An orthodontic appliance can widen a palate. It cannot shrink an enlarged tonsil, straighten a deviated septum, or clear a blocked nasal passage. That’s the practical reason we involve an ENT before starting airway-focused treatment on any patient showing signs of obstructed breathing.

Mouth breathing and airway-related dental development can come from more than one source, often at the same time:

• Enlarged tonsils or adenoids physically narrowing the airway
• Chronic congestion or allergies restricting nasal airflow
• A deviated septum blocking one or both nostrils
• A narrow palate, which is the structural piece orthodontics is built to address

If a child has significantly enlarged tonsils, expanding the palate might help nasal airway volume without touching the obstruction lower in the throat — meaning a family could go through the time and cost of orthodontic treatment and still be dealing with the same breathing problems afterward. Handling the tonsils first, sometimes with a tonsillectomy, often needs to happen before or alongside expansion for the treatment to actually solve the problem.

It runs the other direction too. Local ENTs have referred patients to our Woodland Park office after clearing an airway obstruction surgically, only to find the palate stayed narrow from years of compensatory mouth breathing — the soft-tissue problem was solved, but the skeletal pattern it caused remained.

When Dr. Zitterkopf sees signs of airway obstruction during an orthodontic exam — tonsil size, difficulty breathing through the nose, chronic congestion — the next step is an ENT referral before we finalize an airway-focused treatment plan. It’s not a formality; it’s how we make sure the plan we build actually solves the whole problem.

If breathing issues have come up alongside orthodontic concerns for you or your child, ask about our ENT referral process at our Woodland Park office.