Levetiracetam

Oral health effects

• Limited direct oral effects

  Few specific oral effects; appointment timing around seizure control and managing anxiety are the main considerations.

  Clinical management: Plan atraumatic, well-timed care; have a seizure management plan.

• Swelling of the lips, tongue or gums (angioedema, rare)

  Angioedema affecting the lips, tongue, gums or throat can occur after the first dose or at any time (label warning).

  Clinical management: Ask about previous facial or oral swelling. Acute swelling of the tongue or throat is an emergency; call emergency services and manage the airway. Patients on ACE inhibitors may be at higher risk.

• Severe mucocutaneous reactions (SJS/TEN, rare)

  Rare but serious skin reactions such as Stevens-Johnson syndrome, with painful oral ulceration, are a label warning.

  Clinical management: Ask about new rash, fever or mouth ulcers, especially in the first two months of therapy. Painful erosions of the lips and mouth with skin rash are a medical emergency: refer urgently to the physician and do not delay for dental treatment.