Center of pediatric dentistry, ENT and pediatrics

Adenoid tissue does undergo reverse development by adolescence, but we can't wait if it is already harming the child's development. At MediLavia we follow strict indications for adenotomy: persistent lack of nasal breathing, nighttime breathing pauses (apnea), recurrent otitis and the formation of an “adenoid face type”. The modern operation is performed endoscopically under anesthesia — it is bloodless, precise and virtually rules out tissue regrowth. We perform ENT surgery from age 3; before that we manage the child conservatively together with a pediatrician.

This is one of the most dangerous misconceptions. Under a baby tooth lies the bud of the permanent one, and any infection (caries, pulpitis) can damage or destroy it. Early loss of a baby tooth also leads to bite problems and speech issues. Treatment aims to preserve the tooth until its natural change, ensuring the correct development of the whole maxillofacial system.

If a tooth is more than 50% destroyed, an ordinary filling won't withstand the chewing load and may break off together with the tooth wall. Children's crowns are the “gold standard” of restoration: they fully cover the tooth, protect it from further destruction and repeat caries, restore chewing function and let the child wait for the tooth to change without constant visits to the dentist to “re-glue” fillings.

The term “frequently ill child” is not a diagnosis but a group under dispensary observation. The criteria depend on age, but what matters is not only frequency but also severity: if every cold ends in antibiotics or complications, that's a reason for a thorough examination by a pediatrician and ENT doctor at our center.

Fever is the body's protective response. We recommend looking at both the thermometer and the child's wellbeing. If the child is active and drinking, a temperature up to 38.5 °C need not be brought down.

See a doctor urgently if:

• the fever comes with unusual lethargy, refusal to drink or a severe headache;
• a rash appears that doesn't fade under pressure;
• the fever lasts more than three days without improvement;
• the child has had febrile seizures before.

Baby teeth play the crucial role of “navigators” for the permanent ones. When a tooth is removed long before its natural change, the neighboring teeth slowly start shifting into the freed space. If a special retaining plate (a “space maintainer”) is not placed, the permanent tooth simply won't have room to erupt. This inevitably leads to crowding, malocclusion and the need for complex and costly braces treatment in adolescence.

In modern medicine the risk of adenoid regrowth is minimal (under 6%) and directly depends on two factors:

• Quality of the operation: we perform adenotomy endoscopically with a shaver technique, under a 360° camera. This allows complete removal of lymphoid tissue even in the hardest-to-reach areas. Recurrences in the past often happened due to 'blind' removal, when even a tiny fragment of tissue capable of growth was left in the nasopharynx.
• Individual features: children with pronounced allergies or untreated chronic infections keep a stimulus for lymphoid tissue growth.

Our approach: we don't just operate — after surgery we take the child under the interdisciplinary supervision of a pediatrician and an ENT doctor. By removing the cause of inflammation, we reduce the risk of recurrence to almost zero, giving the child free breathing for years to come.