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Article: Volume 44 Number 3 Page 241 - March 2017

  Dent Update 2017; 44: 241-245  Read article

Paediatric dentistry:  Facial Palsy Masquerading as an Acute Dental Abscess

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Abstract: Facial nerve palsy has specific symptomology, but varied aetiology. Prompt and thorough assessment is required to ascertain if upper or lower motor neurone damage has occurred. This report discusses a 6-year-old female, presenting in the Emergency Department with unilateral facial weakness. Initially thought to be facial swelling relating to her carious dentition, clinical assessment from the maxillofacial team identified that the patient had a unilateral facial palsy, later diagnosed as Bell’s palsy. Her delayed presentation was due to initial misdiagnoses in primary care. This case report aims to highlight its aetiology, clinical features and appropriate management.

Clinical relevance: To make the general dental practitioner aware of different causes of facial paralysis, and to provide GDPs with an algorithm to follow in the presentation of a facial palsy in the primary care setting.

Author notes: Arif Razzak, BDS(Hons), MFDS RCSE, Queen’s Medical Centre DCT1, Frances O’Leary, BDS(Hons), MFDS RCSE, Queen’s Medical Centre DCT1 and Nabeela Ahmed, BDS, FDS, MDChB, MRCS, Queen’s Medical Centre Registrar OMFS, Derby Road, Nottingham NG7 2UH, UK.

Objective: To explain the different causes of facial weakness, how to undertake a clinical examination of the patient and ensure that the condition is correctly managed.