Oral health status of children with mouth breathing due to adenotonsillar hypertrophy

Int J Pediatr Otorhinolaryngol. 2018 Oct:113:11-15. doi: 10.1016/j.ijporl.2018.07.018. Epub 2018 Jul 11.


Objectives: Mouth breathing is an important health problem, commonly encountered in children. In children, adeno-tonsillar hypertrophy is the main reason causing partial or complete upper airway obstruction and reduction in airflow. This study aimed to determine the oral health status of children aged 3-15 years, with mouth breathing who were due to have surgery for adeno-tonsillar hypertrophy and referred to the Department of Otorhinolaryngology at Children's Hospital of a University in Ankara, Turkey between January-July 2015.

Methods: The approval of the Non-Interventional Clinical Researches Ethics Board of Hacettepe University and written informed consents from the parents were obtained. The parents completed a questionnaire before the surgery. The children were examined using dental mirror and explorer under dental unit lighting. Oral health status was evaluated with DMFT/S, dmft/s, ICDAS II, dental plaque and gingival indices. The chi-square test, Kruskal Wallis and Mann Whitney U tests were used to statistically analyse the results, with statistical significance p<0.05.

Results: Of the 170 children who had adenotonsillar hypertrophy with mouth breathing, 150 the parents agreed to participate the study. 77 of the children (51.3%) were male; the mean age was 5.9 ± 2.6. Mean dmft was 3.8 ± 3.6, dmfs 9.7 ± 1.1, DMFT 0.4 ± 1.0 and DMFS 0.6 ± 1.5 respectively. Among the children, 101 (67.3%) had cavitated dental caries, and according to ICDAS II, none had healthy teeth, 15 (10.0%) had initial, 42 (28.0%) had moderate and 93 (62.0%) had advanced caries. Of the children, 89.3% had gingivitis and the proportion of gingivitis in posterior region was found to be significantly higher than anterior region (p < 0,001).

Conclusions: The oral health status of mouth breathing in children with adeno-tonsillar hypertrophy was poor. To reduce the risk of dental caries and periodontal disease among these children, regular dental follow-up and preventive programmes for oral health are needed.

Keywords: Adenotonsillar hypertrophy; Dental caries; Gingivitis; ICDAS II.

MeSH terms

  • Adenoids / pathology*
  • Adolescent
  • Child
  • Child, Preschool
  • Dental Caries / etiology
  • Female
  • Gingivitis / etiology
  • Health Status*
  • Humans
  • Hypertrophy
  • Male
  • Mouth Breathing / etiology*
  • Oral Health*
  • Palatine Tonsil / pathology*
  • Parents
  • Surveys and Questionnaires
  • Turkey