Is my child a mouth breather?

What does it mean?

Mouth breathing refers to the habitual practice of breathing through the mouth rather than the nose.

What can cause my child to breath from the mouth instead of the nose?

It is estimated that 85% of mouth breathers suffer from some degree of nasal obstruction which may be:

1) Developmental and morphologic anomalies like:

• Abnormal development of nasal cavities.
• Enlarged nasal turbinate.
• Short upper lip.

2) Partial obstructions:

• Deviated nasal septum. 
• Localized benign tumor.

3) Infection / Inflammation of nasal mucosa as:

• Chronic allergy.
• Chronic atrophic rhinitis.

4) Enlarged adenoid and tonsils.

5) Traumatic injures of nasal cavity.

6) Genetic pattern.

7) Thumb sucking and other habits

How can this affect my child?

Even though your child is breathing well, it can have several negative consequences, including:

• Posture issues: To breathe more easily, children often tilt their neck forward, straightening the oropharyngeal path, which may give them a "pigeon chest" appearance.                                                                        

• Nasal speech tone: The child’s speech may acquire a nasal tone due to obstructed airflow.
• Adenoid Faces: This is a facial appearance typically associated with mouth breathers.

• Dental changes:

1. Gaps between the upper and lower teeth (open bite)
2. Forward placement of upper front teeth
3. Tongue thrusting due to forward tongue placement
4. Improper occlusion (misalignment of teeth)
5. Increased risk of tooth decay (caries)

How Can I Tell if My Child is a Mouth Breather?

Signs of mouth breathing include:

• Frequent "lip-apart" posture
• Recurring tonsillitis or allergic rhinitis

If you notice these symptoms, it’s advisable to visit a dentist for a professional assessment.

Diagnostic Techniques Used by Dentists:

• Observation: A nasal breather will have lips that lightly touch at rest, while a mouth breather’s lips remain apart.

• Breathing Test: Ask the child to take a deep breath through their nose. A nasal breather’s nostrils will dilate, whereas a mouth breather’s nostrils remain unchanged.

• Clinical Tests:

1. Mirror/Fog Test: A double-sided mirror is placed below the nose and mouth to observe condensation.
2. Massler’s Water Test: The child holds water in their mouth for a certain period to test nasal breathing.
3. Jwemen’s Butterfly Test: A butterfly-shaped cotton piece is placed over the upper lip to monitor airflow.
4. Paper Test: The child is asked to hold a piece of paper between their lips.

How Can Mouth Breathing Be Treated?

Elimination of the cause: 

• If nasal or pharyngeal obstruction has been diagnosed, then removal of the cause is done by surgery. But follow ups are mandatory as obstructive mouth breathing may convert to habitual. 

Symptomatic treatment: 

• The gingiva of the mouth breathers should be restored to normal health by coating the gingiva with petroleum jelly.

Interception of the habit: 

• Physical exercise: deep breathing exercises 
• Lip exercise: 15-30 min/day for 4-5months through holding metal disc between lips 

Oral screen: 

• An effective device that is worn during sleeping hours to reestablish nasal breathing by preventing air entering the oral cavity.

Correction of malocclusion 

Correction of tongue thrust

This point will be discussed in detail in the next article.

In conclusion, 

Addressing mouth breathing early on is essential to prevent long-term health and dental complications. By understanding its causes and seeking timely intervention, parents and caregivers can help children develop healthier breathing habits, leading to improved overall well-being and quality of life. Regular check-ups with healthcare and dental professionals play a crucial role in monitoring and managing this habit for optimal outcomes.