Bell’s Palsy (Facial Paralysis) : Dental Hygiene Perspective

-Facial Paralysis described by Sir Charles Bell, Scottish Surgeon from 19-Th Century

Bells palsy is paralysis of the facial muscles caused by trauma to the 7th cranial nerve, and is not permanent.

Cranial nerve VII controls most facial muscles, including those needed to smile, blink, and wrinkle the forehead. The nerve also controls the function of certain salivary glands and the lacrimal (tear) glands as well as the tiny muscles inside the ear that dampen loud noises.

Signs and Symptoms:

• Weakness or paralysis of one side of facial muscles
• No pain in most of the cases
• Mouth: corner of the moth drops, salivation with
  drooling is uncontrollable
• Eye: Eyelids cannot be closed
• Increased sensitivity to sounds(hyperacusis)
• Difficulty speaking

Intra Oral Symptoms:

- Loss of taste on the front portion of the tongue
- Mastication is difficult
- Increased accumulation of dental biofilm due to loss of self cleansing ability

Etiology:

The cause of Bell's palsy is still unclear. Possible agents: virus (HSV), trauma from extraction, surgery of parotid gland, removal of tumor.

Prognosis:

The paralysis is likely to become worse for the first couple of days, and then gradually get better. In most cases, all symptoms are spontaneously gone within 2 months.

Treatment:

• Anti-inflammatory medication. Corticosteroid medication (prednisone)
• Antiviral medication. Acyclovir (Zovirax) and Famciclovir (Famvir)
• Facial Massage
• Surgery

Dental hygiene Interventions, OHI AND AIDS

¨ Frequent appointments for deplaquing

¨ Ask client to Brush after every meals or at least rinsing with water may be necessary to remove food particles that remove food that may get stuck between the gingiva and cheek.

Author: Boban Fidanoski
CCDH – December 2007