Effects of the Ketogenic Diet for Epilepsy on Pediatric Patients' Oral Health Condition

Abstract

 The objective of this study was to identify factors influencing the dental health of patients on a ketogenic diet to treat epilepsy. The study was conducted from July 2015 to August 2016 involving inpatients or outpatients with epilepsy of the National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders. We administered a face-to-face interview on lifestyle and dental hygiene, performed oral observations, and collected clinical information. Fifty-one children (27 boys and 24 girls, 1 to 14 years of age, mean age: 6.7 years) were included in the analyses. Two adults were excluded. Fifteen children on a ketogenic diet for epilepsy (diet therapy group) were compared with 36 children receiving non-diet epilepsy therapy (control group). No significant differences were observed between the 2 groups in the presence of questionable caries for observation, presence of signs of gum inflammation, presence of signs of gingival hyperplasia, presence of a family dentist, or the oral health behavior. Three guardians (20.0%) in the diet therapy group and no guardian (0%) in the control group were concerned about their children’s bruxism, and a significant difference was observed between the 2 groups (p=0.030). Six guardians (40.0%) in the diet therapy group and 6 guardians (16.7%) in the control group were concerned about the color of their children’s teeth, but no significant difference was observed between the 2 groups (p=0.079). We did not investigate their teeth discoloration in detail, and thus could not determine the cause of such discoloration in this study. The discoloration of their teeth is one of the issues to be solved in the future. In the diet therapy group, there was one guardian who avoided the use of dentifrice due to it containing sweeteners, and it was suggested that we should provide information on dentifrice so that it can be used with confidence.