Breathing is something that we do automatically to stay alive and so most of us do not think twice about it. It is perfectly natural to breathe through the mouth at certain terms such as when running or lifting heavy objects, however if breathing occurs through the mouth habitually then it can lead to many health problems. These problems can be particularly severe for children as mouth breathing can affect the long term development of the face and jaw.

So Why Breathe Through the Mouth?

Normal breathing is when we breathe through the nose with the mouth closed. The most obvious reason for someone to be a mouth breather is that they cannot get enough air through the nose. Common reasons for blocked nasal passages include:

• Allergies – which can cause polyps or swelling of the nasal lining
• Enlarged tonsils or adenoids
• Deviated nasal septum
• Respiratory infections – cold or flu

Signs that may indicate nasal breathing problems or airway obstruction are:

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• Snoring, sleep apnoea
• Frequent upper airway infections
• Sounding ’stuffy’ during the day/night
• Dark circles under the eyes

Effects on Teeth, Jaw and Posture

As mentioned before, mouth breathing can lead to many health problems, in particular dental health problems.

• When we breathe through the mouth, there is loss of saliva and dryness of the mouth and this can increase the risk of tooth decay and inflammation of the gums.
• Also, mouth breathing can lead to alterations in the jaw and facial growth. The normal resting position of the tongue is up against the roof of the mouth to compensate the forces of the cheeks, however when a person breathes through the mouth, the tongue drops. This leads to the narrowing of the upper jaw and elongation of the lower jaw, resulting in the long, narrow face shape, typically known as ‘long face syndrome’. Due to the narrowing of the jaws, crowding of the teeth, overbite problems and malocclusion can be seen.
• Adjustment in head posture is another effect that can result. Chronic mouth breathers tend to tilt the head backwards and lean the head forward in front of the shoulders to keep the airway open. This enables them to breathe better, however can have lead to long term problems of the neck and back.

Treatment

Treatment of mouth breathing depends upon the underlying cause. This requires a multidisciplinary approach where your dentist, GP, ear-nose-throat specialist (ENT) and sleep physician may be involved in determining the treatment needed. Treatment may include prescription of certain medicines, surgery and myofunctional therapy and breathing exercises.

Airway obstruction is a common cause of mouth breathing and sometimes a full assessment by an ENT is needed to decide the treatment of the obstruction. Often certain medicines can be prescribed to increase nasal airflow and reduce obstructions like swelling of the nasal lining and polyps. For more complicated blockages such as enlarged tonsils or adenoids, surgery may be necessary to remove them.

Sometimes even after removal of the airway obstruction, mouth breathing is still present as it has become habitual. If this is the case, myofuntional therapy along with specific breathing and muscle exercises can help in establishing nasal breathing. Exercises that aim at strengthening the facial muscles along with specific oral appliances encourage nasal breathing and therefore can aid in the proper growth and facial development. This is imperative in young children as they are still in their growing stages.