Why We Work with ENTs Before Starting Airway-Focused Treatment

Orthodontic appliances can widen a palate and improve the space available for breathing — but they can’t shrink an enlarged tonsil, clear a deviated septum, or open a blocked nasal passage. That’s why, before we start airway-focused treatment on a patient showing signs of obstructed breathing, we want an ENT (ear, nose, and throat physician) involved.

Mouth breathing, snoring, and airway-related dental development can stem from several different sources, and they often overlap:

• Enlarged tonsils or adenoids physically blocking the airway
• Chronic nasal congestion or allergies narrowing the nasal passage
• A deviated septum restricting airflow through one or both nostrils
• Structural jaw and palate narrowing, which is the piece orthodontics addresses

If a child has significantly enlarged tonsils, expanding the palate might improve nasal airway volume, but it won’t resolve the obstruction lower in the throat. In that case, treating the tonsils first — sometimes with a tonsillectomy — often needs to happen before or alongside orthodontic treatment for the best outcome. Skipping that step means a patient could complete expensive, time-intensive orthodontic treatment and still be dealing with the same breathing problems.

The reverse is true too. We’ve had ENT colleagues refer patients to us after treating tonsils or adenoids, because the airway obstruction is gone but the palate remains narrow from years of compensatory mouth breathing — the skeletal problem persists even after the soft-tissue problem is resolved.

At Life Orthodontics & Pediatric Dentistry, when Dr. Zitterkopf identifies signs of airway obstruction during an exam — tonsil size, nasal breathing difficulty, chronic congestion — we refer to a trusted local ENT for evaluation before finalizing an airway-focused treatment plan. It’s not an extra step for its own sake; it’s how we make sure the plan actually addresses the whole problem instead of just the part orthodontics can reach.

If your child (or you) has had breathing issues along with orthodontic concerns, ask us about our ENT referral process at our Colorado Springs office.