Adenoids and Their Relationship to Oral Health

What are adenoids?

Adenoids, also known as pharyngeal tonsils, are lymphatic structures located at the back of the nose, near the junction with the throat. Their primary function is to help the immune system defend against respiratory infections in childhood.

As a child grows, adenoids usually decrease in size and, in most cases, atrophy during adolescence. However, in some children, these structures can enlarge and cause respiratory and oral problems.

Adenoid hypertrophy and its impact on oral health

When adenoids are enlarged, they can generate a series of problems related to breathing and maxillofacial development:

• Chronic mouth breathing: Nasal obstruction forces the child to breathe through the mouth, which can alter palate development and tooth position.
• Dental malocclusions: Prolonged mouth breathing can lead to open bite, maxillary compression, and protrusion of the upper incisors.
• Snoring and sleep apnea: Adenoid hypertrophy can contribute to obstructive sleep apnea, affecting oxygenation and the child's rest.
• Speech alterations: Nasal obstruction can affect the articulation of certain sounds, leading to pronunciation difficulties.

Symptoms of adenoid hypertrophy

The most frequent signs and symptoms include:

✅ Persistent mouth breathing
✅ Nocturnal snoring and sleep apnea
✅ Chronic nasal congestion
✅ Recurrent ear and throat infections
✅ Bite and facial development alterations
✅ Speech difficulties and nasalized voice

If a child presents these symptoms persistently, it is advisable to consult an otolaryngologist and dentist for a comprehensive evaluation.

Diagnosis of adenoid hypertrophy

The diagnosis of adenoid hypertrophy is based on:

🦷 Detailed medical history: Respiratory symptoms and possible alterations in oral development are analyzed.
🦷 Physical examination: Evaluation of facial growth and tongue position at rest.
🦷 Lateral cephalometric radiograph: Allows evaluation of adenoid size and its impact on the airway.
🦷 Nasal endoscopy: A small camera is inserted to directly visualize the adenoids.
🦷 Sleep studies: In cases of sleep apnea, studies may be performed to evaluate the quality of breathing during the night.

Treatment of adenoid hypertrophy

Treatment depends on the severity of the obstruction and associated symptoms.

🔹 Respiratory therapy and myofunctional re-education: Exercises to improve nasal breathing and strengthen orofacial muscles.
🔹 Use of anti-inflammatories or antihistamines: In mild cases, medications can be used to reduce inflammation.
🔹 Interceptive orthodontics: Maxillary expansion and functional appliances to correct malocclusions resulting from mouth breathing.
🔹 Adenoidectomy: In severe cases where adenoids interfere with breathing or facial development, surgical removal is recommended.

Complications of untreated adenoid hypertrophy

If left untreated, adenoid hypertrophy can lead to long-term consequences, such as:

⚠️ Abnormal palate development (high-arched and narrow palate)
⚠️ Severe malocclusions requiring complex orthodontic treatment
⚠️ Learning difficulties due to oxygenation alterations during sleep
⚠️ Recurrent ear infections that can lead to temporary or permanent hearing loss

Conclusion

Adenoids play a fundamental role in childhood immunity, but their hypertrophy can affect breathing, oral health, and facial development. Early diagnosis and appropriate treatment can prevent complications and improve the patient's quality of life. In severe cases, adenoidectomy is an effective option to restore nasal breathing and prevent malocclusions.

Legal Notice and Disclaimer

This article is part of ONAK's Medical Terms Dictionary and is for informational purposes only. It does not replace consultation with a dentist or otolaryngologist.

ONAK is not responsible for decisions made based on the information contained in this article. It is recommended to consult a specialist for an accurate diagnosis and treatment.

Bibliography

1. Majorana, A., Bardellini, E., Amadori, F. "Adenoid hypertrophy and dental malocclusion: clinical aspects." Minerva Pediatr. 2018; 70(6): 485-490. Available at: https://pubmed.ncbi.nlm.nih.gov/29091279/

2. Linder-Aronson, S. "Respiratory function in relation to facial morphology and the dentition." Br J Orthod. 1979; 6(2): 59-71. Available at: https://pubmed.ncbi.nlm.nih.gov/294332/

3. Cazzolla, A. P., De Franco, A. "Adenoid hypertrophy and oral breathing in children: implications for facial growth and orthodontic treatment." Acta Otorhinolaryngol Ital. 2018; 38(5): 360-366. Available at: https://pubmed.ncbi.nlm.nih.gov/30662853/