Impact of Facial Paralysis on Oral Health: A Systematic Review.

INTRODUCTION

Facial paralysis affects perioral muscle function required for mastication, swallowing and salivary control. Oral health function and outcomes in individuals with facial paralysis is understudied.

OBJECTIVE

To evaluate oral health outcomes including dental caries, periodontal disease, drooling, mastication, and oral competence in facial paralysis patients.

METHODS

A systematic search of PubMed, MEDLINE, Cochrane CENTRAL, and CINAHL identified English-language studies published from inception to September 25, 2025.

RESULTS

Eighteen studies were included: congenital facial paralysis (n = 5), acquired etiologies (n = 6), and mixed cohorts (n = 7). Cohorts with congenital etiologies demonstrated early feeding difficulties, altered salivary composition, and a higher prevalence of early-stage carious lesions. Adults with flaccid facial paralysis showed reduced lip and cheek strength, reduced oral competence, decreased masticatory efficiency and oral-phase swallowing dysfunction compared to healthy controls. Adults with postparalytic synkinesis showed greater plaque accumulation, gingival inflammation and untreated caries on the affected side. Surgical reanimation procedures improved oral competence and drooling control. Oral health-related quality of life scores were consistently worse in affected individuals, with the greatest burden observed in functional and psychosocial domains.

CONCLUSION

Facial paralysis is consistently linked to worse oral health and reduced quality of life, however, structured dental assessment and management remain limited.