Background: The implementation of dietary therapy for patients with intractable epilepsy was surveyed in epilepsy centers in Japan.

Method: Questionnaires were sent to 36 epilepsy centers registered with the Japan Epilepsy Center Association.

Results: Responses were received from all 36 facilities including the collection of questionnaires and answers over the telephone, for a collection rate of 100%. Twenty-one (58%) and 15 (42%) centers did and did not provide dietary therapy, respectively. A positive correlation was observed between the number of certified dietitians and the provision of dietary therapy (p=0.037). A positive correlation was also observed between the number of doctors and the number of patients receiving dietary therapy (p<0.001).

Conclusion: Dietary therapy was not used in 42% of epilepsy centers in Japan. The numbers of doctors and certified dietitians were positively correlated with active dietary therapy. Encouraging certified dietitians to learn dietary therapy in greater depth and arranging the environment so that dietitians can respond appropriately to doctors' requests may result in widespread use of dietary therapy in Japan.

The color and form of the teeth, state of the gingiva, alignment of teeth, and structure of the maxillofacial bone and soft tissues such as lips or cheeks, affect the facial appearance. Therefore, the oral cavity is important not only in terms of function such as pronunciation and swallowing but also in terms of aesthetics. There are direct and indirect factors involved in the expression of dental aesthetics in patients with epilepsy. Direct factors include frequent epileptic seizures, falls due to seizures, and taking antiepileptic drugs. Indirect factors are the difficulty of dental treatment due to frequent epileptic seizures and general complications. Symptoms include tooth crown fracture, tooth loss, tooth discoloration, and malalignment due to tooth dislocation, facial changes due to fractured maxillofacial bone, shape defectiveness due to damage to oral soft tissues, and Phenytoin-induced gingival hyperplasia. To solve the problem, the family doctor who responds to the side effects of antiepileptic drugs and instructs them to wear a protective cap and the family dentist who understands the signs of a patient's seizures, conditions, intellectual development, and other co-existence should have a continuous and close collaboration.