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Medical Forum / General / Dentistry / February 2007Could anesthesia or the oral surgery cause Bell's Palsy?...
Could anesthesia or oral surgery cause Bell's Palsy?... > Could anesthesia or oral surgery cause Bell's Palsy?... Bell's Palsy refers to a condition where the Facial Nerve (cranial nerve # 7) does not function properly. It is in charge of movement of many muscles of the face, including the muscles of facial expression. Although most cases have an unknown cause, some cases are related to viruses. When an injection is given in the mouth, it can temporarily numb these nerves that feed the muscles, but it is the terminal branches of the facial nerve and not the main nerve trunk. Function returns once the local anaesthesia wears off. I haven't read any reports of bells palsy remaining after the local anaesthesia has worn off. An injection on the outside of the mouth, say in the skin, like for Botox treatement sure could affect these muscles, but in the case of botox, muscle paralysis is a desire in order to remove wrinkles. As for oral surgery....that involving extractions cannot affect it. However, if you had maxillofacial or plastic surgery where the skin or jaws were moved, it is possible that the some of the muscles of facial expression maybe affected. However, this is a direct result of the surgery and not by a virus. Former Prime Minister of Canada Jean Chretian is a famous person who I can recall had Bell's Palsy J Suljak DDS > > Could anesthesia or oral surgery cause Bell's Palsy?... > > Bell's Palsy refers to a condition where the Facial Nerve (cranial nerve # > 7) does not function properly. It is in charge of movement of many muscles > of the face, including the muscles of facial expression. Although most > cases have an unknown cause, some cases are related to viruses. rest are trauma to the nerve from cold wind. > When an injection is given in the mouth, it can temporarily numb these > nerves that feed the muscles, but it is the terminal branches of the facial > nerve and not the main nerve trunk. Function returns once the local > anaesthesia wears off. I haven't read any reports of bells palsy > remaining after the local anaesthesia has worn off. Use of Articaine in certain areas on the mouth has also led to temporary paralysis even after the anesthetic has worn off. > An injection on the outside of the mouth, say in the skin, like for Botox > treatement sure could affect these muscles, but in the case of botox, muscle > paralysis is a desire in order to remove wrinkles. Botox use to remove wrinkles is an off-label use of the neurotoxin. > As for oral surgery....that involving extractions cannot affect it. > However, if you had maxillofacial or plastic surgery where the skin or jaws [quoted text clipped - 6 lines] > > J Suljak DDS >> > Could anesthesia or oral surgery cause Bell's Palsy?... >> [quoted text clipped - 18 lines] >> >Botox use to remove wrinkles is an off-label use of the neurotoxin. Actually it isnt. Botox sold for cosmetic purposes is specifically labeled for the use of glabellar wrinkles. >> As for oral surgery....that involving extractions cannot affect it. >> However, if you had maxillofacial or plastic surgery where the skin or jaws [quoted text clipped - 6 lines] >> >> J Suljak DDS > On 4 Feb 2007 19:05:16 -0800, "Alexander Vasserman DDS" > [quoted text clipped - 36 lines] > > >> J Suljak DDS I haven't seen the insert for Botox(r) cosmetic. But I have used Botox(r) Theraputic which is the exact same product (different container for medical billing purposes) I have it's inserts and it's main use is for laryngiospasms nothing in there about wrinkles. If Botox(r) cosmetic is labeled for treatment of "11's" that's news to me but from what I was taught using it for wrinkles such as "crows feet" is generally off label use. >> On 4 Feb 2007 19:05:16 -0800, "Alexander Vasserman DDS" >> [quoted text clipped - 44 lines] >but from what I was taught using it for wrinkles such as "crows feet" >is generally off label use. Its not 'indicated' for crow's feet but it works well, much like the forehead. > Its not 'indicated' for crow's feet but it works well, much like the > forehead. In the "piling on" department...would this woman be a candidate? http://images.spaceref.com/news/2007/nowak.mugshot.jpg Steve  SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 >> Its not 'indicated' for crow's feet but it works well, much like the >> forehead. [quoted text clipped - 4 lines] > >Steve Yea, along with electric shock therapy ;) Who knows, maybe the wrinkles are what really pushed her over the edge. >>> Its not 'indicated' for crow's feet but it works well, much like the >>> forehead. [quoted text clipped - 9 lines] >Who knows, maybe the wrinkles are what really pushed her over the >edge. Well I guess that *depends*... <hehe> couldn't resist. >> Could anesthesia or oral surgery cause Bell's Palsy?... > [quoted text clipped - 23 lines] > > J Suljak DDS http://www.rcsed.ac.uk/journal/vol45_5/4550012.htm Steve I had a patient where I anesthetized and did a filling on an upper left first molar. Everything went normal at the office visit and remained that way for several days after the appointment. 4-5 days later, the patient had Bell's Palsy develop on that side of his face. He blamed me and never came back. I don't think it was related to the dental treatment or it would have been a more immediate reaction. Not 4-5 days later. JME, D >I had a patient where I anesthetized and did a filling on an >upper left first molar. Everything went normal at the office [quoted text clipped - 10 lines] >JME, >D Agreed. On a similar note, BP tends to not recur, so he may still be blaming you for something that was coincidental . (nice word choice, don't ya think ?) > I had a patient where I anesthetized and did a filling on an > upper left first molar. Everything went normal at the office [quoted text clipped - 10 lines] > JME, > D That could not have been caused by the injection of the anesthetic. However if this patient was numb and could not feel his face and drove his car with the window open and extreme cold air blowing on the left side over his left ear (add to this possibly wet hair) , this can cause trauma to the nerve and hence Bell's Palsy next day but not 4-5 days later. This patient ill informed made a rash decision to blame you and I suspect something else may have been a factor as well. Oh well, this kind of blame happens to every dentist every now and then. Patients get the cavities due to neglect, stuff happens when you try and help them, they blame you regardless if it was your fault or act of god. >> Former Prime Minister of Canada Jean Chretian is a famous person who I can >> recall had Bell's Palsy [quoted text clipped - 4 lines] > >Steve Ancedotal at best, doesn't show cause and effect. Believe that HSV1 has a significant role in the C-VII ganglion, with attendant inflammatory response that causes pressure on C-VII that causes the palsy. My wife came down with Bell's palsy last summer, sudden onset, no prodrome, in fact she wasn't even aware until I mentioned it. Tx with Medrol Dose-pack, and Acyclovir. The palsy resolved uneventfully and completly in about 3.5 wks, with substantial improvement seen within the first four days. Believe this was due to starting treatment immediately. Her major complaint was the inability to close the eye on the affected side. We got an eye patch, some gauze, and a moisturizing eyedrop to prevent drying of the eye. YMMV, just my 2¢ > >> Former Prime Minister of Canada Jean Chretian is a famous person who I can > >> recall had Bell's Palsy [quoted text clipped - 23 lines] > > YMMV, just my 2¢ not all Bells Palsy is viral as I discovered when I had it 16 years ago. they gave me prednisone for 4 weeks in decreasing doses. It resolved completely after about 6 months. >> >> Former Prime Minister of Canada Jean Chretian is a famous person who I can >> >> recall had Bell's Palsy [quoted text clipped - 27 lines] >ago. they gave me prednisone for 4 weeks in decreasing doses. It >resolved completely after about 6 months. How do you know it wasn't viral ? Most Bell's Palsy resolves in 6 months with no treatment. > >> >> Former Prime Minister of Canada Jean Chretian is a famous person who I can > >> >> recall had Bell's Palsy [quoted text clipped - 31 lines] > > Most Bell's Palsy resolves in 6 months with no treatment. I fell asleep after taking a shower with a fan blowing on my face to keep me awake while I was cramming for a exam. I fell asleep regardless and when I woke up my left side of my face was numb for several minutes. That morning I was siting in my car and having a soda and I drooled. I looked in the mirror and the left side of my face had no movement. It got worse in the next 2 days then got better. Spoke to several MD's and was told this is very common, "Trauma from temperature can also cause Bell's Palsy". It only makes sense. >> >> >> Former Prime Minister of Canada Jean Chretian is a famous person who I can >> >> >> recall had Bell's Palsy [quoted text clipped - 40 lines] >several MD's and was told this is very common, "Trauma from >temperature can also cause Bell's Palsy". It only makes sense. IMO the temperature thingy was only a trigger, i.e. reducing host resistance. Also lack of sleep is trauma in and of itself. We all remember exam time, reduced host resistance. Soda for breakfast, you get the idea. Another possible cause is that you may have impinged C-VII during sleep. Say you slept on your book or something while at your desk. > >> >> >> Former Prime Minister of Canada Jean Chretian is a famous person who I can > >> >> >> recall had Bell's Palsy [quoted text clipped - 51 lines] > C-VII during sleep. Say you slept on your book or something > while at your desk. !!!!!!!!!!!!!!!!!!!!!!!!!!! I was on my bed not laying on a desk. when I woke up half my face facing the fan was numb and face cold as hell. Why is it so hard for you to accept that this was temperature induced? after all nobody knows the actual cause of Bell's Palsy and i am not doubting that viral is possible, just saying you can get it from extreme cold temperature trauma. One of the MD's I have seen for this condition said this was fairly common in teenage girls with wet hair sitting by airconditioner. Add to my situation driving a car that same morning with window open wind blowing .... need I say more It wasn't on my right side of my face steering wheel in USA is on the left side ... get the picture.!!!! Does viral have preference to left side vs right?? 50% 50% chance. I'll bet if you look at statistics of Bell's Palsy in the USA and affected side you will see higher numbers for left side and if you look at the same statistics say in Japan or UK you will see slightly higher on right side. All I am saying is that some of the Bell's Palsy cases can be due to temperature trauma. Whether that is considered Psudo-Bell's Palsy i don't know and for all practical purposes I do not see why that is important. fact is this is a form of stroke and is not pleasant because aside from the muscles not working, you can not close your eye lid and your eye get's dried out and is exposed to sunlight etc... It can also be caused from local anesthetic such as an improper IA nerve block but this form returns at the end of the day. Other types last for months. >> >> >> >> Former Prime Minister of Canada Jean Chretian is a famous person who I can >> >> >> >> recall had Bell's Palsy [quoted text clipped - 78 lines] >improper IA nerve block but this form returns at the end of the day. >Other types last for months. Good Gawd man, calm down. I understand your argument but don't agree with it. What is the incidence of Bell's Palsy in, oh I dunno, lets say Alaska... or how about mountaineers on Everest? Mebbe Antarctic researchers ? I still say that the cold is just a trigger. You know, like HSV after a sunburn, etc... Let's just agree to disagree. > I still say that the cold is just a trigger. > You know, like HSV after a sunburn, etc... I went to Minneapolis last weekend. The temps were below zero and wind chills were MINUS 30 and worse. I saw hundreds of faces and none that were saggy. Whenever something weird happens, we often look to find a 'cause'. Many times factors that were mere coincidence get credit. I'm no Bell's Palsy expert, but it would seem there might be a difference between 'trigger', 'contibuting factor', and true 'cause'. Maybe there isn't a disagreement at all. ;-) D >> I still say that the cold is just a trigger. >> You know, like HSV after a sunburn, etc... [quoted text clipped - 16 lines] >;-) >D Tink that about sums it up. Thank you for your diplomatic response. I didn't want you turning Wubba loose. D > Tink that about sums it up. > Thank you for your diplomatic response. We all know how ugly that can be ;-) >I didn't want you turning Wubba loose. > >D > >> Tink that about sums it up. >> Thank you for your diplomatic response. > > I still say that the cold is just a trigger. > > You know, like HSV after a sunburn, etc... [quoted text clipped - 16 lines] > ;-) > D Chilly faces is not the same thing as prolonged cold passing over the ear canal where the cranial nerve exits the skull. Perhaps you should look at some of the people who climbed mount everest and see how their tissues get damaged by cold climate. Fact is you do not know, and yet you argue. Again Bell's Palsy is idiopathic meaning no body knows the cause viral and temp are just 2 of the theories. Maybe a little open mindedness on your part is in order. I am not disputing either theory at this point just pointing out I know both exist and the temperature theory is in line with what I personally experienced. I wasn't even arguing, but if you must.... A fan blowing on your face as you sleep inside is trauma from the cold? I ain't buying it. Most California dudes have no clue about cold. Sometimes I really wonder about you. Steve >>>I still say that the cold is just a trigger. >>>You know, like HSV after a sunburn, etc... [quoted text clipped - 27 lines] > out I know both exist and the temperature theory is in line with what > I personally experienced. > I wasn't even arguing, but if you must.... > [quoted text clipped - 4 lines] > > Most California dudes have no clue about cold. I may be off base here, Steve, but I have a powerful feeling Alex wasn't always a California dude. Steve > Sometimes I really wonder about you. > [quoted text clipped - 31 lines] >> out I know both exist and the temperature theory is in line with what >> I personally experienced. OK, my bad. I still wonder about him. Steve > I may be off base here, Steve, but I have a powerful feeling Alex > wasn't always a California dude. > > Steve > OK, my bad. > [quoted text clipped - 6 lines] > > > Steve I lived in Ukraine and Toronto before ending up in California. So I know what cold is. And just because this happened in California, does not mean conditions could not be recreated to produce intense cold temperatures. One thing I found living here is that the temperature difference between during the day and evening is quite severe. You could be in a t-shirt during the day and have to wear a sweater at night or early morning. Temperature in California can be deceiving. In Toronto it is cold but it is consistently cold all day not much of a temperature change. patient: Doctor doctor there is a virus in my ear!!! doctor: Oh don't worry it looks like a Bell's Palsy, it's nothing to sneeze about. On Feb 11, 9:15 pm, "Alexander Vasserman DDS" <purple543...@yahoo.ca> wrote: > patient: Doctor doctor there is a virus in my ear!!! > > doctor: Oh don't worry it looks like a Bell's Palsy, it's nothing to > sneeze about. patient: Doctor doctor there is a virus in my ear!!! doctor: Yes and it looks like a Bell's Palsy. That sure will give you something to drool about. > On Feb 11, 9:15 pm, "Alexander Vasserman DDS" <purple543...@yahoo.ca> > wrote: [quoted text clipped - 8 lines] > doctor: Yes and it looks like a Bell's Palsy. That sure will give you > something to drool about. Is that a Bell's palsy in your pocket or are ya happy to see me? Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 >patient: Doctor doctor there is a virus in my ear!!! > >doctor: Oh don't worry it looks like a Bell's Palsy, it's nothing to >sneeze about. The facial motor ganglion is anterior to the external auditory meatus. The vestibular portion of C-VII senses balance. > >patient: Doctor doctor there is a virus in my ear!!! > [quoted text clipped - 4 lines] > > The vestibular portion of C-VII senses balance. figures lack of sense of humour. ok i'll explain it to you bell's palsy=virus=cold=flu=what we've been talking about=double meanings....get it now. is that all you can think about anatomy. GEEZ. no fun. >> >patient: Doctor doctor there is a virus in my ear!!! >> [quoted text clipped - 10 lines] >talking about=double meanings....get it now. > is that all you can think about anatomy. GEEZ. no fun. Mebbe you missed the obvious point. It wasn't that funny to begin with. > >> >patient: Doctor doctor there is a virus in my ear!!! > [quoted text clipped - 14 lines] > > It wasn't that funny to begin with. yes and I'm not exactly Russell Peters. "be a man". >> >figures >> >lack of sense of humour. [quoted text clipped - 8 lines] >yes and I'm not exactly Russell Peters. >"be a man". You are certainly no Danny Gans either. > >> >figures > >> >lack of sense of humour. [quoted text clipped - 10 lines] > > You are certainly no Danny Gans either. dude fact is an improv joke (good or bad) hit you over the head and you continued with anatomy 101. I think you need to get out more. >> I wasn't even arguing, but if you must.... >> [quoted text clipped - 9 lines] > >Steve Kaanaadaa ? >> I may be off base here, Steve, but I have a powerful feeling Alex >>wasn't always a California dude. >> >>Steve > > Kaanaadaa ? Hey, what wrong with being from Canada? :) >>> I may be off base here, Steve, but I have a powerful feeling Alex >>> wasn't always a California dude. [quoted text clipped - 3 lines] > > Hey, what wrong with being from Canada? :) I think it's a long way around thru the Bering Strait. Steve AV's one of those "baffle 'em with bullsh*t" type of guys. Did you see his comment about Jackass 3 ? True colors, I say. >I wasn't even arguing, but if you must.... > [quoted text clipped - 40 lines] >> out I know both exist and the temperature theory is in line with what >> I personally experienced. > > I still say that the cold is just a trigger. > > You know, like HSV after a sunburn, etc... [quoted text clipped - 16 lines] > ;-) > D and no I did not have a recurrence since I quit the practice of sleeping wet after a cold shower which my ear next to a fan. >> > I still say that the cold is just a trigger. >> > You know, like HSV after a sunburn, etc... [quoted text clipped - 19 lines] >and no I did not have a recurrence since I quit the practice of >sleeping wet after a cold shower which my ear next to a fan. It would be an interesting experiment to see if you could induce a recurrence by this method. A cold shower ? Hmmmm.... > fact is this is a form of stroke This is a bogus statement. Bell's palsy is *not* caused by a CVA. That's a different kettle of fish entirely. Might have some similar symptoms but the etiology is vastly different. >and is >not pleasant because aside from the muscles not working, you can not >close your eye lid and your eye get's dried out and is exposed to >sunlight etc... Am well aware of the symptoms. Did you read my post about my wife having it last summer ? BTW have you ever had a recurrence ? > > fact is this is a form of stroke > [quoted text clipped - 12 lines] > > BTW have you ever had a recurrence ? i never said it was a Cerebral Vascular Accident which is caused by a thrombus. A stroke in the sense that it causes motor muscles not to work. >> > fact is this is a form of stroke >> [quoted text clipped - 16 lines] >thrombus. A stroke in the sense that it causes motor muscles not to >work. I think a more accurate term would be "neuritis" There are two types of CVA, occlusive or hemorrhagic. >Could anesthesia or oral surgery cause Bell's Palsy?... Bell's palsy is considered idiopathic. That's a fancy word for saying we don't know the cause. Anything that reduces the host resistance can be a 'trigger'. Modern theory is that HSV is involved, so current therapy includes anti-virals and anti-inflammatories. Bell's palsy tends to resolve in three to six months with no permanent damage, with or without medications. |
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