Changes in Dentofacial Development in Tracheostomized Pediatric Patients

Introduction: Considering the known impact of the absence of nasal flow on dentofacial growth, tracheotomy should be considered to have a negative impact in pediatric age. However, literature on the association between pediatric tracheotomy and dentofacial development is scarce. The objective was to characterize the population of tracheostomized children regarding dentofacial development, in a Portuguese Tertiary Pediatric Hospital.

Methods: Retrospective study with data from clinical records of tracheostomized children, between 2009 and 2022, in a Portuguese Tertiary Pediatric Hospital. Of the initial population of 57 children, 28 were excluded (tracheotomized for less than 1 year, more than 7 years old, and deceased patients). A sample of 29 patients (N=29) was obtained, and frontal, profile, and intra-oral dental photographs taken, and posteriorly analyzed by a stomatologist.

Results: The median age at which tracheotomy was performed was 3 months old. The underlying reason was due to upper airway obstruction in 38%, low respiratory failure/prolonged ventilation in 31%, and syndromes involving craniofacial dysmorphia in 31%. The median tracheotomy time was 65 months and 55% have already been decannulated. Of the patients with syndromes, 56% had severe dentofacial disharmony (DFD), 22% moderate, and 22% mild. Of the patients low respiratory failure/prolonged ventilation, 44% had mild DFD, 56% had no DFD. Of the patients with upper airway obstruction, 36% had moderate DFD, 18% mild DFD and 45% had no DFD. 38% were followed up in a stomatology consultation and 14% in Maxillofacial Surgery (CMF). 17% were subjected to dental/maxillofacial interventions.

Conclusions: The results show that the decrease or absence of nasal flow alters the dental harmony. The authors suggest a multicenter database to better characterize tracheostomized children in order to optimize treatment planning dental care in this population.