The difficulties presented by facial paralysis or Bell’s palsy can result in long-term oral complications. Facial paralysis often results in muscle weakness, which changes the way that patients eat, drink, talk, and smile. As a result, facial paralysis can cause a myriad of unpleasant side effects, many of which pose a threat to maintaining good oral health. Individuals with facial paralysis are prone to biting the surface of their inner gums on the affected side, which can lead to ulcerations and infection. The lack of facial muscle control may also create challenges with functions that had previously been automatic, such as eating and drinking.
Oral and Dental Hygiene Considerations for Patients
It’s easy to take for granted the things that our bodies do on autopilot. The majority of people don’t have to worry about the way that their facial muscles are working while they enjoy a meal, but this can be a large source of anxiety for patients with facial paralysis. The physical motion of chewing and drinking can be challenging and result in drooling of saliva and food contents, which can be embarrassing. Eating and drinking in public is something that is so common, yet patients with facial paralysis often avoid it at all costs. This isolation over time can lead to negative changes in the patient’s mental and emotional frame of mind. To avoid drooling, people with facial paralysis usually chew all of their food on the unaffected side of their mouth. While this may seem like a good idea, it can actually result in jaw pain and disorders like temporomandibular joint dysfunction. Patient education, facial reanimation treatment, neuromuscular retraining, home dental hygiene (brushing and flossing), routine dental examination and periodontal appliances may be necessary to avoid long-term complications in the oral cavity for facial paralysis and Bell’s palsy patients.
Dry mouth can also be an unwanted side effect of facial paralysis. Saliva plays an important role for the health of the mouth. Saliva prevents root decay, cracked lips, rough tongue, bad breath and most importantly reduces the risk of infection on the tongue, cheeks and gums. To treat dry mouth, dentists may recommend mouth rinses that have fluoride and apply fluoride varnishes during the dental visits. Over the counter medications such as Biotine may also help some patients. Sugar-free gum, sugar-free hard candies and ice chips can also help relieve dry mouth. It is always recommended for patients to avoid carbonated drinks, caffeine, alcohol and tobacco and use of lanolin-based lip balm to help moisturize their dry lips.
When we eat, it’s common for small pieces of food to get stuck between the gums and cheeks. For the average person, this is not a problem because they have sensation of the food, and can use their tongue to dislodge it. When a patient with oral numbness / dry mouth syndrome has this experience, they will not notice the food. If the food particles remain in the month for long periods of time, this can lead to major tooth decay. Furthermore, biting of inner gums may not be noticed, and will lead to even more severe ulcerations and infections. As a result, it is very important for facial paralysis and Bell’s palsy patients to be aware of these potential issues and to schedule regular dental exams.
In summary, there are many important considerations that both patients and dentists should take into account when dealing with facial paralysis and Bell’s palsy. Educating patients about how facial paralysis can affect their oral health is of the upmost importance so that the patients practice proper home dental hygiene, such as brushing and flossing, as well as go in and see their dentist for routine dental exams. At the Facial Paralysis Institute, we recommend our patients find a dentist to be one of the members of their team of facial paralysis experts. If you are located in the Los Angeles area, we recommend Katrin Azizzadeh, DDS, who has special expertise in dental care for patients with facial paralysis.
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