Dental Complications after AN surgery

AN patients with facial problems are at a much greater risk for developing dental problems.  Unfortunately, the issue of possible dental complications as a result of facial paralysis has not received sufficient attention.

The first cause of problems is direct, when the paralysis prevents the patient from feeling what happens inside their mouth.  The lack of sensitivity makes maintaining proper dental hygiene more challenging. Pieces of food that we normally sense and clean out remain unnoticed, even during brushing, and are left to decay. 

A further cause of dental problems is a reduced flow of saliva, caused by damage of the nerves that control the salivary glands.  Saliva acts as a buffer to the acids; reduced flow allows the acids build up and destroy tooth enamel, leading to rapid tooth decay. When coupled with poorer dental hygiene, dental problems are very likely.

(2003) I had surgery to remove AN in 1993 at the US Army hospital.  The facial paralysis was horrible at first, no saliva. I still have some facial paralysis and little saliva on that side. As a result of low saliva I lost my teeth and now wear dentures.

Another problem is radio osteo necrosis, or bone death of the gums. This can happen when blood flow is reduced as a result of facial paralysis.  In patients with radio osteo necrosis, gums do not heal as for other patients.  Major dental work, such as extractions, become more complicated and have more risks.  For AN patients who are already at greater risk of dental problems, this is is not welcome news.

There is good news though: with information and extra preventative efforts, major problems can be avoided. It's important for the patients to work with their dentists and make sure that the dentists are aware of their AN treatment and side effects.

I've spoken to 4 or 5 dentists, 1 radiation doctor, and 1 neurosurgeon who acknowledge the possible [dental] problems for surgical outcomes such as my husband's.  In hindsight, had we known, I would have put a higher priority on the dental hygiene. I probably would have gotten a sonic toothbrush with automatic timer to aid in cleaning. I would have insisted more on his not smoking. Smoking interfere with healing, including the mouth.

Last Edited: Wednesday, August 13, 2003