Oral health status and dental care needs among adults living with epilepsy in Cameroon: an analytical cross-sectional study

Abstract

People living with epilepsy (PLWE) often face significant barriers to oral healthcare due to stigma, marginalization, and limited access to services, especially in low-resource settings. This study compared the oral health status and dental care needs of people living with epilepsy with matched controls without epilepsy at Laquintinie Hospital in Douala, Cameroon. We conducted an analytical cross-sectional study from February to May 2024. A total of 210 participants were enrolled, including 70 PLWE and 140 age-, sex-, and lifestyle-matched non-PLWE controls. PLWE were eligible if they had been diagnosed at least six months prior. Participants were consecutively recruited from the Neurology Department outpatient clinic. Oral health was assessed using the Simplified Oral Hygiene Index (OHI-S), Community Periodontal Index of Treatment Needs (CPITN), and the decayed, missing, and filled teeth (DMFT) index. Associations were evaluated using chi-square tests and odds ratios, with significance set at p < 0.05. PLWE had significantly higher rates of poor oral hygiene compared with controls (85.7% vs. 27.1%; OR = 16.11, 95% CI: 7.49–34.65, p < 0.001). Gingivitis was more prevalent among PLWE (71.4% vs. 57.9%; OR = 7.02, 95% CI: 3.44–14.31, p < 0.001), as was localized chronic periodontitis (18.6% vs. 6.4%; OR = 10.70, 95% CI: 4.05–24.50, p < 0.001). Over half of PLWE required restorative dental care (58.6% vs. 44.6%). Poor oral health is highly prevalent among PLWE, particularly gingivitis. Integrating routine oral screening into epilepsy follow-up programs could improve long-term quality of life, especially in resource-limited settings.