. Seizure and medicine intake history were not taken at every appointment. The emergency anti-epileptic drug was not available in the dental office. The primary challenges reported were patient motivation, poor oral hygiene, gingival hyperplasia, and bracket breakage.

 

Conclusion: Orthodontic treatment of epileptic patients is highly challenging. Modified treatment strategies should be adopted to ensure optimal care for such patients.

References

Thijs RD, Surges R, O'Brien TJ, Sander JW. Epilepsy in

adults. Lancet. 2019;393(10172):689-701. DOI:

1016/S0140-6736(18)32596-0.

Todaro V, Giuliano L, Cicero CE, Spina L, Colli C, Cuellar

S, Cosmi F, Vilte E, Bartoloni A, Crespo Gómez EB, Nicoletti

A. Prevalence of epilepsy in the rural area of the Bolivian

Gran Chaco: Usefulness of telemedicine and impact of

awareness campaigns. Epilepsia Open. 2023;8(1):125-33.

DOI: 10.1002/epi4.12677.

Knowles JK, Helbig I, Metcalf CS, Lubbers LS, Isom LL,

Demarest S, Goldberg EM, George AL Jr, Lerche H,

Weckhuysen S, Whittemore V, Berkovic SF, Lowenstein DH.

Precision medicine for genetic epilepsy on the horizon: Recent

advances, present challenges, and suggestions for continued

progress. Epilepsia. 2022;63(10):2461-75. DOI: 10.1111/

epi.17332.

Schöpper M, Ludolph AC, Fauser S. Dental care in patients

with epilepsy: a survey of 82 patients and their attending

dentists and neurologists in southern Germany. Int Dent J.

;66(6):366-74. DOI: 10.1111/idj.12251.

Kwon CS, Wagner RG, Carpio A, Jetté N, Newton CR,

Thurman DJ. The worldwide epilepsy treatment gap: A

systematic review and recommendations for revised definitions

- A report from the ILAE Epidemiology Commission.

Epilepsia. 2022;63(3):551-64. DOI: 10.1111/epi.17112.

Pironi V, Ciccone O, Beghi E, Paragua-Zuellig H, Patel AA,

Giussani G, Bianchi E, Venegas V, Vigevano F; ILAE Task

Force on Access to Treatment. Survey on the worldwide

availability and affordability of antiseizure medications:

Report of the ILAE Task Force on Access to Treatment.

Epilepsia. 2022;63(2):335-51. DOI: 10.1111/epi.17155

Bin Abdulrahman KA, Alharbi MG, Alzeer AM. Awareness

and attitudes toward epilepsy among medical students and

interns in Riyadh, Saudi Arabia. Prim Health Care Res Dev.

;23:e70. DOI: 10.1017/S1463423622000597.

Alomar S, Kadi M, Alabbas D, Aljeddawi M, Alsulaiman S,

Baeesa S, Sabbagh A. Awareness and attitudes toward epilepsy

among medical and allied healthcare students - A survey study

in a teaching hospital in Jeddah. Epilepsy Behav.

;102:106815. DOI: 10.1016/j.yebeh.2019.106815.

Smereka J, Aluchna M, Aluchna A, Szarpak £. Preparedness

and attitudes towards medical emergencies in the dental office

among Polish dentists. Int Dent J.2019;69(4):321-28. DOI:

1111/idj.12473.

Al Ghanam MA, Khawalde M. Preparedness of Dentists and

Dental Clinics for Medical Emergencies in Jordan. Mater

Sociomed. 2022;34(1):60-65. DOI: 10.5455/msm.2022.33.60-

Gale NK, Heath G, Cameron E, Rashid S, Redwood S. Using

the framework method for the analysis of qualitative data in

multi-disciplinary health research. BMC Med Res Methodol.

; 18;13:117. DOI: 10.1186/1471-2288-13-117.

Denzin NK, Lincoln YS. The sage handbook of qualitative

research. 5th ed. Safe Publications, Inc; 2017.

Kienitz R, Kay L, Beuchat I, Gelhard S, von Brauchitsch S,

Mann C, Lucaciu A, Schäfer JH, Siebenbrodt K, Zöllner JP,

Schubert-Bast S, Rosenow F, Strzelczyk A, Willems LM.

Benzodiazepines in the Management of Seizures and Status

Epilepticus: A Review of Routes of Delivery, Pharmacokinetics,

Efficacy, and Tolerability. CNS Drugs. 2022;36(9):951-75.

DOI: 10.1007/s40263-022-00940-2.

Knowles JK, Helbig I, Metcalf CS, Lubbers LS, Isom LL,

Demarest S, Goldberg EM, George AL Jr, Lerche H,

Weckhuysen S, Whittemore V, Berkovic SF, Lowenstein DH.

Precision medicine for genetic epilepsy on the horizon: Recent

advances, present challenges, and suggestions for continued

progress. Epilepsia.2022;63(10):2461-75. DOI:

1111/epi.17332.

Ghosh S, Sinha JK, Ghosh S, Sharma H, Bhaskar R, Narayanan

KB. A Comprehensive Review of Emerging Trends and

Innovative Therapies in Epilepsy Management. Brain Sciences.

;13(9):1305. DOI: https://doi.org/10.3390/

brainsci13091305

Hassan A, Assim B, Mohammad B. Special Care Dentistry

and Epilepsy. King Khalid University Journal of Health

Sciences.2023;8(1):6-11. DOI: 10.4103/ KKUJHS.

KKUJHS_37_22

Tiwari S, Verma RK, Dhull KS, Suma G. Assessment of Oral

Health Status in Epileptic Children and Healthy Children in

Bengaluru City: A Comparative Study. Int J Clin Pediatr Dent.

;14(6):768. DOI: 10.5005/jp-journals-10005-2081.

Alqahtani H. Medically compromised patients in orthodontic

practice: Review of evidence and recommendations. Int

Orthod. 2019;17(4):776-88. DOI: 10.1016/j.ortho.

08.015.

Katyayan A, Diaz-Medina G. Epilepsy: Epileptic Syndromes

and Treatment. Neurol Clin. 2021;39(3):779-95 DOI:

1016/j.ncl.2021.04.002.

Qasim M, Sufiyan A, Shaukat M, Rabbani S, Khan A N,

Khan N R. Knowledge, Attitude and Practices of Dentists

Towards the Dental Treatment of Epileptic Patients. Pakistan

Journal of Medical & Health Sciences. 2022;16(4):1130-32.

DOI: https://doi.org/10.53350/pjmhs221641130.

Goswami M, Johar S, Khokhar A. Oral Health Considerations

and Dental Management for Epileptic Children in Pediatric

Dental Care. Int J Clin Pediatr Dent. 2023;16(1):170-76. DOI:

5005/jp-journals-10005-2516.

Abou-Khalil B. W. Update on Antiseizure Medications 2022.

Continuum (Minneapolis, Minn). 2022;28(2): 500–35 DOI:

https://doi.org/10.1212/CON.0000000000001104.

Downloads

Published

2024-04-25

How to Cite

Naureen, S. ., & Kiani, H. G. . (2024). Experiences and Challenges faced by Orthodontists while Treating Epileptic Orthodontic Patients: A Qualitative Study. Journal of Bahria University Medical and Dental College, 14(02), 107–112. https://doi.org/10.51985/JBUMDC2023287

Issue

Section

Original Articles