Well-Controlled Epilepsy Dental — ORE Part 1 MCQ

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EasyHuman Disease & Dental ManagementWell-Controlled Epilepsy DentalORE Part 1

A patient with well-controlled epilepsy attends for routine dental treatment. They have had no seizures for 2 years and take levetiracetam regularly. Which is the most appropriate management?

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Correct answer: E — Confirm their usual levetiracetam has been taken and ensure seizure-emergency drugs are immediately accessible

Explanation lettering: C = shown as A · D = shown as B · B = shown as C · E = shown as D · A = shown as E

A is correct. This patient has stable, well-controlled epilepsy, so routine primary-care dentistry is appropriate. Check that their usual levetiracetam has been taken, obtain any relevant individual seizure plan, and ensure the team can access emergency drugs and follow the practice seizure protocol. NHS advice stresses not missing antiseizure medication, while SDCEP guidance requires midazolam to be readily accessible with emergency drugs for medical emergencies in dental practice. General anaesthesia or hospital referral is not routinely required solely because a patient has epilepsy; these may be considered only where seizure control, cooperation or treatment complexity warrants it. Local anaesthetic is not contraindicated by epilepsy alone. There is no indication to prescribe a supplementary anticonvulsant dose before routine dental treatment; alteration of epilepsy treatment should be directed by the patient's prescriber or specialist.

Reference: Scottish Dental Clinical Effectiveness Programme, Practice Support Manual, “General requirements for midazolam” (accessed July 2026): https://www.psm.sdcep.org.uk/topics/medical-emergencies-and-life-support/medical-emergency-drugs/controlled-drugs/general-requirements-for-midazolam/