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

Mouth breathing and airway-related dental development often come from more than one source at once:

• 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 designed to address

If a child has significantly enlarged tonsils, palatal expansion might improve nasal airway volume without touching the obstruction lower in the throat — meaning a family could complete orthodontic treatment and still deal with the same breathing problems afterward. Addressing the tonsils first, sometimes with a tonsillectomy, often needs to happen before or alongside expansion for treatment to actually solve the problem.

The reverse happens too. Local ENTs have referred patients to our Falcon office after clearing an airway obstruction surgically, only to find the palate remained narrow from years of compensatory mouth breathing — the soft-tissue problem was solved, but the skeletal pattern it left behind wasn’t.

When Dr. Zitterkopf sees signs of airway obstruction during an exam — tonsil size, trouble breathing through the nose, chronic congestion — the next step is an ENT referral before we finalize an airway-focused treatment plan. It’s not an extra hoop to jump through; it’s how we make sure the plan actually addresses 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 Falcon office.