(This article is co-authored as a collective study by Dr Mriganka Sekhar Ghose, Dr Adhikansh jaggi, Dr Ruqaiyah johar, Dr M.D. Manzur Ahmed, Dr Brijesh singh, Dr Kowshik. V, Dr Naga S. L., Dr Pranavi Nittala, Dr Arra Goutham Kumar, Dr Priya Jha, Dr Harinikhita, Dr Rashid Ali, Dr Shubham Jain, Dr Sourav Dutta, Dr Asif Ali Mudgal, Dr Rupali R Patwekar)
Among all the dentists 85.8% (199) had never seen any complication of facial palsy, 5.6%(13) had seen the complication, and 8.6% (20) were either not willing to tell or were unaware of the symptoms. 
Clinical evaluation Evaluation of the case is based on the following steps 8
Abstract
Bell’s palsy is a condition that causes temporary facial paralysis (palsy). It usually only affects the muscles on one side of the face. Facial nerve palsy scarcely occurs as a rare complication of inferior alveolar nerve block (IANB) injection which is often carried out in dental procedures being performed in the lower jaw11. This article’s purpose is to report how commonly facial paralysis is encountered by dental professionals after inferior alveolar nerve blocks. A survey involving 233 dentists from different parts of India was conducted to determine the number of dentists who come across this complication in their practice.Introduction
The term facial palsy generally refers to weakness of the facial muscles, mainly resulting from temporary or permanent damage to the facial nerve 1,2. The facial nerve is important for expression of emotion and communication, and ay significant damage to this nerve can lead to a worsening quality of life 3. Facial paralysis occurs when the facial nerve (cranial nerve VII) gets injured, and subsequently results in asthenia, drooping and loss of facial movement on one side (unilateral) or both sides (bilateral) of the face. Possible causes for facial palsy include inflammation, trauma, stroke, or tumours. 4 It may also occur without a known cause, which is referred to as Bell's palsy. During extraction of the mandibular posterior tooth, inferior alveolar nerve block (IANB) is usually administered. One of the important complications of IANB is facial palsy.5 Facial nerve paralysis might be portrayed in 2 ways depending on the onset of palsy; immediate and delayed.6- Immediate facial nerve palsy occurs due to direct injection of anaesthetic solution touching the facial nerve usually followed by an intra-glandular injection into the parotid gland. It is observed within minutes following the injection and subsides within a few hours.
- On the contrary, the delayed type could be a result of an ischemic paralysis in the stylomastoid foramen region led by a sympathetic vascular reflex. It is important to consider the possibility that it could be attributed to central nervous system involvement in the delayed type.
Material and Method
An online questionnaire and face-to-face interview-based survey was conducted to identify the prevalence of facial palsy as a complication of inferior alveolar nerve block. Data collection procedure and tools Before the start of the survey, education and training of the fifteen examiners was conducted to ensure uniformity and eliminate examiner bias. Survey interview Assessment was done using a questionnaire consisting of some closed and open-ended questions like the gender of the dental practitioner, his/her demographic details, and his/her qualification; and one close-ended question – “Did any of your patients ever come back to you complaining that he she suffered facial paralysis a few hours after you gave the inferior alveolar nerve block for extraction of his/her tooth?”Result
A survey including 233 dentists from different parts of India was conducted to determine the number of dentists who had observed facial palsy after an inferior alveolar nerve block. Of the participants, 116 were male and 117 were female dentists. Among them, 130 were BDS dentists, 87 were MDS dentists, and 16 were interns/students. Among all the dentists 85.8% (199) had never seen any complication of facial palsy, 5.6%(13) had seen the complication, and 8.6% (20) were either not willing to tell or were unaware of the symptoms. Discussion
A total of 233 dentists were included in the survey, and confirmation of facial palsy after IANB was considered based on the judgment of the practitioner filling out the survey form. The fifteen trained examiners guided the dentists through a face-to-face interview ensure uniformity and eliminate examiner bias. This survey was aimed to find out how many people suffer from facial palsy as an after-effect of the regular nerve block technique used for the extraction of mandibular molar (IANB), as facial palsy is a known complication of this nerve block. Facial palsy can occur due to multiple reasons 4, but this research survey aims on the facial palsy after IANB anaesthesia, which can be seen as it’s complication. Finding out the frequency of occurrence of the facial palsy after IANB will help in determining a better treatment plan for the complication, anticipation of the risk before giving the block, management of the complication and counselling of the patient for consent. The result of the survey shows that 13 dentists out of 233 have seen the complication of IANB as facial palsy, which is a very rare condition. No significant co-relation was found between the dentist’s demography, gender, qualification and observation of the complication. Clinically, facial palsy presents the following clinical features (Table 1)7Clinical evaluation Evaluation of the case is based on the following steps 8 - History taking for the site, onset, characteristics, and duration of the condition with the amount of recovery is important.
- Facial examination at rest and in motion for analysing mimetic muscle tone and symmetry, while differentiating between weakness(paresis/hemiparesis) and total flaccidity(paralysis). This includes:
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