In Candid Conversation With Ent Specialist & Relation Between Ent Issues and Crowded Teeth.

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Dear Friends,

There is a strong correlation of ENT issues and crooked teeth. For example, if the child is mouthbreathing and has enlarged adenoids or tonsils, there are sure shot chances that the teeth will be crooked/ malaligned and the jaws will not grow correctly. Also a persons immunity is compromised if he/ she mouth breathes as the inherent immunity due to air passing through the nostrils is hampered. Nasal passages are bypassed and viruses get entry into the throat which is a direct passage to the lungs.

I have prepared this questionnaire of frequently asked questions  and the ENT Specialist at INHS Asvini Hospital, Dr. Amey Kothekar has been kind enough to answer them for us.

Q1. When should I see ENT specialist for my child?

A1. Child having cough/cold/fever should be first screened by Designated COVID center (screened doesn’t always mean tested). After clearance from COVID center child can have consultation ( point not to forget that simple cough cold and fever can be managed at home, don’t unnecessary expose your child the risk of contacting COVID).

Child with ear pain without history of cold and cough can consult ENT surgeon.

Child suspected to have foreign body in ear /nose throat should consult ENT surgeon As soon as possible. Level of urgency in decreasing order of frequency Throat ( including wind pipe and Food pipe) followed by Nose followed by Ear. ( inorganic non irritant foreign body like plastic bead in ear can be removed at a later instance.

Q2. On what basis is it decided to go for adenoidectomy/ tonsillectomy?

A2. Recurrent Throat infection with bad breath causing multiple hospital visit and subsequent missing  school for significant days is an indication for tonsillectomy. Child having frequent mouth breathing  and snoring in night during sleep is an indication for adenoidectomy. Generally tonsil and adenoid problem go hand in hand. Adenoidectomy ( adenoid removal) and tonsillectomy ( tonsil removal) can be clubbed in one sitting and both the surgeries are done via mouth with no external scars.

Q3. What are adenoids?

A3. Adenoid is protective immune (lymphoid) tissue just behind the nose and below the center of brain not visualized by naked eyes unless some mirror or endoscope is used. It is meant to protect the child from pathogens which entering through each breath. More common in children and tend to regress (get smaller and smaller) by the age of 12 years. And may completely disappear in adults.

Q4. Why are adenoids enlarged so often nowadays?

A4. Recurrent infections especially cough/cold AND allergy is one of the most common cause. Nowadays due to increased awareness and better diagnostic modalities, Adenoid are commonly found.  Why adenoids are getting enlarged now a days is a misnomer.

Q5. Why do kids get ear infections? How do you treat them?

A5. Children have a smaller and slightly straight Eustachian Tube ( Tube which connects middle ear; which is behind the ear drum, and nose. This tube helps in equalizing middle ear pressure with atmospheric pressure) The peculiar anatomy of Eustachian tube in children makes them prone to ear infections. Ear infections are treated by ear cleaning ( by ENT surgeon and not by self cleansing) antibiotic &/or antifungal ear drops.

Q6. Treatment for sinusitis? 

A6. Treatments for sinusitis range from medicines to Sinus surgery. However the predisposing cause for sinusitis like allergy/ deviated nasal septum/blocked sinus opening/ nasal polyp needs to be addressed.

Q7. Do you see any correlation between adenoids, tonsils and teeth malocclusions?

A7. Yes. Child having enlarged adenoid get habituated to mouth breathing and can have protruding incisor and over crowding of teeth and subsequent malocclusion. Tonsillitis patients many a times have bad breath.

Q8. How important is it to breathe from the nose?

A8. Our body especially lungs are designed in such a way that we must breath from nose. Breath from nose is having appropriate temperature and humidity required by lungs due to the intrinsic mechanism of nose and sinuses. Breath from mouth lacks such characteristics and hence has a bad effect in lungs.

Q9. Any advice in these covid-19 times for the general public?

A9. Avoid unnecessarily going  out, maintain social distancing, cover your nose and mouth by mask if you are going out. At home cover your mouth and nose with a hankerchief during sneezing and coughing. Wash your hands and feet after coming from outside with soap ans water. If you develop cough/cold/fever/ breathing difficulty report to your designated COVID center. Get information only from authentic sources. Don’t spread and don’t believe in rumors. Don’t self medicate. Follow the timely instructions given by the govt/health care authorities. Don’t get unnecessarily panicked by COVID 19. Stay cheerful stay healthy.

Hope this information was useful to you dear readers. Please feel free to share the information to as many people so we can help more people and especially children!

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