Blocked Nose in Children

This page is for blocked nose in CHILDREN

Click here for Blocked nose in ADULTS

• Does your child have a blocked nose?
• Does your child sleep with the mouth open?
• Does your child suffer from poor quality/ restless sleep?
• Does your child snore? Noisy breathing?
• Does your child have dark circles under the eyes?
• Does your child have crooked teeth/ dental problems/ teeth grinding?
• Does your child get cranky/ irritable/ tired/ have poor concentration?
• Would you like your child to breathe normally through the nose?

Read this page to find out how your child's blocked nose can be fixed and how your child can breathe normally through their nose:

What problems are caused by a blocked nose in a child?

In children, a blocked nose can cause many different problems, including some or all of the following:

• Mouth-breathing
• Noisy breathing
• Poor-quality/ restless sleep/ tossing and turning/ waking up during the night
• Snoring
• Reduced oxygen intake
• Behaviour changes
• Problems with Learning/ Problem-solving/ Memory/ Concentration
• Sore throats
• Dark circles under the eyes
• White patches on the teeth (from drying out whilst mouth-breathing)
• Crooked teeth
• Teeth grinding and clenching at night (Bruxism)
• Dry, cracked lips
• Nose bleeds (from drying out of the nose lining due to turbulent air flow)
• "Nasal" voice

In severe cases, blocked nose may lead to:

• Obstructive sleep apnoea
• Severely reduced oxygen intake
• Irritability/ inattention/ hyperactivity/ disruptive behaviour
• Significant problems with Learning/ Problem-solving/ Memory
• Unhealthy gums
• Dry, cracked lips
• Sinus problems
• Bed-wetting
• Night sweats

But my child doesn't complain of a blocked nose! Surely, my child's nose can't be blocked if he/ she isn't complaining?

Most children, and their parents, won't know they have a blocked nose! Usually, the child's parents don't realise, because they just assume it is normal for some children to mouth-breathe. However, mouth-breathing in children is NOT normal! If you recognise some of the symptoms listed above, there is a good chance your child has significant nasal blockage, without you realising it.

Wait! What does a blocked nose have to do with crooked teeth/ dental problems?

A clear nasal passage is critical to the development of normal teeth in children. Normally, children should breath through their nose, especially at night. If the nose is blocked, children will breathe through their mouth. This is abnormal.

How does mouth-breathing affect the teeth?

When children mouth-breathe, their teeth can grow crooked, and their upper jaw may become too narrow affecting the shape of their face.

How does mouth-breathing cause crooked teeth and a narrow jaw?

When children breathe through their nose normally, the mouth is closed. When the mouth is closed, the jaws grow wide and the teeth grow straight as they are guided by the tongue and lips of the closed mouth.

When children abnormally mouth-breathe, the mouth is open and the tongue cannot guide the teeth. This results in the jaw staying narrow and the teeth growing crooked.

Won't braces fix my child's crooked teeth?

Yes, but if the nose is not fixed, once the braces come off, the teeth may become crooked again!

Fixing the nose early means your child may avoid braces altogether.

How can I tell if my child's nose is blocked?

Watch your child closely when they are asleep. If their mouth is open when they breathe, their nose is blocked! You need to watch them throughout the night, not just when they go to sleep or when they wake up in the morning. The mouth only has to be open a tiny bit to cause lots of problems.

Other tell-tale signs include those listed above.

What causes a blocked nose in children?

In the majority (>95%) of children, blockage is caused by:

• Big adenoids
• Big Inferior turbinates

Other common causes of blockage in children include:

• Hayfever (Allergic rhinitis)
• Deviated septum (much less common)

Much less common causes of a blocked nose in children include:

• Sinusitis
• Objects the child has pushed in to the nose
• Other rare causes (birth defects, Tumours/ cancers (very rare), etc)

How can I find out what is causing my child's blocked nose?

Dr Singh specialises in nose problems in children. Dr Singh uses special tests to find out exactly what is causing your child's problems.

What tests can Dr Singh perform?

Dr Singh will examine your child's nose using special instruments.

Dr Singh will pass a super-fine camera into your child's nose to look at the septum, turbinates and adenoids (the nose is made numb first using a numbing spray). You can watch the camera on a TV monitor and see for yourself exactly what is causing your child's blocked nose.

Dr Singh may arrange allergy tests, blood tests, nasal airflow tests and very rarely, an Xray.

Our practice is unique as we have a trained in-house scientist along with all the equipment required to perform these tests on-site. This avoids the need for multiple appointments at multiple locations.

Despite all the tests and high-technology available, the most accurate tool is your doctor's knowledge, training and experience!

Can my child's blocked nose be treated?

Yes.

In almost every single child with blocked nose, the cause can be found and treated.

How will my child's blocked nose be treated?

The treatment used will depend on the cause.

Anatomical problems can be fixed with surgery. In most cases, this is "day-surgery" (your child will return home on the same day as the procedure). Your child will be asleep during the procedure (general anaesthetic).

• Large adenoids: These are fixed with an adenoidectomy procedure
• Large inferior turbinates: These are fixed with Coblation to the inferior turbinates
• Deviated septum: This is treated with septoplasty, but NOT until the child’s facial growth has slowed down/ mostly stopped (typically around age 15-16+). Prior to that age, an adenoidectomy and coblation to the inferior turbinates is performed as a temporary measure. In older children (age 5-15), an inferior turbinoplasty is often performed.

How are other causes treated?

• Hayfever (Allergic rhinitis): This can often be treated with nasal steroid sprays, antihistamines or de-sensitisation. If these measures are not enough, Coblation to the inferior turbinates is performed.

Are there any alternative treatments to surgery?

Yes. There are always options and it is always your choice as to whether to have surgery. In general, you can try other options first and choose surgery if nothing else works. Non-surgical options include:

• Do Nothing: If your child's problem is not severe, you may choose not to have any treatment at all.
• Medication: Try Nasal steroid sprays and antihistamine tablets/ sprays from your pharmacy or from your GP. They work best for children with allergy but may sometimes help children without allergy. Medications should be tried for at least a month before giving up.
• De-sensitisation: If allergy tests prove that your child has allergy, then de-sensitisation can sometimes be an option. This involves a series of regular weekly-monthly injections or drops, taken for several years. This is normally arranged by an allergy specialist (Immunologist)

We recommend that you consider trying these non-surgical options. Then see Dr Singh when you are ready for surgery. There is a long waiting list to see Dr Singh and it is best if you see Dr Singh for surgery after the non-surgical treatments have failed.

Are there any risks to surgery?

Yes. Everything we do in life has risks. Even something as simple as crossing the street has risks... but we still cross the street. Dr Singh will explain the risks of your child's procedure and provide you with an information pamphlet that explains the risks in detail. If you have any questions about risks, ask Dr Singh during your consultation.

What should I do next?

See your GP. If your GP is unable to treat your child's blocked nose, ask your GP for a referral to see Dr Singh.

I have already seen a doctor - I was told nothing could be done for my child's problems. What should I do?

Almost all children with blocked nose can be treated or improved. Dr Singh is a children's nose specialist and has expertise in difficult and complex cases.

Ask your GP for a referral to see Dr Singh.

I have already seen a surgeon and my child had an operation. It didn't work! What should I do?

Most cases of blocked nose in children can be fixed or improved. Dr Singh is a children's nose specialist and has expertise in performing revision surgery where previous surgery has been unsuccessful.

We recommend that you return to see your original surgeon first. If nothing further can be done and your child still has symptoms, consider asking your original surgeon or your GP for a referral to see Dr Singh. Dr Singh always works together with your GP and your other specialists to achieve your child's best health outcome.