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These soft structures are part of the body’s immune system and, like gate sentries at the back of the mouth, they trap bacteria, viruses or any pollutants in the air that we breathe into our body. Obviously, when air is taken in through the mouth, the filtering effects of the nose are bypassed, and the tonsils will have to work harder to clean the air before it reaches the lungs.

Some doctors may argue that these structures will eventually shrink away and therefore advocate against its removal. However, according to the British Lung Foundation there is good reason to have these obstructive structures removed during this important growing stage for the child.8

Parents will have to weigh up the benefits gained by solving the immediate problem of apnea and nightly sleep deprivation, against the negative impact of a surgery under general anesthesia.

Encouraging the child to sleep with a closed mouth and to breathe through the nose will ensure that air is cleaned and filtered at the entrance. This is obviously nature’s preferred way. The tonsillar tissues will then not have to deal with an overload situation.

References

1 DL Smith et al, Frequency of snoring, rather than apnea – hypopnea index, predicts both cognitive and behavioral problems in young children, Sleep Medicine, 2017 Jun; 34(2017):170-178

2 AR Jackman et al, Sleep-disordered breathing in preschool children is associated with behavioral, but not cognitive, impairments, Sleep Medicine, 2012;13(6):621–631.

3 U Schütz-Fransson & J Kurol, Rapid maxillary expansion effects on nocturnal enuresis in children: a follow- up study, Angle Orthodontist, 2008 Mar;78(2):201–8

4 S Moore, Sleep-Wrecked Kids: Helping Parents Raise Happy, Healthy Kids, One Sleep at a Time, Grammar Factory, Australia, 2018

5 JA Owens, Neurocognitive and behavioral impact of sleep disordered breathing in children, Pediatric Pulmonology, 2009 May; 44:417–422

6 H Andersson & L Sonnesen, Sleepiness, occlusion, dental arch and palatal dimensions in children attention deficit hyperactivity disorder (ADHD), European Archives of Paediatric Dentistry, 2018 Apr;19(2):91–97

7 M Zaffanello et al, Obstructive sleep-disordered breathing, enuresis and combined disorders in children: chance or related association?, Swiss Medical Weekly, 2017 Feb;147:w14400

8 BritLungFoundation, 2013 Feb 12, The effects of OSA, video, viewed 2018 Sep, https://www.youtube.com/watch?v=UuvsYf12Gb8

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