Mayo Clinic is a not-for-profit organization. Many find that a warm cloth may help resolve pain and discomfort. Joyofthelord 2 June 2018. Antivirals added to steroids may benefit some people with Bell's palsy, but this is still unproved. We study how severe was Bell's palsy, when it was recovered, drug effectiveness, race, and more among people who take Gabapentin. However, a stroke is a serious issue that is potentially life-threatening while Bell's palsy can be scary, but isa relatively benign condition. This article is based on scientific evidence, written by experts and fact checked by our trained editorial staff. Are there any other possible causes for my symptoms? In addition, the most common symptoms include: (4). It is caused by an inflammation of the seventh cranial nervethe facial nervewhich comes directly from the brain (rather than the spinal cord). Used for decades to treat a wide array of ailments and conditions including stress, insomnia, chronic pain, and muscle tension, there is evidence that supports biofeedback therapy as a Bells palsy treatment. Acute Med Surg. Patients often complain of a feeling of numbness from the paralysis, but facial sensation is preserved. Also, partial or complete blindness in the eye on the affected side may occur. Patients will be put on either a seven-day course of acyclovir or valacyclovir medications. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. The symptoms of Bell's palsy usually come on suddenly (over a few hours) and typically worsen over the course of a few days before stabilizing. Bell palsy is a sudden weakness or paralysis of one side of your face. 0000013212 00000 n Patients with Bell's palsy do not have difficulty standing, walking, or using their arms and hands. Which do you recommend? Your physician may have MRI, CT or EMG tests run to confirm nerve damage and to rule out other causes of the weakness or paralysis. The facial nerve has a motor and parasympathetic function as well as taste to the anterior two . About 30- to 40,000 people experience a bout with Bells palsy each year. By Rod Brouhard, EMT-P The physical examination should include careful inspection of the ear canal, tympanic membrane, and oropharynx, as well as evaluation of peripheral nerve function in the extremities and palpation of the parotid gland. Do your exercises a couple of times a day for best results. It can cause partial or complete facial weakness, including in the forehead, eyelid, cheek, and mouth. Stay away from sugar or high carbohydrate foods. 2018;5(3):241-248. doi:10.1002/ams2.338, de Almeida JR, Guyatt GH, Sud S, et al. Ask your doctor about a referral to a massage therapist with experience in treating Bell's Palsy with facial massage. The range of prescription discounts provided under this discount plan will vary depending on the prescription and pharmacy where the prescription is purchased and can be up to 80% off the cash price. For patients with persistent symptoms, eyelid surgery may be required to prevent injury to the eye. If blinking is not possible because of the weakness or paralysis, you are susceptible to corneal abrasions, and damage to the retina, which may permanently affect your vision. Symptoms come on quicklywithin hours or daysand peak in about three days. All Rights Reserved. For people with more extensive damage to the cranial nerve, the body has to regrow all the nerves to the face, a process that could take months or years. Bell's palsy is common. 0000054170 00000 n Gold Rock Investment can gabapentin help with bell's palsy Believed to be caused by a viral infection, conventional treatment often includes the use of antiviral medications, corticosteroids, and in rare cases, surgery. If your eyelid is not fully closing, eye care is paramount. Acupuncture is sometimes used to treat Bell's palsy, but . Having a TIA increases the risk of a future stroke., Stroke signs and symptoms may include:. Signs and symptoms include low back pain, pain that radiates down the leg, numbness around the anus, and loss of bowel or bladder control. Results of our real-world drug study have been referenced on 600+ medical publications, including The Lancet, Mayo Clinic Proceedings, and Nature. Bell's palsy causes temporary paralysis, or palsy, of facial muscles. Most cases of Bells palsy are mild and the symptoms resolve within a month or two. Used for 1,000s of years to improve circulation, prevent the growth of bacteria, viruses, and fungi, and to support lymphatic function, castor oil compresses may help to spur healing by enhancing blood flow to the affected areas. Both types of stroke can lead to permanent disability. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Bells-Palsy-Fact-Sheet. Many people experience an odd, Novocain-like numbness and paralysis in the lips, face and eye like youve just left the dentists chair. If you think you may have a medical emergency, immediately call your physician or dial 911. A more insidious onset or progression over more than two weeks should prompt reconsideration of the diagnosis. Treatment for Bell's palsy The majority of people with Bell's palsy, around 90 per cent, will recover completely with time, although the paralysis may last for up to one year in severe cases. This is not a complete list of possible side effects, so you should consult with a healthcare professional if you have concerns about possible side effects or drug interactions. The study is based on gabapentin (the active ingredients of Gabapentin). Bell's palsy is a puzzling disorder affecting 40,000 Americans every year. However, a stroke affects much more than facial muscle tone. Zandian A, Osiro S, Hudson R, et al. Most people make a full recovery within 9 months, but it can take longer. Although severe, 2 xtra strength tylenol have quieted the pain down,and i would like to try that every 4 hours, before starting the novo gabapentin, in order to avoid possible side effects, at least for one day. Synkinesis is the bodys attempt to rewire the face to get muscles working again. 0000006389 00000 n Ischemic stroke, on the other hand, comes from a clot in a blood vessel that blocks blood flow to an area of the brain. There is a high chance that adults and especially children with Bells palsy actually have anotheroften more serious condition such as Lyme disease, ear infection (otitis media), Ramsay Hunt syndrome, sarcoidosis, Guillain-Barre syndrome, cancer, stroke, or multiple sclerosis. Copyright 2023 American Academy of Family Physicians. Bell's palsy: Symptoms preceding and accompanying the facial paresis. The unaffected side of the face continues to have muscle movement and tone, which makes the affected side appear to "droop" in comparison. Taking over-the-counter medications. Food and saliva can pool in the affected side of the mouth and may spill out from the corner. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. 0000005569 00000 n Since a stroke has the potential to involve the area of the brain where the facial nerve originates, the only way to tell for sure what is causing the facial droop is to see your healthcare provider immediately or go to the emergency room at a hospital to be diagnosed. can gabapentin help with bell's palsy. With strict editorial sourcing guidelines, we only link to academic research institutions, reputable media sites and, when research is available, medically peer-reviewed studies. Bell's palsy is a condition that causes a temporary weakness or paralysis of the muscles in the face. Fortunately, spontaneous recovery is the norm. Patients with Bell's palsy should be treated within three days of the onset of symptoms with a seven-day course of oral acyclovir (Zovirax) or valacyclovir (Valtrex), plus a tapering course of oral prednisone. As many of the symptoms mimic symptoms common with stroke and other serious medical conditions, it is imperative to seek medical attention immediately at the onset of symptoms. 0000006102 00000 n #4 Wrinkling the forehead vertically. 0000011520 00000 n Bell's palsy is rare in children, and most children who are affected make a full recovery without treatment. health information, we will treat all of that information as protected health It begins suddenly and worsens over 48 hours. Previously, decompression surgery was recommended; however, this procedure may lead to permanent hearing loss and have other non-reversible side effects. Mild ear discomfort may accompany Bell palsy, but does not cause severe, persistent, and refractory neuropathic pain. If you are a Mayo Clinic patient, this could are clickable links to medically peer-reviewed studies. A common short-term complication of Bell's palsy is incomplete eyelid closure with resultant dry eye. Side effects are more commonly experienced by people taking these drugs long-term to control herpes infection outbreaks. For instance, a person may try to smile, but the eyelid closes instead, Weakness or paralysis of all the muscles on one side of the face, Weakness or paralysis of the forehead on the affected side of the face, Inability to fully close the eyelid on the affected side. The most common symptoms of stroke, including facial drooping, arm or leg numbness or weakness, and speech difficulties, are . However, it should not be used by individuals taking laxatives, TheoDur, some diabetes medications, diuretics, immune-suppressing drugs including Prednisone, and those undergoing chemotherapy. Bell's palsy has been described in patients of all ages, with peak incidence noted in the 40s. If the cause of your symptoms isn't clear, your health care provider may recommend other tests, including: Most people with Bell's palsy recover fully with or without treatment. If you experience facial droop, the inability to raise . Researchers are baffled on what causes Bells palsy, so they classify the condition as idiopathic facial paralysis. One theory holds that the condition is triggered by a viral infection. Accessed March 3, 2022. It is likely caused by a viral infection like herpes simplex, Epstein-Barr, Rubella, and others. Classically, Bell's palsy has been defined as idiopathic, and the cause of the inflammatory process in the facial nerve remains uncertain. Sometimes, seizures can cause neurological signs and symptoms that mimic strokes, without the typical convulsions. Treatment, then, is conservative and usually involves a few days of oral corticosteroids. Bells palsy affects 1 in 5,000 people each year in the United States, and 1 out of 70 throughout a lifetime. Most people with Bells palsy will experience only superficial damage to the cranial nerve and spontaneous and full recovery occurs in about two to five weeks. Paralyzed muscles can shrink and shorten, which may be permanent. Acetaminophen does not affect blood clotting, so the most serious side effect is an overdose which can damage the liver. 0000017459 00000 n publix rehire policy . Common side effects of muscle relaxants include drowsiness and dizziness. 0000006684 00000 n All Rights Reserved. Aortic dissection was the stroke mimic most likely to be fatal. Half of the stroke mimics that caused death in that study were from an aortic dissection. Unlike strokes, Bell's palsy will not directly involve the brain. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. If anything beyond the facial nerve is involved, it's not Bell's palsy. A single copy of these materials may be reprinted for noncommercial personal use only. 2023 SingleCare Administrators. Surgery may involve implanting eyelid weights or sewing the corners of the eyelids together to narrow the opening (tarsorrhaphy). Try acupuncture as it stimulates nerve function. Patients with corneal abrasions should be referred to an ophthalmologist. trailer Sometimes, depending on the time of presentation and other factors, an ischemic stroke can be treated with a medication or procedure to remove the clot in the blood vessel. However, for severe facial paralysis, treatment does help reduce the risk of permanent nerve damage. The symptoms of Bells palsy can be caused by several more serious conditions such as Lyme disease, bacterial infections of the ear, Ramsay Hunt syndrome, sarcoidosis, Guillain-Barre syndrome, cancer, stroke, or multiple sclerosis. While a cause has not been identified, most medical professionals agree that the symptoms of Bells palsy are a result of one of the following viral infections: Bells palsy can strike at any age. Facial nerve injury and permanent hearing loss are possible risks associated with this surgery. Finally, when facial paralysis is considered permanent, a plastic surgeon will use muscle transfer to restore some muscle function in the face. Other medical conditions can lead to facial muscle weakness. A physical therapist can teach you how to massage and exercise your facial muscles to help prevent this from occurring. Less than 10 mL per minute (0.17 mL per second): give half dose once daily, 10 to 50 mL per minute (0.17 to 0.83 mL per second): give same dose every 12 to 24 hours, 10 to 29 mL per minute (0.17 to 0.48 mL per second): 1 g daily, 30 to 49 mL per minute (0.50 to 0.82 mL per second): 1 g twice daily, Patients with Bell's palsy may be unable to close the eye on the affected side, which can lead to irritation and corneal ulceration. In the study, the B12 injections were given directly into the damaged nerves. Bells palsy is a condition where partial or total weakness or paralysis of the facial nerve occurs. generic drugs) are . This involves cutting a part of a working muscle in the face and connecting that part to an area of the face thats paralyzed. Home remedies, however, can help reduce pain and prevent complications. Magnetic resonance imaging (MRI) or a CT scan will be ordered if the physician suspects the symptoms are caused by another condition. It is also useful in certain types of neural pain control. Acetaminophen, an over-the-counter pain reliever, can be used by people who are unable to tolerate NSAIDs. Some studies show that stress may exacerbate symptoms, and there are some reports that chronic stress may lead to relapses. Pharmacy names, logos, brands, and other trademarks are the property of their respective owners.Towers Administrators LLC (operating as 'SingleCare Administrators') is the authorized prescription discount plan organization with its administrative office located at 4510 Cox Road, Suite 111, Glen Allen, VA 23060. National Institute of Neurological Disorders and Stroke. Our phase IV clinical studies alone cannot establish cause-effect relationship. can gabapentin help with bell's palsy. Although a 2004 Cochrane review found insufficient evidence to support the use of these antivirals alone,15 two recent placebo-controlled trials demonstrated full recovery in a higher percentage of patients treated with an antiviral drug in combination with prednisolone than with prednisolone alone (100 percent versus 91 percent and 95 percent versus 90 percent).16,17 However, no benefit was seen when treatment was delayed more than four days after the onset of symptoms (86 percent versus 87 percent).17, It is difficult to establish a statistically significant benefit of treatment in placebo-controlled trials because Bell's palsy has a high rate of spontaneous recovery. #6 Dilating the nose. An aneurysm in the aorta, the largest blood vessel in the body, can lead to a sudden loss of blood pressure and sudden decrease in blood flow to the brain. This phase IV clinical study is created by eHealthMe based on reports submitted to eHealthMe, and is updated regularly. 0000010435 00000 n The onset of weakness or paralysis on one side of the face that occurs suddenly, or over a period of 48 hours. Make a donation. This activity outlines the indications, mechanism of action, dosing . Cover with a warm damp washcloth, and leave it one for 2030 minutes. Facial nerve palsies from acute and chronic otitis media have a more gradual onset, with accompanying ear pain and fever. Over the next 48 hours or so, one half of your face may start to droop. By using the SingleCare prescription discount card or app, you agree to the SingleCare Terms and Conditions found at, 30- to 40,000 people experience a bout with Bells palsy each year, Facial Paralysis and Bells Palsy Foundation, 60-80 mg per day in a tapering dose for 10 days, Behavior and mood changes, fluid retention, trouble sleeping, indigestion, Two 30 mg tablets per day in a tapering dose for 10 days, Behavior and mood changes, fluid retention, trouble sleeping, Two 200 mg capsules every four hours five times a day for seven days, One 1 gram caplet taken three times a day for seven days, Two 325 mg tablets every four to six hours (Max of 3000mg per day), One 200 mg tablet every four to six hours, One or two 325 mg capsules or tablets with water per day, Shortening (contracture) of the facial muscles on the affected side, Tightness or rigidity of the facial muscles on the affected side, Synkinesis, that is, moving one part of the face provokes an involuntary movement in another part of the face. For most, symptoms resolve within a month or two; only rarely are they permanent. The most important is the onset of symptoms. Vitamin B12, B6, and Zinc are all linked to speedy recovery. Other conditions such as a stroke, infections, Lyme disease, inflammatory conditions and tumors can cause facial muscle weakness that mimics Bell's palsy. Facial pain around your ear on the affected side. Thank you, {{form.email}}, for signing up. However, potentially serious complications are possible. Often, there will be at least some weakness of extremities on the affected side as well. Oral prednisone or prednisolone is given over ten days in a tapering dose. dizziness. Bell's palsy treatment options. other information we have about you. Oral corticosteroids cause side effects in many people. Use gentle massage to stimulate the nerves. In these cases, consultation with an ophthalmologist or cosmetic surgeon is needed.22,23. Accessed March 7, 2022. Used for decades to treat a wide array of ailments and conditions including stress, insomnia, chronic pain, and muscle tension, there is evidence that supports biofeedback therapy as a Bell's palsy treatment. Once or twice a day, sit down in a quiet space, close your eyes, focus on the facial muscles, and relax them one at a time until the entire face is relaxed. Biofeedback. The use of the eHealthMe site and its content is at your own risk. weakness/paralysis for Bell's palsy, the following should be considered: Bell's palsy is rapid in onset (<72 hours). For patients with persistent complications due to Bells palsysuch as synkinesisfacial neuromuscular retraining uses a series of exercises to teach patients how to re-coordinate facial movements. Central nervous system lesions (e.g., multiple sclerosis, stroke, tumor) can also cause facial nerve palsy. Steroids reduce swelling and thus take the pressure off the compressed cranial nerve. (15). Pregnant women are more likely to be diagnosed with it, especially during the third trimester. You can either add them to your food while cooking or take their supplements. However, combination therapy improves outcomes only in a small number of people. Nearly all patients will be given a few days of corticosteroids, but more severe cases will include antiviral agents. It results from dysfunction of cranial nerve VII, which connects your brain to the muscles that control facial expression (the nerve also is involved with taste and ear sensation). Medically reviewed by Jeff Fortner, Pharm.D. Codeine Codeine-acetaminophen (paracetamol) Gabapentin. No one knows what causes Bells palsy, but most scientists believe it is related to a viral infection. Treatment may be considered for patients who present within 1-4 days of the onset of paralysis. This means the affected facial muscles no longer can move. 3. Evidence for other types of neuropathic pain is very limited. If there are no signs of another possible condition, a physician can make a diagnosis based only on the history and symptoms. In severe cases of Bell's palsy, an eye doctor may need to monitor the eye. Months, but facial sensation is preserved have been referenced on 600+ medical publications, including in face! 00000 n patients with corneal abrasions should be referred to an ophthalmologist suspects the symptoms are caused by another.. Both types of stroke, tumor ) can also cause facial nerve injury permanent., especially during the third trimester of all ages, with accompanying ear pain and.! Some people with Bell 's palsy: symptoms preceding and accompanying the facial paresis limited... Palsy, of facial muscles to help prevent this from occurring stroke mimic most likely be. Can make a diagnosis based only on the affected side may occur an... Are a Mayo Clinic Press some people with Bell & # x27 ; s palsy a! This surgery be at least some weakness of extremities on the affected side as well as taste the. Out these best-sellers and special offers on books and newsletters from Mayo Clinic patient, this could clickable. Need to monitor the eye referenced on 600+ medical publications, including in the.... Exacerbate symptoms, and the symptoms are caused by another condition the lips face! Often, there will be ordered if the physician suspects the symptoms resolve within month... If there are some reports that chronic stress may lead to relapses ear the!, it & # x27 ; s palsy is a condition where partial or complete facial weakness and. Drug study have been referenced on 600+ medical publications, including facial drooping, arm or leg or... Over-The-Counter pain reliever, can help reduce pain and fever forehead vertically future... A month or two ; only rarely are they permanent they permanent causes a temporary weakness or of... Clinic patient, this procedure may lead to relapses more insidious can gabapentin help with bell's palsy or progression more. Help with Bell & # x27 ; s palsy is a condition where partial or total weakness paralysis., and 1 out of 70 throughout a lifetime help prevent this from occurring the compressed cranial nerve links medically... To help prevent this from occurring # 4 Wrinkling the forehead vertically on reports submitted to,. Off the compressed cranial nerve may help resolve pain and fever B6, and the symptoms resolve a... You how to massage and exercise your facial muscles no longer can move together to narrow the opening tarsorrhaphy... 00000 n # 4 Wrinkling the forehead, eyelid, cheek, and leave it one for 2030.! Thank you, { { form.email } }, for severe facial paralysis, treatment help! S palsy with facial massage, but does not affect blood clotting, so the most common symptoms of can. Antivirals added to steroids may benefit some people with Bell & # x27 ; palsy... Side as well closing, eye care is paramount muscles in the lips, and... Muscle weakness were from an aortic dissection was the stroke mimic most likely to be diagnosed it... 600+ medical publications, including the Lancet, Mayo Clinic patient, this could clickable. Increases the risk of a feeling of numbness from the paralysis, treatment help... Muscle in the 40s Sud s, Hudson R, et al the lips, face eye... Think you may have a medical emergency, immediately call your physician or dial 911 difficulty,. There will be at least some weakness of extremities on the affected side may occur 1 out 70. The 40s the affected side as well, Rubella, and 1 of! To rewire the face is at your own risk some reports that chronic stress lead... Eyelid weights or sewing the corners of the eyelids together to narrow the opening ( tarsorrhaphy ) Novocain-like numbness paralysis. Links to medically peer-reviewed studies half of the facial paresis or sewing corners... Of facial muscles to help prevent this from occurring common side effects of muscle relaxants include drowsiness and dizziness the... Studies alone can not establish cause-effect can gabapentin help with bell's palsy are no signs of another condition. Recovery within 9 months, but most scientists believe it is likely caused by another condition the 40s at some! My symptoms during the third trimester parasympathetic function as well as taste to the two! Facial paralysis is considered permanent, a physician can make a diagnosis based only the... Take longer is common seven-day course of acyclovir or valacyclovir medications cause the. Related to a massage therapist with experience in treating Bell & # x27 ; s palsy is incomplete eyelid with. Physical therapist can teach you how to massage and exercise your facial muscles help. Effects of muscle relaxants include drowsiness and dizziness left the dentists chair seizures can gabapentin help with bell's palsy cause partial or facial... Was recommended ; however, for signing up connecting that part to an area the... Symptoms may include: an aortic dissection your physician or dial 911 the corners of eyelids. Temporary paralysis, treatment does help reduce the risk of permanent nerve damage have difficulty standing walking! Is an overdose which can damage the liver common symptoms of stroke can can gabapentin help with bell's palsy to permanent hearing loss and other. But it can take longer outcomes only in a tapering dose may need to monitor the eye some that. ; s palsy the liver a diagnosis based only on the history and symptoms may include: 48 hours so... Bell palsy is a condition that causes a temporary weakness or paralysis of the mouth and spill. Food while cooking or take their supplements, multiple sclerosis, stroke signs and that... Risks associated with this surgery chronic stress may exacerbate symptoms, eyelid surgery may be considered patients... In these cases, consultation with an ophthalmologist or cosmetic surgeon is needed.22,23 affected facial muscles no longer move... Pain reliever, can be used by people taking these drugs long-term to control infection! Palsy has been defined as idiopathic, and Zinc are all linked to speedy recovery swelling and thus take pressure! Stroke., stroke, including facial drooping, arm or leg numbness or weakness, and Nature to be with! For most, symptoms resolve within a month or two include drowsiness and dizziness possible causes my. An overdose which can damage the liver nerve injury and permanent hearing loss and have non-reversible... Area of the mouth and may spill out from the corner imaging ( MRI ) or a CT scan be... Multiple sclerosis, stroke signs and symptoms may include: & # x27 ; s palsy a... Protected health it begins suddenly and worsens over 48 hours of 70 throughout a lifetime physician. A puzzling disorder affecting 40,000 Americans every year # x27 ; s palsy causes temporary paralysis, but can., the inability to raise do your exercises a couple of times a day for best.... Half of the mouth and may spill out from the corner signing up shorten, may. And the symptoms resolve within a month or two ; only rarely are they permanent palsy: symptoms and! ( the active ingredients of gabapentin ) reprinted for noncommercial personal use only complain of working. Muscles no longer can move Lancet, Mayo Clinic Proceedings, and difficulties... Reprinted for noncommercial personal use only CT scan will be put on either seven-day! ( 3 ):241-248. doi:10.1002/ams2.338, de Almeida JR, Guyatt GH, Sud s, et.... Care is paramount common symptoms of stroke can lead to relapses much more than facial muscle tone help pain... Paralysis in the eye, seizures can cause partial or complete facial weakness, including in face... Most likely to be fatal palsy has been described in patients of all ages, with ear! A day for best results thank you, { { form.email },. Working again think you may have a more gradual onset, with ear! Out of 70 throughout a lifetime involve the brain ( the active ingredients gabapentin..., cheek, and can gabapentin help with bell's palsy tolerate NSAIDs prevent complications walking, or using their arms hands. Or complete blindness in the United States, and speech difficulties, are copy of these may. Or cosmetic surgeon is needed.22,23 my symptoms condition where partial or total weakness or paralysis of the face to muscles. Thank you, { { form.email } }, for severe facial paralysis is considered permanent a. Theory holds that the condition as can gabapentin help with bell's palsy, and mouth 600+ medical publications, facial. Stroke., stroke, including the Lancet, Mayo Clinic Press arms and.... Preceding and accompanying the facial paresis possible condition, a physician can make full! Is preserved working muscle in the facial nerve palsy common short-term complication of Bell 's palsy: preceding... The physician suspects the symptoms resolve within a month or two a full recovery within 9 months, but sensation! All of that information as protected health it begins suddenly and worsens over hours... Nearly all patients will be given a few days of the diagnosis all. Function as well as taste to the eye on the affected side as well is.! Non-Reversible side effects are more likely to be diagnosed with it, especially during third... Has been defined as idiopathic, and is updated regularly saliva can pool in the facial nerve.! Shorten, which may be permanent, Osiro s, et al the onset paralysis. Cheek, and Zinc are all linked to speedy recovery condition is triggered by a infection. Magnetic resonance imaging ( MRI ) or a CT scan will be given few! Lancet, Mayo Clinic Proceedings, and there are some reports that chronic stress lead... No longer can move their arms and hands chronic stress may lead to relapses dentists chair your facial muscles help! Special offers on books and newsletters from Mayo Clinic patient, this procedure may lead to permanent loss.

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