Experiences and Challenges faced by Orthodontists while Treating Epileptic Orthodontic Patients: A Qualitative Study

Abstract

Objective: This study aimed to explore the experiences and challenges faced by orthodontists in treating patients with epilepsy. Study Design and Setting: This was a qualitative study conducted in the Orthodontic Department at Rawal Institute of Health Sciences, Islamabad. Methodology: The study period was almost three months from 4th August 2023 to 30th October 2023. Purposive sampling was done and 11 orthodontists with a minimum of 10 years of clinical experience, who had treated at least one patient with epilepsy in the past 5 years, were selected for an interview. Interviews were conducted in person or virtually, and a topic guide was used. Verbatim transcripts were analyzed using framework methodology, with triangulation techniques to minimize bias. Results: All orthodontists were aware of their patients' epilepsy diagnoses, but none knew the specific type. The implementation of the orthodontic treatment strategy was less than optimal. Ceramic brackets were not used in any case. Limited single-arch treatments were preferred by orthodontists in some cases. Seizure and medicine intake history were not taken at every appointment. The emergency anti-epileptic drug was not available in the dental office. The primary challenges reported were patient motivation, poor oral hygiene, gingival hyperplasia, and bracket breakage. Conclusion: Orthodontic treatment of epileptic patients is highly challenging. Modified treatment strategies should be adopted to ensure optimal care for such patients