Breathing via mouth might not sound something unusual to few, but, to bring to one’s knowledge, mouth breathing can lead to extensive issues in terms of dental health & facial development in children.
For normal dentofacial growth there must be normal breathing. Increased forceful efforts to maintain the air flow through the nasal passages may be considered to be the prime cause of mouth breathing.
What causes mouth breathing?
Usually the underlying cause of mouth breathing is chronic nasal obstruction. When the nasal airway gets obstruct one tends to breathe through the mouth automatically.
The causes of nasal airway obstruction can be due to:
- Inflammation & infection of nasal mucosa
- Deviated nasal septum
- Enlarged tonsils
- Pharyngeal lymphoid tissue hypertrophy
- Nasal polyps
- Short upper lip
- Enlarged adenoids
- The shape of the nose
- Enlarged turbinates
- Obstructive sleep apnea
How mouth breathing develops?
While breathing through the nose, the air entering into your nasal and oral pharynx, your throat is not going to heavily affect the lymphoid tissue in the adenoids & tonsils which is the last barrier to catch harmful particles in the air before it reaches your lungs.
Besides clearing the air from harmful particles, nasal breathing stimulates production of gases & substances in the nose which are going to facilitate the entrance of the air in the lungs & prevent infection in your respiratory system.
Mouth breathing allows the air to pass directly into your throat where the adenoids & tonsils are located. The air entering into your body through your mouth has not previously been purified & the lymphoid tissue in the adenoids & tonsils become the first defensive barrier against the harmful particles contained in the air. As a consequence that lymphoid tissue occupying a large volume, your throat makes more difficult for the nasal breathing & you make a habit of breathing through your mouth.
How mouth breathing affects dentofacial health?
Mouth breathing may cause grievous effects on one’s oral health. Breathing via mouth causes dryness of mouth, throat & ear infections & decreased saliva production.
Saliva plays a key role due to its physical, chemical & antibacterial properties. Henceforth, when not enough saliva is produced, the likelihood of decay & gum issues increases as the bacteria slowly demineralises the tooth surface.
In order to breathe through your mouth, your lower jaw has to come down as well as your tongue has to rest on the floor of your mouth.
Breathing through your nose is the correct way & so the tongue is able to rest on your palate stimulating a normal growth & development of your upper jaw.
Conversely when you breathe through your mouth, your tongue has to descend & protrude. At the same time the pressure of your cheeks increases pushing the upper jaw inwards, so the growth & development of your upper jaw is negatively affected resulting in a narrow & high palate.
The upper dental arch acquires a V-shape instead of being around a dental arch. Therefore your teeth do not have space to properly align. This also produces an incorrect swallowing function every time you swallow between 1600-2400 times per day, the tongue positions low staying away from your palate that forces the tip of your tongue to position between your upper & lower front.
That pushes your front teeth to show out of your mouth & your tongue resting on the floor of your mouth with the tip of the tongue between your front teeth that is called an open bite (as your upper & lower front teeth do not touch when you close your mouth).
All those dysfunctions: mouth breathing, incorrect tongue posture, open mouth & incorrect swallowing are going to continue affecting the growth & development of your upper & lower jaws. And as a consequence there is less room for your teeth & they become crooked.
Hence, mouth breathing lead to facial changes by causing one’s face to grow downward that eventually lead to long & narrow faces, incompetent lips, crooked teeth, proclined upper & lower anteriors, high palatal vault, narrow upper arch etc. Adenoid faces are the characteristic feature of mouth breathers.
Breathing through the nose improves the lip competence that further helps your jaws to grow & develop better. But more importantly it makes you healthier.
How to diagnose mouth breathing
In order to diagnose if your child is breathing through the mouth or nose, you need to:
- Closely observe his/her lips. If the lips are held wide apart (incompetent) then this indicates your child is developing the tendency to breathe through the mouth due to obstruction in the nasal airway.
- Ask the patient to take a deep breath through the nose. The mouth breathers tend to inhale through the mouth. In such cases there will be no changes in the size or shape of the external nares.
- Mirror or fog test: a double sided mirror is held between the nose & mouth. Whichever side indicates fogging of the mirror concludes the type of breather.
- Massler’s water holding test: ask the patient to hold water for few minutes. If the patient is a mouth breather he will not be able to retain the water for long.
- Massler & Zwemer butterfly test/cotton test: butterfly shaped cotton strands are placed below nostrils. If the fibres flutter downwards on exhalation, then the patient is a nasal breather & if fibres flutter upwards then the patient is a mouth breather.
Treatment of mouth breathing
The causative agents should be treated first.
In case of any pharyngeal or nasal obstruction must be removed via surgery or use of medications like: nasal decongestants, antihistamines, steroid nasal sprays etc.
Respiratory allergy should be brought under control.
In order to correct narrow arches, use of expansion appliances must be executed for rapid maxillary expansion.
Even after removal of the causative agent the habit persists then exercises must be considered the mode of correction.
- Patient is asked to hold the pencil between lips during the day time.
- During night time the lips are sealed with surgical tape in case of habitual mouth breathing.
Button pull exercise: patient is asked to hold a button behind the lips with a thread passing through the button. The patient is asked to pull the thread while restricting it from being pulled out by using lip pressure.
Oral screen: is a habit breaking appliance that controls abnormal muscle habits & works on the principle of force application & elimination. It is placed in the vestibule between the lips, cheeks & the teeth.
If you are concerned about your child’s mouth breathing & its adverse effects, schedule an appointment at Dr. Sachdeva’s dental implant clinic in Delhi.
There are many habits that are considered to be normal for certain age. If you can differentiate between normal & abnormal habit, its effect & cause then it can be dealt in an effective way & can work towards the resolution of the issue. It’s always better to provide your child with an interceptive treatment before he/she needs a corrective treatment.
