What is adenoid facies?

Chronic mouth breathing caused by adenoid hypertrophy may affect facial and dental development, leading to a series of facial deformities such as elongated maxilla, elevated palate, mandibular retrusion, protruding maxillary incisors, thick upper lip, and an expressionless face.

Clinically, this characteristic facial appearance is referred to as "adenoid facies."

What causes adenoid facies?

Chronic nasal obstruction (allergies, asthma), adenoid hypertrophy, or anatomical abnormalities. The most common cause in children is adenoid hypertrophy.

Adenoid hypertrophy blocks nasal airflow, leading to mouth breathing. Prolonged mouth breathing increases oral pressure, elevating the palate, elongating the maxilla, protruding the incisors, thickening the upper lip, retracting the mandible, and preventing natural lip closure, resulting in a dull or vacant facial expression.

However, facial appearance is influenced by multiple factors, and the correlation between mouth breathing alone and these facial features remains debated. It is unclear how long mouth breathing is required to cause such changes. The link between "nasal obstruction" and facial deformities (e.g., malocclusion, poor facial structure) may be stronger.

Which departments treat adenoid facies?

Dentistry, Otolaryngology, Pediatrics

Who is most at risk for adenoid facies?

People with chronic nasal obstruction (allergies, asthma), adenoid hypertrophy, or anatomical abnormalities; particularly children with adenoid hypertrophy or adults with a history of adenoid hypertrophy.

What are the main symptoms of adenoid facies?

• Skeletal changes: Elongated maxilla, protruding maxillary incisors, mandibular retrusion.
• Dental changes: Crowded teeth, misalignment, malocclusion.
• Soft tissue changes: Thick upper lip, inability to close lips naturally.
• Facial changes: Loss of nasolabial folds, dull or vacant expression.

How is adenoid facies diagnosed?

• Nasopharyngoscopy: Reveals adenoid hypertrophy or other airway obstructions (adenoids typically regress by age 10 in adults).
• Characteristic facial features: Elongated maxilla, mandibular retrusion, protruding incisors, thick upper lip, expressionless face.
• X-ray measurements: Increased SNA and ANB angles, decreased SNB angle.

How is adenoid facies treated?

A multidisciplinary approach including surgery, medication, and orthodontics:

• Restore nasal airflow: Surgical adenoidectomy or medication to control hypertrophy.
• Correct habits: Use masks, lip tapes, or vestibular shields to stop mouth breathing.
• Orthodontics: Correct jaw development abnormalities.
• Functional training: Lip/tongue muscle exercises and breathing training.

What is the prognosis for adenoid facies?

Prognosis is generally good with continuous, proper treatment.

Main impacts on life:

• Appearance: Altered facial aesthetics may affect social interactions.
• Psychology: May lead to introversion, low self-esteem, or other negative mental states.

How to prevent adenoid facies?

Prevent root causes like adenoid hypertrophy or nasal obstruction:

• Early treatment for mouth breathing (respiratory/anatomical issues).
• Avoid colds, tonsillitis, and upper respiratory infections.
• Strengthen immunity through nutrition and exercise.
• Treat adenoid hypertrophy promptly to maintain nasal airflow.
• Persist with functional training during treatment.
• Provide emotional support and encouragement.