Tonsils/Adenoids/breathing problems affecting normal facial growth -

As a dentist who has treated many types of orthodontic problems, I have seen the effect of improper growth of the face and teeth. One of the most serious problems from the effect of abnormal growth is due to breathing problems of the upper airway. This is called UPPER AIRWAY OBSTRUCTION (UAO).

Children whose upper airway is blocked by adenoidal tissue can't breathe through their noses, so they adopt an abnormal pattern of breathing through their mouths.

Typically these children will have have one or more of the following symptoms:

In children without UAO, the breathing is done mostly through their nose. The tongue is able to position itself against the sides of the upper and lower teeth most of the time. The teeth in a normal growth pattern are positioned in a "neutral zone" between the outside force (pushing in) of the cheeks and the inside force (pushing out) of the tongue. The result - nice symmetrical round upper and lower arches, usually with the upper teeth overlapping the lowers on the outside of the arch.

• In children with UAO, the adenoids in the back of the nose/upper throat prevent normal nose breathing. Instead, these patients adapt in the following ways:

• The tongue is kept low in the mouth so that air can more easily travel through the mouth

• The lower jaw is many times brought forward to pull the lingual tonsils away from the back of the throat. Because the tongue spends comparatively little time inside the upper arch, there is no force to balance the cheeks and lips, and the upper arch collapses in by the unchecked muscle forces of the cheeks and lips, resulting in a crowded, narrow upper arch, many times with a crossbite on one or both sides.

Because the lower jaw is pushed forward much of the time in an attempt to pull the large lingual tonsils off the back wall of the throat to improve airflow, a frequent result is a more forwardly positioned lower jaw, which can cause the lower front teeth to be further ahead than the upper front teeth . This is called"Class 3 Malocclusion".

This mouth is very typical of an adult with untreated early childhood upper airway obstruction. The upper arch is narrow and V-shaped due to the tongue having spent very little time inside that arch during growth. The front teeth are typically stained from being dry throughout childhood (from mouth breathing).

 

These are images of a 16-yr-old who has altered facial growth due to upper airway obstruction all of his life. This patient is currently in orthodontic treatment at this office.

If these children are not treated, the tonsils, adenoids, and associated breathing problems will cease to be a problem by puberty in most of the cases, due to the adolescent growth spurt. They will most likely be able to breath through their nose again. But by that time, the (abnormal) growth caused by them will be complete! Many of these patients will have had so many years of breathing improperly that they will probably retain the same abnormal breathing habits into their adult years.

The bottom line - they will have very narrow upper arches with a high-vaulted palate, an underdeveloped mid-face, crowding, and crossbites. All because of a breathing problem! If you think that one or more of your children (or grandchildren) may have such a problem, please make an appointment with an ear, nose, and throat specialist physician to have them evaluated.