Dental Issues in Facial Palsy

Original Editor - Wendy Walker

Lead Editors - Wendy Walker, Kim Jackson, Rishika Babburu and Tony Lowe

Dental Problems in Facial Palsy[edit | edit source]

In people with Facial Palsy, teeth on the palsy side of the mouth may show more signs of decay, and the gums on that side may have more disease than the unaffected gums[1]. People with reduced saliva production (which occurs in facial palsy) are known to be at risk of developing caries on the affected side because of the reduction in the benefits of saliva: the acidity in the mouth is increased which affects several factors which contribute to the development of caries, such as proliferation of acid-producing bacteria, inability to buffer the acid produced by bacteria or from ingested foods, loss of minerals from tooth surfaces and inability to replenish the lost minerals[1][2].
This is often exacerbated by the fact that food may collect in the cheek on the palsy side, as a result of the lower muscle tone in the cheek. In addition, the increased difficulty in brushing the teeth on that side may mean that unless great care is taken, food is left in contact with the teeth and gums far longer than usual.

Function of Saliva[edit | edit source]

Someone who suffers from any dryness of the mouth (due to reduced saliva production) no longer has the benefit of the natural protection that saliva provides: saliva helps to neutralise the acid that attacks teeth, and it also helps to fight the bacteria that form dental plaque (plaque is the thin, sticky film that keeps forming on your teeth) and cause tooth decay and gum disease. For more information see the Dry Mouth page.

Dental Care[edit | edit source]

It is recommended that anyone with facial palsy continues to visit the dentist on a regular basis, even if they are not aware of any dental problems. The dentist will be able to assess the plaque build-up, help remove it and advise on appropriate management.
People with facial palsy frequently find that food accumulates in the cheek,so it is useful to try and brush the teeth after each meal (and even snacks) to remove the food.

Many dental products contain Sodium Lauryl Sulphate(SLS), and some people with dry mouth find this can irritate the mouth and make the condition worse. If you think this might be the case, suggest your patient tries switching to a toothpaste which does not contain SLS (such as Sensodyne Daily Care, or Biotene Toothpaste) for 2 weeks and see if they notice an improvement.

Dentures[edit | edit source]

People who have false teeth sometimes find that the denture does not fit as well - again, this is due to the reduced tone in the cheek on the affected side. In someone who has recently developed facial palsy, there is no need to rush to get the denture altered, as over the next few months as the tone in the cheek improves, the denture should start to fit well. However, if the palsy has been present for a year or morer, it is recommend that they visit their dentist for a review.

  1. 1.0 1.1 Su N, Marek CL, Ching V, Grushka M. Caries prevention for patients with dry mouth. J Can Dent Assoc. 2011
  2. Tschoppe P, Meyer-Lueckel H. Mineral distribution of artificial dentinal caries lesions after treatment with fluoride agents in combination with saliva substitutes. Arch Oral Biol. 2011 Aug;56(8):775-84. doi: 10.1016/j.archoralbio.2011.01.002. Epub 2011 Feb 2. PMID: 21292240