Epilepsy Orthodontic Considerations — ORE Part 1 MCQ

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ModerateOrthodonticsEpilepsy Orthodontic ConsiderationsORE Part 1

A patient with well-controlled epilepsy takes carbamazepine and is planned for fixed-appliance orthodontic treatment. Which aspect of care requires particular attention?

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Correct answer: B — Gingival enlargement and plaque control

**A is correct.** Carbamazepine is associated with gingival overgrowth. This is particularly relevant with fixed appliances because brackets and ligatures increase plaque retention and may worsen gingival inflammation or enlargement. Treatment should therefore include careful periodontal assessment, reinforced plaque-control instruction and review of gingival health throughout treatment. **B** is incorrect: well-controlled epilepsy is not an automatic contraindication to orthodontics. **C** is not the best answer: long-term carbamazepine has reported bone-density effects, but this does not mandate altered orthodontic force levels in a routine case. **D** is unsupported; brackets do not trigger seizures. **E** is not a recognised relevant adverse effect of carbamazepine.

Reference: Gallo C, Bonvento G, Zagotto G, Mucignat-Caretta C. Gingival overgrowth induced by anticonvulsant drugs: A cross-sectional study on epileptic patients. Journal of Periodontal Research. 2021;56(2):363-369. https://pubmed.ncbi.nlm.nih.gov/33368283/