Why does facial palsy cause problems with eating and drinking?
Normally when we eat, we seal our lips together to create a vacuum which enables us to create enough pressure within our mouth to swallow. Our lips also seal to prevent leakage of food and fluid. Facial palsy can cause weakness of the lips which can make it difficult to seal your lips around cups and cutlery resulting in leakage of food or fluid when eating and drinking. Eating and drinking can be messy which may make you reluctant to eat out or in the company of others.
Facial palsy may also cause weakness in the cheek muscles. This may cause food to collect in the weak side of your mouth. One of the functions of the cheek muscle is to keep the food in the centre of the mouth or between the teeth for chewing. A weak cheek may mean that chewing and preparing food for swallowing may be difficult. Food may pouch or collect in your cheek and be difficult for you to clear.
Weakness of the lips and cheek may also make brushing your teeth and spitting out difficult.
What can help with drinking and eating?
If you are having difficulty with chewing and preparing food then the following advice may help:
- Avoid hard, chewy foods as these can be difficult to prepare and choose a soft easy chew diet (such as pasta dishes, fish, well-cooked meats and vegetables).
- Avoid mixed consistencies, for example, cereals in milk. Mixed consistencies are more difficult to control and may be more likely to cause coughing. Look for firmer alternatives, for example, a firm porridge.
- Avoid stringy, chewy foods and those with pips, skins, shells, or husks, (e.g. raw tomatoes, lettuce, chewy meats, sweet corn, peas, baked beans).
- You may find rice and dry, crumbly foods difficult and they can cause coughing.
- If your mouth is dry then make sure your food is moist by adding extra butter, gravy or sauces. For more information about dry mouth please follow the link below.
- Try smaller mouthfuls as these are easier to control and less likely to spill from your mouth.
- Brush your teeth after meals to ensure no food debris is left behind or trapped inside your cheek. You may need to use your finger to clear any food debris from your cheek. It is important to do this in order to avoid tooth decay.
- Always sit upright in a well-supported chair during mealtimes and when having snacks.
- Allow plenty of time, as eating will be slower.
- Keep distractions to a minimum during meal times to help you concentrate.
- When drinking avoid tipping your head back as this may lead to coughing and or choking. Drinking from bottles should be avoided. Try using a thin-lipped cup or a Kapi-cup (see below).
- You may find that you aren’t eating enough so think about ways of boosting your calorie intake by having drinks like Complan. Use whole milk instead of skimmed etc. It may be worth seeing a dietitian who can prescribe supplement drinks which provide a full range of vitamin, minerals, protein, and calories.
Taping the lower lip
One thing that often helps is to support the lower lip with some transpore tape. You can buy this from Amazon or similar. Buy the 2.5 cm width and you can then tear it to the width that works best for you. Using a narrow piece of tape which is long enough to place just below the lip and lift up towards the outer corner of the mouth. There is no right or wrong way to do this just experiment with the position of the tape to find the best support. Alternatively, support your lower lip with your index finger. Use it to help form a seal to prevent leakage and aid swallowing.
Taping the cheek can help improve eating and drinking by supporting the weak muscles. Follow the link below and watch the video on how to tape your cheek. If you have bilateral facial palsy then the information applies to both sides. Taping the cheek is just for people who are in the flaccid stage of recovery.
Kapi-cup – helping you drink without tipping your head back. It is often easier to drink from a thin-lipped cup or glass, for example, a fine bone china cup or mug with a wide brim. Alternatively, your therapist can provide you with a Kapi-Cup. This is a thin, plastic mug, with the nose cut out so that you can drink without tipping your head back.
Why can facial palsy cause drooling/dribbling?
Drooling usually occurs because the lips are weak and do not seal when your mouth is closed. This will become more noticeable when your head is forward and down, as gravity takes the flow of saliva to the front of your mouth which then leaks out through the weakest part of your lips.
What can help prevent drooling/dribbling?
- Try and remember to swallow more frequently to prevent saliva building up in your mouth.
- Sip water to help you remember to swallow more frequently.
- Lip strengthening exercises may help improve lip closure so ask for a referral to your local therapist who has experience in treating people with facial palsy.
- Avoid lowering your head or letting it drop forward. Try and keep your head upright. Looking down means that you have the effect of gravity to manage. Looking down means that saliva can pool in the front of your mouth and so leak out more easily.
- If you have severe cheek and lip weakness, you may find that taping your cheek will give you some support and comfort and may also help reduce the amount of drooling.
- If your problems are severe you may need to ask your GP for medication to help reduce the amount of saliva you make. However, this is a difficult balance because there is often a combination of dry mouth and drooling.
- When people have facial weakness, the lower lip tends to hang down and expose the teeth, particularly if you have bilateral facial palsy. This can make the teeth and gums dry. Wearing the tape underneath your lower lip to lift it up may help reduce this exposure.
- Make sure you brush your teeth after meals to get rid of any food residue from between your teeth or food which has collected in your cheeks. This is very important because food debris in the mouth creates a breeding ground for bacteria and you will therefore be more vulnerable to tooth decay and gum disease.
- Rinsing and spitting out is often impossible so it might be worth purchasing a water pick/flosser which will enable you to remove all the food debris with ease.
Follow the link below for more advice on dental issues.
Last reviewed: 27-09-2023 || Next review due: 27-09-2025