Have you ever seen your child with his or her mouth slightly open when sleeping? You might think it’s no concern, but habitual mouth breathing in children is a sign of an underlying problem that can negatively impact their oral health and development.

We often overlook mouth breathing as a simple habit. Of course, sometimes (due to nasal obstruction), mouth breathing is completely normal for a while. But, did you know? If left untreated, chronic mouth breathing can lead to:

• Severe dental issues
• Developmental problems
• Oral health
• Facial development issues

And more health issues. In this article, we will discuss how mouth breathing affects tooth growth, the risks involved, and the importance of early identification and treatment.

What is mouth breathing?

Think of the nose as a built-in humidifier and air cleaner for the body. When a child is breathing through the nose, the air is warmed, dust and allergen-filtered, and humidified before it reaches the lungs. Mouth breathing bypasses this vital process.

Mouth breathing occurs when a child consistently breathes through the mouth instead of the nose. This may be due to many causes:

• Nasal obstruction caused by allergies
• Inflamed adenoids or tonsils
• Other upper airway obstructions

How mouth breathing affects your child’s health

Let’s take a look at the effects of chronic mouth breathing:

Dental and orthodontic issues

One of the most worrying effects of chronic mouth breathing in children is its impact on dental occlusion. This malocclusion is primarily caused by two factors: a disruption of the muscle balance around the mouth and the incorrect resting position of the tongue. When the tongue is not in the right place, dental arch development might be incomplete.

The habit of open mouth posture disrupts the existing muscle balance around the mouth and the position of the tongue, which is essential for dental arch development. This imbalance can cause:

• Narrowing of the upper jaw: Also called maxillary constriction, which causes crowding of the teeth.
• Rotation of the mandible: Backward or downward rotation of the mandible, resulting in a receding chin and crooked bite.
• Malocclusions: Increased incidence of malocclusions.

Mouth-breathing children are much more prone to malocclusions than nasally breathing children. Mouth-breathing orthodontic issues generally require repair treatment.

Impact on facial growth

Mouth breathing, besides affecting teeth, also alters the pattern of facial growth. Nasal airflow obstruction and frequent open-mouth posture can trigger:

• Long, thin faces with sunken cheeks.
• Hanging eyelids or a tired appearance.
• Small or receding chin.
• Palate alterations affect speech and the ability to swallow.

All of these features are referred to together as “adenoid facies,” which is typically related to chronic nasal obstruction with mouth breathing in childhood. The earliest treatment of mouth breathing will avoid or even reverse some of them.

Oral health implications of mouth breathing

Mouth breathing also leads to drying of the oral cavity as the air flow out of the mouth evaporates saliva, which otherwise lubricates teeth and gums. Reduced saliva secretion compromises oral defense mechanisms and encourages:

• Cavities: Because of an acidic oral environment and plaque accumulation.
• Gingivitis and periodontal disease: Because of increased plaque and dry gums.
• Halitosis (bad breath): Due to bacterial growth in a dry mouth.

Saliva is also necessary for maintaining a proper balance of oral pH, neutralizing acid that causes cavities. Mouth breathing essentially takes away this protective defense, creating an environment in which aggressive bacteria thrive.

Other connected health issues

In addition to dental and facial consequences, mouth breathing in children is also associated with other health issues, such as:

• Sleep-disordered breathing with increased risk of obstructive sleep apnea.
• Restless sleep, daytime fatigue, irritability, and poor concentration.
• Speech impairment due to an altered oral posture employed for the production of sounds.

Early intervention in mouth breathing can therefore have beneficial effects over broader fields than oral health alone.

What are the causes of mouth breathing in children?

The most frequent reason for chronic mouth breathing in children is upper airway obstruction. Significant causes include:

• Enlargement of adenoids and tonsils
• Allergic rhinitis, which causes nasal obstruction
• Problems in the nose (like a deviated septum, nasal polyps)
• Chronic sinusitis

These obstructive forces reduce nasal breathing and result in children acquiring mouth breathing habits that may persist even after correction of the obstruction.

How to detect mouth breathing?

Early detection of mouth breathing is also crucial to prevent long-term dental and developmental problems. Pediatricians, dentists, and orthodontists can screen for the signs during visits. However, parents also need to detect some easy telltale signs and symptoms that indicate a child is a habitual mouth breather. These include:

• Habitual open-mouth posture: Frequent open-mouth posture even during wakefulness or rest, since the mouth naturally can remain slightly ajar due to nasal airway blockage or habit.
• Snoring or noisy breathing during sleep: Snoring or noisy breathing could indicate nasal obstruction or sleep-disordered breathing.
• Dry mouth: Dry lips or mouth upon waking, since mouth breathing dries oral tissues by reducing salivary output.
• Perpetual halitosis: Repeated bad breath due to dry mouth and bacterial buildup.
• Crowding, open bites, or malaligned teeth: Crowded teeth, turned teeth, open bites, or visible shifts in teeth position can occur.
• Appearance of face after altered growth: Alterations in facial appearance, also referred to as “adenoid face,” with a slender, long face, sagging eyelids, or diminished chin due to altered facial growth.
• Behavioral symptoms: Some behavioral symptoms, such as drowsiness during the daytime, inattentiveness, irritability, or hyperactivity, may suggest mouth breathing (though these may or may not be related to it).

If you notice these signs in your child, you can have a pediatrician, pediatric dentist, or specialist investigate. You can also observe your kids at play and at rest for repetitive habits of using the mouth rather than the nose.

Early intervention

Interventions are determined by cause but often include:

• Medical treatment of nasal infection or allergy.
• Surgical removal of adenoids or tonsils if necessary.
• Myofunctional therapy (a series of exercises to retrain the proper tongue, lip, and jaw muscle position).
• Early intervention to direct proper jaw and tooth development.

Successful treatment can improve breathing, restore oral function, and promote normal facial growth.

The bottom line: Mouth breathing needs intervention

Mouth breathing in children is more than a simple habit; it is a serious problem that has ramifications for dental health, facial development, and general health.

Habitual mouth breathing disrupts the normal oral environment and craniofacial development, leading to malocclusions, increased risk for cavities, dry mouth issues, and facial developmental changes. These reasons are why early intervention by a multidisciplinary team is critical to avoid the consequences and foster normal growth patterns.

Don’t wait. If you notice any of these signs in your child, schedule an appointment with a pediatric dentist or a pediatrician. Early diagnosis and treatment can prevent a lifetime of dental, facial, and overall health issues. Take action today to protect your child’s smile and health.

Sources:

• National Library of Medicine: The impact of mouth breathing on dentofacial development: A concise review
• Dental health, halitosis, and mouth breathing in 10-to-15-year-old children: A potential connection

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