Everything about Bell’s Palsy

November 08, 2018

  

It is easy to take for granted things the human body does on autopilot. Most people do not have to worry about how their facial muscles work. They can easily enjoy a meal, drink with friends, speak to co-workers, and smile at passersby. But for patients with Bell’s palsy, any physical movement of the face can be challenging, or even impossible. The result can be frustrating, embarrassing, and even detrimental to oral health. 

What is Bell’s Palsy?

In the United States, Bell’s palsy is the leading cause of facial paralysis. The condition was discovered by Scottish anatomist and neurologist Sir Charles Bell and it refers to facial weakness or paralysis on one side of the face (unilateral paralysis). That said, Bell’s palsy and facial paralysis are not interchangeable terms. Facial paralysis occurs for a number of reasons including trauma, tumors, and salivary gland inflammation. Recent studies indicate that Bell’s palsy occurs if a viral infection, most commonly herpes simplex, herpes zoster, chickenpox, mumps, or bacterial infection such as Lyme disease or tuberculosis, causes inflammation of the facial nerve specifically located behind the temporal bone. The nerve becomes swollen and rapidly shuts down, resulting in immediate facial paralysis on one side.

The condition more commonly affects people aged 15 to 60, those with diabetes or upper respiratory disease, and women during pregnancy, especially in the third trimester or one week after giving birth. Patients who experience such sudden facial paralysis need to go to the emergency room immediately and get tested for the root cause. Bell’s palsy and facial paralysis are rare, complex conditions. Patients will need to consult with an ear, nose, and throat specialist or facial nerve specialist in the first few weeks of paralysis so they can receive necessary tests and make sure there is no cause other than the Bell’s palsy.

Common side effects for patients with Bell’s Palsy

Aside from the apparent paralysis and lack of feeling, Bell’s palsy changes the way people smile, speak, eat, and drink. Individuals with Bell’s palsy tend to chew all of their food on the unaffected side of their mouth. It is common sense, but the practice can result in jaw pain and temporomandibular joint dysfunction, or other disorders. Patients with Bell’s palsy are also more prone to biting their cheeks, inner gums, and other soft tissues of the mouth without even noticing. This can lead to swelling, infection, or ulcerations.

It is also common for small pieces of food to get stuck between teeth, gums, and cheeks. Most people have some sensation and can feel the food. They use their tongue or other means to dislodge it. Patients with oral numbness from Bell’s palsy may not notice the food particles. If they remain lodged in the mouth for an extended period of time it can cause  a major infection and tooth decay.

Another common side effect of Bell’s palsy is dry mouth or xerostomia. When the facial nerve is damaged the salivary glands on that side of the mouth produce less saliva. And saliva is crucial for the health of the mouth. It helps prevent cursory conditions like dry lips, rough tongue, and bad breath. Saliva helps prepare food for swallowing and contains enzymes important for digestion. Perhaps most importantly saliva protects teeth from infection, plaque, and decay. If the body cannot produce enough saliva patients often experience problems in these areas.

Dental and oral hygiene for patients with Bell’s Palsy

There are several important considerations patients and dentists should keep in mind when dealing with Bell’s palsy. Educating patients about the impact of this kind of facial paralysis on oral health is of utmost importance. These patients often require vigilant at home oral hygiene, more frequent dental exams, and perhaps periodontal treatments or appliances. In approximately 85% of cases, Bell’s palsy symptoms disappear on their own within three months. The patient regains full facial feeling and movement. But if paralysis lingers longer than eight months patients might also need neuromuscular retraining and facial reanimation treatment.
 

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