Evaluation of the awareness of dentists and otorhinolaryngologists about the effect of breathing pattern on craniofacial development and malocclusion

Objective: Craniofacial development is a complex biological process shaped by the interaction of genetic and environmental factors. Respiratory patterns play a critical role in this development, directly influencing dentofacial morphology. This study aims to evaluate the knowledge, awareness, and clinical attitudes of dentists and otorhinolaryngologists (ENT specialists) in Türkiye regarding the impact of mouth breathing on craniofacial growth. Materials and Methods: This cross-sectional study included 96 dentists and 79 ENT specialists. A structured questionnaire was administered to collect data on demographic characteristics, the perceived effects of mouth breathing, early diagnostic approaches, and interdisciplinary referral practices. Data were analyzed using the NCSS 2007 software. Descriptive statistics were calculated, and group comparisons were performed using Pearson's Chi-square test. A significant level of p<0.001 and p<0.05 was adopted. Results: Although both professional groups demonstrated a high level of theoretical knowledge, this awareness was not consistently reflected in clinical practice. Only 51% of dentists reported referring patients to an ENT specialist upon detecting mouth breathing, while 79.7% of ENT specialists stated that they refer patients when maxillary constriction is identified. Moreover, 88.6% of ENT specialists reported that they do not refer patients to an orthodontist following adenotonsillectomy. Dentists were significantly more likely to refer patients to an orthodontist in cases of retrognathia (p=0.006), prognathism (p=0.012), dental crowding (p=0.001), diastema (p=0.001), anterior open bite (p=0.001), crossbite (p=0.001), and delayed tooth eruption (p=0.041). Conversely, ENT specialists had higher referral rates for functional symptoms such as temporomandibular joint sounds (p=0.001), bruxism (p=0.001), and mandibular deviation (p=0.014). Additionally, ENT specialists' referral behaviors differed significantly by age group (p=0.006), type of institution (p=0.001), and years of professional experience (p=0.001). Conclusion: The findings of this study underscore the critical importance of early identification and appropriate management of mouth breathing in preventing malocclusion and skeletal deformities. Enhancing interdisciplinary collaboration and optimizing referral pathways are essential strategies for mitigating long-term craniofacial developmental abnormalities. Keywords: Craniofacial development, mouth breathing, malocclusion, maxillary constriction, multidisciplinary approach