Deciding to Have Surgery
Is it true tonsil trouble can also cause dental problems?
Yes. Bulging tonsils and adenoids can lead to mouth breathing, which dries out the gums, which can lead to periodontal disease. "Mouth breathing can put a child at greater risk for tooth decay," says Michael Roberts, D.D.S., chairman of pediatric dentistry at the University of North Carolina, in Chapel Hill.
How do I decide if my child's tonsils should be removed?
It's often a tough call. Tonsillectomy (and typically a simultaneous adenoidectomy) is absolutely recommended if the tonsils are so large they obstruct breathing or swallowing, or if your child is diagnosed with OSA. And surgery is also recommended if children have chronic strep throat, tonsillitis, middle-ear infections, mononucleosis, or similar illnesses -- particularly if they don't respond well to antibiotics.
What constitutes a chronic condition? The American Academy of Otolaryngology-Head and Neck Surgery points to a study showing the benefit of tonsil removal for kids who have had three or four tonsil infections in a year. Other medical groups, including the American Academy of Pediatrics, say it's not necessary unless the child has had seven infections in one year or five infections in each of two years. "There's no research that definitively proves what's most appropriate," Dr. Chang says.
Is there any reason not to have tonsils taken out?
Definitely. A tonsillectomy is considered extremely safe, but like all surgeries, it involves risks. The operations are performed under general anesthesia, a risk in itself. And though removing the adenoids is relatively swift and simple, removing tonsils can cause up to 14 days of throat pain, sometimes quite severe.
If my child needs surgery, what should I expect?
Tonsil-adenoidectomy is often done on an outpatient basis: Children go home after a few hours in the recovery room. After surgery, pain can be anything from mild to awful. Children won't want to eat or drink much -- but they need fluids in order to avoid dehydration. Be prepared to push liquids, and give your child acetaminophen to make swallowing easier (avoid ibuprofen after surgery because it increases the potential for bleeding). Your child may vomit, since pain medication can cause tummy turmoil.
Copyright © 2003 Amy Linn. Reprinted with permission from the October 2003 issue of Parents Magazine.