You'll find hundreds of files on cleft lip, cleft palate here on widesmiles.org.

This one is about: Dr Liu comments on Eartubes vs Antibiotics


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Ear tubes are "artificial" and not permanent. They either fall out on their own over time or need to be removed at a later time. They are placed to relieve fluid buildup (resulting in pressure buildup) in the middle ear. Normally, pressure buildup is equalized by a tube that runs between the middle ear and the sinuses. (That's why children with clefts are more susceptible to ear infections since whatever goes in the mouth has the chance to go directly into the middle ear.)  When this process is blocked, pressure builds in the middle ear which over time, can cause hearing loss.

Now, to why I have such an interest in ear tubes. I have seen over the last 10 years, an increasing number of 6-8 year old children with very crumbly permanent first molars. That is, these molars are very chaulky and easy to fall apart when a child bites into anything hard.  And, they can be very sensitive. In other words, these molars are very poorly formed.

Invariably, when I talk to the parents of these children, they tell me that their child had chronic ear infections.  And, instead of getting ear tubes, the children were put on antibiotics all the time.

I wanted to do a study about this when I was still teaching at Loma Linda University.  Now that I am in private practice full time, I don't have the time or resources to do this. I have spoken to many other dentists and even ENT Drs. and they all think that I have a very valid suspicion.  A rule of thumb I have heard from ENT and pediatricians that I think are reputable is that if a child gets more than 2 or 3 ear infections in a year, put in ear tubes.  With children with clefts, it was standard routine at Loma Linda to put the tubes in whenever the first surgery took place.
At subsequent surgeries, ENT would either check the tubes or put in new ones if the old ones had fallen out.

John R. Liu, DDS
Dental Consultant, Wide Smiles


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