Swollen Tonsils in Kids: A Dentist’s Guide to Identify the Issue

People are often surprised to hear there are links to a child’s dental health that isn’t necessarily their teeth. Probably the most significant, are signs of a child’s wellness and immune system.

An example of these are swollen tonsils and adenoids, which signal that your child’s airway may be preventing them from breathing properly. Additionally, more and more crooked teeth are seen in children today, which also mean the child’s airway is cramped.

You may have been told that swollen tonsils and adenoids should only be removed if you get recurrent infections. However, there are many other factors to consider when it comes to getting your child’s tonsils removed.

The problem with small airways, is they are linked to difficulty breathing during sleep. Children today are suffering from a sleep-disordered breathing epidemic.

Possibly the most serious consequence of sleep-disordered breathing is it increases systemic inflammation – which is the root cause of nearly all disease.

Tonsils are the set of lymphatic tissue on either side of the throat, while adenoids are a patch of tissue found high in the throat. Both work to trap germs that are breathed in through the nose and mouth.

Swollen tonsils can present with pain with or with no pain. There are many different presentations. Here’s a few signs and symptoms to check.

• Redder than normal tonsils.
• A white or yellow coating on the tonsils.
• A slight voice change due to swelling.
• Sore throat
• Ear Aches
• Croaky voice
• Uncomfortable or painful swallowing.
• Swollen lymph nodes (glands) in the neck.
• Bad breath.

However, if you see any sign of enlarged, swollen infected tonsils you should consider how your child is breathing when they sleep. These are some of the signs of sleep-disordered breathing in children:

• Jolting awake
• Snoring
• Mouth breathing
• Sleeping with mouth open
• Labored breathing
• Choking or gasping for air
• Talking in sleep
• Sleep walking
• Bed wetting
• Teeth grinding
• Trouble concentrating or ADHD symptoms 

 

Which kids are at risk of swollen tonsils and sleep apnea symptoms?

Swollen tonsils and adenoids, and tonsillitis, and sleep apnea share common causes. Kids that have small airways, may be more prone to needing braces. That’s why if your child has crooked teeth, then you should always check for other symptoms impacting their breathing.

Common risk factors for small jaws, crooked teeth, swollen tonsils and snoring in kids include:

• Poor diets that lack nutrients for healthy teeth and include harmful factors that disrupt the immune system.
• Rubber nipple bottles over breastfeeding, which doesn’t require as strong of a sucking force.
• Mushy baby food that doesn’t require infants to chew so their jaws are weaker. [Read this article on Baby-led Weaning]
• Increase in allergies that force children to mouth breath and interfere with proper palate development.
• Thumb-sucking habits or pacifier use that are allowed to continue for too long.

First of all, there is no need to beat yourself up for any of these. As a society we’ve come to accept all of these as completely normal. Truth of the matter is each one of these are fairly new customs, only occurring in the last 60 years or so.

 

Enlarged tonsils and adenoids can inhibit your child’s brain development

Now you might be wondering, what’s the matter with waking up a few time throughout the night? Well, besides the fact that it makes you feel not fully rested and sometimes completely exhausted, it also interrupts what’s known as your glymphatic system.

The glymphatic system is how your brain cleans out neurotoxic waste and it occurs during the deepest stages of sleep. It was only discovered in 2012, which means we have a lot to learn about this important system. What we do know is your brain actually shrinks by 60 percent to allow for fluids to rinse through – that’s pretty incredible.

When you aren’t getting quality sleep, you’re not allowing your brain to fully recover. In children, one of the biggest symptoms of sleep disordered breathing is attention deficit/hyperactivity disorder, more commonly known as ADHD. The connection between poor sleep and ADHD is a fairly common occurrence, but frequently overlooked by practitioners.

Over time this causes serious health problems and is why it’s best if you catch signs in your child sooner rather than later. The good news is there’s a lot that can be done to open an airway and prevent sleep-disordered breathing, which brings us back to your child’s tonsils.

 

What does it mean if my child snores and their tonsils are swollen?

All of those factors that close the airway are making it more difficult for us to breathe when we sleep. Especially, in the deep stages of sleep where your body goes completely limp to prevent you from moving during important recovery processes.

Your body actually goes paralyzed during the last stage of sleep to prevent you from moving during your dreams. When this happens your airway collapses and your tongue slides to the back of your throat, where it can cause labored breathing or snoring. What happens next is your brain senses the lack of oxygen and thinks, “Oh no! He’s suffocating!” In which case it will do whatever it can to startle you awake.

As we get older these symptoms slowly get worse but usually aren’t enough to send someone looking for answers. Signs of sleep-disordered breathing when left untreated include:

• Attention deficit/hyperactivity disorder
• Brain fog
• Difficulty concentrating
• Excessive daytime sleepiness
• Insomnia
• Memory loss
• Mood swings
• Gastric Reflux
• Depression
• Anxiety
• Chronic fatigue

Lifelong sleep-disordered breathing causes an increased risk for many chronic illnesses, such as:

• Alzheimer’s disease
• Anxiety
• Depression
• Heart disease
• Diabetes
• Obesity
• Hormone imbalance
• Numerous psychiatric diseases

Again, these are signs of a much bigger problem, yet we’ve come to accept them as relatively normal. Keep a close eye out for any of these symptoms in your child – they could be an indicator of a small airway.

 

How do you know if your child’s tonsils and adenoids are swollen?

There are a couple things you can check for before you even step foot in your dentist’s office. First, there’s the Mallampati Score, which rates how large an airway is when your child extends his or her tongue. If your child is more than Class I, you should have their adenoids or tonsils checked.

Second, check for signs of mouth breathing in your child. If you see your child mouth breathing when watching television or through the day, it’s a risk factor for both crooked teeth and sleep apnea.

If you find either of these two warning signs of a small airway I recommend you make an appointment with an airway focused dentist or physician. They will refer you to an ear nose and throat surgeon for further assessment for tonsillectomy or adenoidectomy.  The treatment should consider both dental growth, tonsils and adenoids and airways.

 

 

Healthy teeth, tonsils, and airways are all connected.

Spotting the sign of airway and sleep disorders is key for childhood development.

As your child ages a small airway can cause compounding health problems. Don’t panic, it’s never too late to correct an airway, but that being said – the earlier you catch it the better. Many people will go their entire lives completely unaware that the size of their airway has any impact on their health.

By reading this article you are already way ahead of the game. Have you noticed swollen tonsils in your child? Have you sought treatment? Leave your questions and comments in the section below.

Now we want to hear from you. Please leave your questions in the comments below.

For more information on Dr. Lin’s clinical protocol that highlights the steps parents can take to prevent dental problems in their children: Click here.

 

Resources:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2958867/

https://www.health.harvard.edu/newsletter_article/Inflammation_A_unifying_theory_of_disease

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4651462/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4636982/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3880190/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3129712/