TEETH AND TONSILS – WHEN TO SEE AN ORTHODONTIST

TEETH AND TONSILS – WHEN TO SEE AN ORTHODONTIST

Did you know that enlarged adenoids and tonsils are heavily implicated in the development of severe orthodontic problems? And that they can lead to a long face?

Orthodontists are well aware of the link between enlarged adenoids/tonsils, and how this problem can profoundly affect the growth and shape of a child’s face.  We deal with the effects every day!  For some, a long face is simply inherited from their parents.  For others, enlarged adenoids/tonsils may be the reason.

Enlarged adenoids/tonsils are strongly linked to sleep-disordered breathing (SDB) in children.  Enlargement of the tonsils and adenoids can restrict airflow through the nose, causing children to snore, have poor sleep quality, and even suffer from obstructive sleep apnoea.

This often leads children to become “mouth-breathers”, a problem which can play havoc with the development of their teeth and jaws, and lead to the “long-face” look.

Orthodontists may use the expression “adenoid face” to describe the typical appearance of children who suffer from enlarged adenoids/tonsils.

Typical facial and dental features associated with this condition include:

  • Drowsy-looking eyes
  • Dark circles under the eyes
  • Narrow, pinched-in nostrils
  • Open mouth expression
  • Elongated facial shape
  • V-shaped dental arches
  • High-arched palate
  • Severely crowded teeth
  • Cross bites at the back of the mouth

So, what’s the big deal?

Sleep-disordered breathing is emerging as a major health concern, especially in children.  A large proportion of common childhood problems could potentially be explained by SDB.  This includes behavioural problems like ADD, slow learning, irritability, small stature and even bed-wetting.

Enlarged adenoids/tonsils are the major culprits associated with SDB in children.

Dental professionals are well placed to spot the signs and symptoms of enlarged adenoids/tonsils because we see children on a regular basis, and from a young age.  This can help confirm a diagnosis by providing an early and appropriate referral to an ENT specialist or sleep physician for thorough investigation and treatment.

Any child with the typical facial features of enlarged adenoids/tonsils should see a Specialist Orthodontist as soon as the problem is noticed, no matter the age of the child. An Orthodontist can closely monitor facial growth and potential dental side effects, allowing for early intervention if the side effects become severe.

While there is a good deal of anecdotal evidence that early orthodontic intervention, such as palatal expansion, can reduce the severity of SDB, and minimise many of its problems, it is important to remember that a diagnosis of SDB should only be made by a specialist medical doctor.  This ensures that any underlying medical problems causing the enlarged adenoids/tonsils can be treated appropriately.

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