Transient facial nerve palsy following dental local anaesthesia

Facial nerve palsy is a rare but known complication of dental local anaesthesia and may be underreported. We describe a case of a transient facial nerve palsy following the administration of an inferior alveolar nerve block and discuss the immediate practical management. Knowing the likely transient nature of this complication means the patient can be reassured and unnecessary referral avoided. While the blink reflex is inhibited, steps are needed in order to protect the cornea and prevent secondary infection and scarring.

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A Clinical Audit into the Success Rate of Inferior Alveolar Nerve Block Analgesia in General Dental Practice

Primary Dental Care ◽

10.1308/135576101322462174 ◽

2001 ◽

Vol os8 (4) ◽

pp. 139-142 ◽

Cited By ~ 13

Author(s):

Andrew Keetley ◽

David R Moles

Keyword(s):

Facial Nerve ◽

Success Rate ◽

Local Anaesthetic ◽

Nerve Palsy ◽

Facial Nerve Palsy ◽

Inferior Alveolar Nerve ◽

The Other ◽

Dental Practice ◽

Inferior Alveolar Nerve Block ◽

Dental Practitioners

Aims and objectives The aim of this study was to produce some observational evidence of the success rate of inferior alveolar nerve block (IDB) analgesia that is achieved in general dental practice. The objective was to help provide some measure of expected failure rates and help dental practitioners in their self-appraisal of this crucial basic skill. Method Up to 100 consecutive IDB analgesia procedures for four dentists were recorded. In a subdivision of this study 200 consecutive IDBs for a fifth dentist were recorded. This dentist had the greatest experience of giving IDB analgesia of the dentists in this study. In this part of the study the dentist made a note if he anticipated that the procedure would fail. The reason for this was that it was felt that experienced dental practitioners could predict when failure was about to occur. The level of facial nerve palsy was also recorded. Results Overall, 533 of 580 (91.9%) local anaesthetic administrations were deemed to be successful. The only factor that significantly affected the likelihood of success was the practitioner administering the local anaesthetic, and this was only borderline statistically significant. In order to be certain that the other factors did not affect the outcome, the data were re-analysed using the technique of Poisson regression. This technique investigated the effects of each of the factors in turn while controlling for the differences in success that can be attributed to the different practitioners. The regression analyses also did not detect any differences in success that could be attributed to any of the other recorded factors. The incidence of facial palsy was 0.3%. Conclusion This paper gives an insight into the possible success rates to be encountered by general dental practitioners when they administer IDB analgesia. The only recorded factor that could be shown to affect the chance of a successful local analgesic was the operator. The incidence of facial nerve palsy at 0.3% may be more common than has previously been considered.

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Transient Delayed Facial Nerve Palsy After Inferior Alveolar Nerve Block Anesthesia

Anesthesia Progress ◽

10.2344/11-03.1 ◽

2012 ◽

Vol 59 (1) ◽

pp. 22-27 ◽

Cited By ~ 14

Author(s):

Fotios H. Tzermpos ◽

Alina Cocos ◽

Matthaios Kleftogiannis ◽

Marissa Zarakas ◽

Ioannis Iatrou

Keyword(s):

Facial Nerve ◽

Medical History ◽

Nerve Block ◽

Nerve Palsy ◽

Facial Nerve Palsy ◽

Inferior Alveolar Nerve ◽

Inferior Alveolar Nerve Block ◽

Clinical Appearance ◽

Dental Procedures ◽

Nerve Block Anesthesia

Facial nerve palsy, as a complication of an inferior alveolar nerve block anesthesia, is a rarely reported incident. Based on the time elapsed, from the moment of the injection to the onset of the symptoms, the paralysis could be either immediate or delayed. The purpose of this article is to report a case of delayed facial palsy as a result of inferior alveolar nerve block, which occurred 24 hours after the anesthetic administration and subsided in about 8 weeks. The pathogenesis, treatment, and results of an 8-week follow-up for a 20-year-old patient referred to a private maxillofacial clinic are presented and discussed. The patient's previous medical history was unremarkable. On clinical examination the patient exhibited generalized weakness of the left side of her face with a flat and expressionless appearance, and she was unable to close her left eye. One day before the onset of the symptoms, the patient had visited her dentist for a routine restorative procedure on the lower left first molar and an inferior alveolar block anesthesia was administered. The patient's medical history, clinical appearance, and complete examinations led to the diagnosis of delayed facial nerve palsy. Although neurologic occurrences are rare, dentists should keep in mind that certain dental procedures, such as inferior alveolar block anesthesia, could initiate facial nerve palsy. Attention should be paid during the administration of the anesthetic solution.

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