The Association of Tonsil Hypertrophy with Pediatric Dentofacial Development: Evidence from a Cross-Sectional Study of Young Children in Shanghai, China

Xianqin Tong; Yuanyuan Li; Gang Yang; Hao Zhang; Yiwei Jiang; Jin Yu; Dongxin Da; Xiaoli Zeng; Yuehua Liu

doi:10.2147/NSS.S381020

The Association of Tonsil Hypertrophy with Pediatric Dentofacial Development: Evidence from a Cross-Sectional Study of Young Children in Shanghai, China

Nat Sci Sleep. 2022 Oct 19:14:1867-1875. doi: 10.2147/NSS.S381020. eCollection 2022.

Authors

Xianqin Tong^#^{1

2}, Yuanyuan Li^#^{2

3}, Gang Yang^{1

2}, Hao Zhang^{2

4}, Yiwei Jiang^{2

4}, Jin Yu^{2

4}, Dongxin Da^{2

4}, Xiaoli Zeng^{2

4}, Yuehua Liu^{1

2}

Affiliations

¹ Department of Orthodontics, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, People's Republic of China.
² Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, People's Republic of China.
³ Department of Preventive Dentistry, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, People's Republic of China.
⁴ Department of Pediatric Dentistry, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, People's Republic of China.

^# Contributed equally.

Abstract

Purpose: The prevalence of dentofacial deformity was reportedly higher than decades ago, to which upper airway (UA) obstruction-induced sleep-disordered breathing (SDB) might contribute a lot. Tonsil hypertrophy appears relatively common in the population of young children. Given that the association between tonsil hypertrophy and pediatric dentofacial deformity remained controversial, this cross-sectional research was designed to explore the internal relationship of those among young children in Shanghai, China.

Patients and methods: A stratified cluster sampling procedure was adopted, and a representative sample of 715 young children (8-10 years old) was recruited. The OSA-18 quality-of-life questionnaires (OSA-18) were finished by their guardians, and well-trained orthodontists performed the oral examinations. After collecting the valuable information, the descriptions and analyses were run by statistical software (SPSS, version 26.0).

Results: 715 participants (334 boys and 381 girls) were involved in the analyses. As calculated, the current prevalence of malocclusion identified by Angle's classification was 45.6% in this sample. No evident relation between OSA-18 scores and dentofacial abnormalities (P > 0.05) was found. With the enlargement of tonsil size, the proportion of children with triangular dental arch form (P < 0.05) and high vault palate (P < 0.001) was increasingly higher. More children with protruding profiles and fewer upright profiles were observed as the tonsil size increased, although it did not show a statistical difference (P = 0.103).

Conclusion: Dental and craniofacial growth deficiency has become more prevalent among children, demanding more concerns from health authorities. Tonsil hypertrophy plays an essential role in the direction of dentofacial development. More efforts from local health authorities should be made to enhance public propaganda and education on the prevention and interruption of tonsil hypertrophy and related dentofacial abnormalities.

Keywords: OSA-18; dentofacial growth; malocclusion; sleep-disordered breathing; tonsil enlargement.