Dravet syndrome can have some surprising effects on many parts of the body — including the teeth and gums. A lifelong form of epilepsy, this rare disease starts in early infancy and may involve long-lasting seizures, side effects from treatment, and eating difficulties. All of this can take a toll on your dental health and quality of life.

If you feel like you or your child with Dravet syndrome has more dental problems than most people, you’re probably right. Here, we’ll discuss six ways that Dravet syndrome can affect the teeth and gums.

1. Delayed Tooth Development

The first seizures from Dravet syndrome usually happen during the first year of life — with seizure onset often happening between 5 and 8 months of age. This is around the time most babies start teething. However, babies with Dravet syndrome might get their teeth later. When their teeth finally come in, they may be smaller or shaped differently than normal.

2. Tooth Wear and Breakage

Many people with Dravet syndrome grind or gnash their teeth — a condition called bruxism. Grinding can wear down the tooth enamel (outer layer) and cause you to bite your tongue or inner cheeks. In addition, seizures can cause the jaw to clench tightly. Because of this, seizures can lead to dental injuries such as broken or missing teeth or even a fractured jawbone.

People with epilepsy who grind their teeth may do so for many reasons. Things like seizures, stress, sleep issues, and taking certain medications — such as some older anti-seizure medications — may contribute to nighttime grinding.

Several members of MyEpilepsyTeam have reported experiencing bruxism:

“I grind so badly that my teeth are flat with no enamel left from vomiting.”

“If it’s not grinding teeth, it’s the biting on the tongue.”

“I grind my teeth, and my dentist recommended a mouth guard.”

“The dentist eventually tracked really strange wear that my teeth were getting that indicate grinding.”

If you or your child grinds their teeth, talk to a dentist. They can help come up with a treatment plan to protect your or your child’s teeth.

3. Cavities

Kids with epilepsy often use medications that can affect oral health and increase the risk of tooth decay and gum disease. Along with nutrition challenges that are common in Dravet syndrome, these drugs can raise the risk of caries (cavities) — small holes left by tooth decay. Cavities develop when bacteria in the mouth feed on sugars left behind by foods or drinks. The bacteria produce acid, which slowly eats away at the tooth surface.

Some liquid oral (taken by mouth) medications that treat Dravet syndrome contain a type of sugar called sucrose to make them taste better. One study looked at children with epilepsy who took liquid oral medications for more than three months compared to other forms of medications. Cavities were found in over 76 percent of kids who took the liquid drugs, compared to 55.6 percent of those taking other drug forms.

Children with Dravet syndrome may also have a hard time brushing their teeth. Motor skills and coordination challenges may make it difficult to clean teeth thoroughly, setting the stage for oral hygiene issues that may lead to cavities.

4. Dry Mouth

Saliva helps keep your mouth clean and moist. Most people experience occasional dry mouth, or a lack of saliva, when they’re dehydrated. However, chronic (long-term) dry mouth can cause or worsen oral health problems like cavities, mouth sores, and gum disease.

Dry mouth can be a side effect of some anti-seizure medications used for the treatment of Dravet syndrome. So, certain drugs used for seizure control may contribute to dry mouth along with other factors, such as dehydration and mouth breathing.

5. Gum Problems

Dental health doesn’t just refer to teeth. Your gums — the pink tissue that supports teeth — are also a part of your overall dental health. Dravet syndrome and some of its treatments can affect gum health in a couple of major ways.

Gingivitis

Gingivitis — or, the early, first stage of gum disease — develops when plaque (a sticky layer of bacteria) builds up on your teeth. This leads to an infection that can cause red, tender, swollen gums and bad breath.

Plaque buildup and dry mouth, a possible side effect of anti-seizure medications, can lead to gum disease.

Gum Overgrowth

Some people with seizure disorders develop gum enlargement or overgrowth of gum tissue — a condition called gingival hyperplasia. This can cause the gums to become puffy and bleed easily. Gingival hyperplasia can make teeth appear smaller than they actually are. Overgrown gums also make it harder to brush and floss, which can contribute to cavities and gum disease.

This problem can be a side effect of some seizure medications. The anti-seizure drug phenytoin (Dilantin, Phenytek) has been shown to cause gingival hyperplasia in up to half of people who take it for one to two years. Less commonly, gingival hyperplasia may happen as a result of taking sodium valproate.

6. Need for Root Canals

People with Dravet syndrome might need a root canal after injuring a tooth during a seizure. During a root canal procedure, the inflamed or infected pulp (soft tissue) inside a tooth is removed. People with tooth trauma may need a root canal even if the tooth itself isn’t broken.

Signs you may need a root canal include:

• A tooth that has chipped or cracked
• Darkening/discoloration of the tooth
• Small bumps (like pimples) on the gums
• Severe tooth pain, especially when chewing
• Swelling or tenderness in the gums
• Sensitivity to hot or cold foods and drinks

A root canal can relieve pain in the long run, but the treatment itself can cause short-term pain or soreness. People with Dravet syndrome and other types of epilepsy might find root canal treatment challenging, especially if they have sensory issues or have anxiety about medical procedures. Dentists can work with you to help make you feel more comfortable during treatment.

Getting Informed Dental Care for Dravet Syndrome

If you or your child has Dravet syndrome, it’s important to find a dentist who understands your needs. Make sure your dental team knows how to respond if a seizure happens during a visit. Let them know when the most recent seizure happened and which medications are being taken to manage Dravet syndrome.

Dental tools often include bright lights, which can sometimes trigger seizures in people with Dravet syndrome. To avoid this, you may want to wear dark glasses or ask the dentist to adjust the lighting during treatment.

Good dental care is essential for everyone, but especially for people with Dravet syndrome. Regular dental checkups and cleanings can help catch problems early — and keep teeth and gums as healthy as possible.

Join the Conversation

On MyEpilepsyTeam, people share their experiences with epilepsy, get advice, and find support from others who understand.

Do you experience frequent dental problems with Dravet syndrome? Let others know in the comments below.