儿童癫痫的牙科问题和管理:概述

Nirmala Svsg, S. Degala
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摘要

现代医学将癫痫定义为一种以频繁反复发作为特征的慢性神经系统疾病。癫痫发作是一种疾病的征兆,表现为运动、感觉或意识的发作性障碍,是由突然的、同步的、不适当的和过度的放电引起的,这些放电干扰了癫痫发作部位的大脑正常功能[[发作与种族、年龄和性别无关]。然而,癫痫在男性中发生的频率高于女性。口腔表现为舌头或颊黏膜软组织撕裂,多见于牙齿和颌骨的撕脱、脱位和骨折,还有颞下颌关节半脱位。由于药物治疗,牙龈增生,复发性溃疡样溃疡和牙齿发育异常,如小牙齿和延迟出牙。通过心理行为准备、镇静等减轻患者压力。地西泮是首选药物,因为它具有抗便秘的特性。在癫痫患者中使用清醒镇静和全身麻醉并不是禁忌。在某些情况下,为了安全有效地提供牙科护理,可能需要一氧化二氮或静脉镇静。避免静脉注射局部麻醉剂。预约时间应短,刷牙程序及定期检查的重要性,如需移动牙齿及更换牙齿,宜选用固定式。本文就儿童癫痫的病因、临床特点及牙科治疗作一探讨。
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Dental concerns and management of children with Epilepsy: An overview
Modem medicine defines epilepsy as a chronic neurologic disorder characterized by frequently recurrent seizures. A seizure is a sign of a disease, which manifests as an episodic disturbance of movement, feeling, or consciousness caused by sudden synchronous, inappropriate and excessive electrical discharges that interfere with the normal functioning of the brain site of location of seizures the disease occurs independent of race, age and gender ]. However, epilepsy has been occur more frequently in men than in women. Oral manifestations are soft tissue lacerations of tongue or buccal mucosa, avulsion, luxation and fractures of teeth and jaws are more common and also subluxation of the temporo mandibular joint.due to drug therapy gingival hyperplasia, recurrent apthous like ulceration and anomalous dental development like small teeth and delayed eruption.reduce stress on the patients with psychobehavioral preparations, sedation etc. Diazepam is the drug of choice because it has anticonvilsant properties.The use of conscious sedation and general anesthesia is not contraindicated in patients’ epilepsy. In some situations nitrous oxide or intravenous sedation may be necessary to safely and effectively provide dental care. Avoid IV local anesthetics. Appointments should be short, importance of tooth brushing procedures and regular review, if appliances are indicated for tooth movement and tooth replacement, fixed type are preferred. This article discuss about etiology, clinical features and dental management of children with epilepsy.
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