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Case 14: Case of the enlarged Adenoids-Airway and dentistry. There’s always a connection!

A 12-year-old girl presented to our practice for orthodontic treatment to correct her crooked smile. Prior to jumping in to treat the patient, my orthodontist and I sat down to diagnose. This patient had a known history of breathing through the mouth at night while asleep. 

Let’s go back to basics…10th standard biology. Is breathing through the mouth harmful? What do you think? Does the mouth have filters as the nose does to filter out bacteria and dust? What happens if the mouth is left open at night to facilitate life’s basic necessities? Would that affect the growth of the jaws? The answer to the last question is a big resounding” YES”! The downward position of the tongue in a mouth breather prevents the proportionate growth of the upper jaw and the patient ends us having a larger tongue and a larger lower jaw when compared to the upper jaw. The teeth in the smaller upper jaw are now cramped for space and start erupting one behind the other giving the appearance of a crowded smile. The teeth in the lower jaw start tipping in towards the tongue to compensate for the disproportionate growth in both jaws.

Back to our 12-year-old patient: The question to ask is “Why” is she a mouth breather in the first place? A referral to the ENT specialist revealed enlarged adenoids at the back of her throat. We put braces on hold and encouraged her to receive treatment for the enlarged adenoids to facilitate normal breathing through the nose. We also provided her with a mouth breathing appliance to encourage her to practice breathing through the nose. Constant follow ups and once we were convinced that she was no longer breathing through the mouth, 2 years later she was ready for braces. 

A good night’s uninterrupted sleep is of utmost importance where there is no room for compromise! This case demonstrates that the mouth is the gateway to one’s overall health and well-being!

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