Grow Up Smiling!

The Surprising Ear-Nose-Tooth Connection

The link in children between dental malocclusion—condition in which upper and lower teeth are not correctly aligned—and the common middle-ear infection (otitis media) remains unclear. A child with ear infections appears to be more likely to have a posterior crossbite (a kind of malocclusion), but no significant connection between any kind of malocclusion and ear infection has been determined.

However, a child who has dental malocclusion—or its beginnings—and a tendency to develop ear infections may actually have an underlying problem that causes both: mouth breathing. Just as the name suggests, mouth breathing occurs when the nasal passages experience chronic blockage, and because the child can’t breathe well out of his nose, he breathes primarily through his mouth.

So, what can cause chronically blocked nasal passages? Seasonal allergies, surely. Another major cause is swollen tonsils and/or adenoids.

The change from nasal to mouth breathing often results in chronic middle ear infections, sinusitis, upper airway infections and sleep disturbances such as apnea and snoring. And mouth breathing has been shown to affect the growing face, causing not only the teeth and jaw to be mismatched but, over time, significant abnormal facial development that can affect a child emotionally and socially, especially if it occurs during the critical growing years.

If a child sleeps poorly, he may well act tired, behave poorly and have difficulty concentrating, especially at school—all of which can lead to a (mis)diagnosis of ADHD. In many such children, when the enlarged tonsils and/or adenoids are removed, “behavior, attentiveness, energy level, academic performance, and growth and development” all improve, according to Yosh Jefferson, DMD, in an article he wrote for the journal General Dentistry in 2010.

Once mouth breathing is resolved, dental malocclusions and craniofacial issues can then be addressed—leading to a happy, if often initially unexpected, ending.