The Oral Findings and Dental Management of Patients with West Syndrome: A Case Series and Literature Review

Abstract

Objectives: West syndrome (WS) is a rare disorder with an estimated prevalence of 1 in 4000 live births, characterized by infantile spasms, hypsarrhythmia, and psychomotor developmental impairment. The available information on dental care forWS patients remains limited. The aim of this study was to describe oral manifestations and dental management in a series of WS patients. Methods: Fourteen patients diagnosed with WS were evaluated, including 10 males and 4 females, aged 12-41 years. Medical and dental variables were collected for all patients. Results: The most frequent oral findings were poor oral hygiene (64.2%), gingivitis (64.2%), dental caries (57.1%), and bruxism/tooth wear (28.5%). Only one patient had dental fractures (due to trauma), and none exhibited drug-induced gingival enlargement. Initial dental treatment was carried out under general anesthesia in 42.3% of the patients. However, following desensitization, half of the patients showed improved behavior and were ultimately treated using non-pharmacological behavioral support techniques. Conclusions: This series represents the largest published to date on the dental aspects of WS. Dental treatment needs of WS patients are considerable, and their management is primarily determined by the degree of epilepsy control, the presence of comorbidities, and the level of cooperation. Nevertheless, these patients may benefit from desensitization strategies to improve their behavior. As subsequent sessions were conducted, the behavior of 1 in every 3 initially non-compliant patients showed significant improvement.

Keywords: West syndrome; dental care; dentistry; epilepsy; oral manifestations.

Figure 1

Neglected oral health status in a patient with West syndrome, with poor oral hygiene, dental caries, and gingivitis.