Unilateral Chewing After Stroke: Protect Your Jaw and Teeth

The Hidden Challenge Many Stroke Survivors Face

After a stroke, many survivors develop the habit of chewing primarily on one side of their mouth. This unilateral chewing pattern affects up to 60% of stroke patients and occurs due to weakness, sensory neglect, or compensatory habits that develop during recovery.
(Journal of Dental Research, 2011)

While this adaptation might seem minor, research shows it can lead to significant oral health complications over time.

Why Stroke Survivors Chew on One Side

Muscle Weakness: Stroke often weakens the muscles on one side of the face and mouth, making it difficult to chew effectively on the affected side.

Sensory Neglect: Some stroke survivors experience reduced awareness or sensation on one side, leading them to unconsciously favor the unaffected side.

Compensatory Habits: What begins as a temporary adaptation during acute recovery can become a fixed pattern if not addressed through rehabilitation.

The Research: What Happens When You Chew on One Side

TMJ Strain and Jaw Discomfort

Studies consistently show that predominantly chewing on one side creates muscle imbalances that can lead to temporomandibular joint (TMJ) disorders. The overworked side experiences increased stress, while the underused side can become stiff and weak.

Uneven Tooth Wear

Research demonstrates that preferential chewing causes significantly different wear patterns between sides. The dominant chewing side experiences accelerated wear, while teeth on the unused side may develop different occlusal contact patterns.

Increased Plaque and Decay Risk

The unused side of the mouth receives less mechanical cleaning action from food and tongue movement, leading to increased plaque accumulation. This creates a higher risk for cavities and gum disease on the neglected side.

Strategies to Restore Balance

1. Practice Mindful Bilateral Chewing

When safe to do so, consciously alternate chewing between both sides. Start slowly and only as your swallowing function allows. Work with your speech-language pathologist to determine when this is appropriate for your recovery stage.

2. Orofacial Exercises with Professional Guidance

Speech-language pathologists and occupational therapists can prescribe specific exercises to:

• Strengthen weakened facial muscles
• Improve coordination between both sides
• Restore balanced chewing patterns
• Enhance overall oral motor function

3. Enhanced Oral Hygiene for the Neglected Side

Pay extra attention to cleaning the less-used side of your mouth:

• Spend additional time brushing neglected areas
• Use interdental cleaners to remove plaque buildup
• Consider an electric toothbrush for more effective cleaning
• Ask your dental hygienist for personalized techniques

4. Regular Professional Monitoring

Schedule dental checkups every 3-6 months to:

• Monitor for uneven wear patterns
• Detect early signs of TMJ problems
• Address plaque buildup before it becomes problematic
• Adjust your oral care routine as needed

Technology Solutions for Better Oral Health Monitoring

For stroke survivors who want to enhance their oral health monitoring, innovative tools like the Feno Smartbrush offer advanced scanning capabilities. This AI-powered device features built-in oral scanner that can detect plaque buildup and inflammation particularly valuable for identifying problems on the neglected side of the mouth that traditional brushing might miss.

The Feno system provides personalized oral health reports and connects users with oral health coaches, which can be especially beneficial for stroke survivors who need extra guidance in maintaining consistent oral care routines. While primarily designed for efficient cleaning (20 seconds versus traditional 2-minute brushing), its scanning technology can help identify early signs of the uneven wear and plaque accumulation common with unilateral chewing patterns.

When to Seek Professional Help

Contact your healthcare team if you experience:

• Persistent jaw pain or clicking
• Difficulty opening your mouth fully
• Noticeable tooth sensitivity or pain
• Ongoing swallowing difficulties
• Worsening facial weakness

The Path Forward: Small Steps, Big Impact

Research shows that addressing unilateral chewing patterns early in stroke recovery leads to better long-term outcomes. While the habit is common and understandable, proactive management can prevent complications and improve overall quality of life.

Remember: recovery is a gradual process. Work closely with your rehabilitation team to develop strategies that are safe and appropriate for your individual situation.