Breathe Better, Live Better Part 2: Treating Problems Caused By Mouth Breathing

By Dr. Emily Watson

Perhaps you notice it when your child is sleeping. Or maybe it’s while they are watching TV.

Instead of breathing through the nose, the child is breathing through the mouth, a habit that can seem “normal,” but actually can affect a child’s health, growth, and development. In my previous article, I discussed problems that can be caused by mouth breathing: inflammation of the gums, increased risk of cavities, severe overbites, or underbites – just to name a few. In the most severe cases, jaw surgery might be required to correct the problem.

This is why the sooner we can act, the better. At our office, we stress the “Big Three”: (1) Nasal breathing, (2) Lips together, (3) Tongue at the roof of your mouth. The more someone practices this, the better the breathing habits they will develop over time.

But why does mouth breathing happen to begin with? Why would a child favor mouth breathing to nose breathing?

A number of reasons could be behind it. Tonsils can be enlarged. So can adenoids. The child may have a deviated nasal septum, where the thin wall between the nostrils is displaced, or suffer from allergies that clog up the nose.

When breathing through the nose becomes difficult for whatever reason, the natural urge is to switch to the mouth. After all, breathing is so crucial to our health and survival that the body gives us two ways to accomplish it.

One of those ways happens to be superior to the other.

What We Evaluate During a Consultation Appointment

We all breathe through our mouths some of the time; the trouble occurs when someone becomes a mouth breather almost exclusively.

So what can be done if your child routinely chooses the mouth over the nose? And how can you head off the troubles that could be brewing with the child’s teeth and jaws?

The first order of business is to determine the “why” behind the habit. With all of our patients at my office, we administer a Pediatric Sleep Questionnaire. This is a tool that helps us screen for sleep-disordered breathing or sleep apnea. In some cases, we will refer the patient to an ear, nose and throat specialist.

An examination can tell us a lot, such as whether they have a high, narrow palate, if they have an overbite, if they have an underbite, or if they have severe crowding. Often, a narrow jaw develops because the tongue is not resting at the roof of the mouth.

Recommendations

Once we’ve determined the problem, we can then decide on a course of action.

Mouth breathing can lead to an underbite, severe crowding, or a backward growth pattern for the jaw. Treatment often involves trying to regain or counteract what has been lost. For example, you can stimulate the forward growth of the upper jaw with different appliances or a facemask.

Many children whose mouths are headed for a crowded future are helped by palatal expanders. The expander is attached to the upper back teeth and applies gentle pressure that, over time, widens the jaw, allowing more room for incoming adult teeth.

Another appliance some patients use is Advanced Light Force (ALF). ALF uses light flexible wires to correct crooked teeth and to develop the upper jaw and midface forward.

But even if the underlying physical problem is addressed, that mouth-breathing habit can be ingrained, and if the patient — child or adult — continues to breathe incorrectly, the treatment could relapse. So another treatment that helps is myofunctional therapy, which is a sort of physical therapy for the mouth where we retrain the child on proper breathing, swallowing, and where to rest the tongue.

Myofunctional therapy takes the patient through exercises that help improve breathing, including learning to use an optimal resting posture. This takes us back to numbers two and three of the Big Three I mentioned earlier. That resting posture is lips together and tongue at the top of the mouth. Myofunctional therapy is especially important if the child’s tonsils or adenoids have been removed. If the child continues to mouth breathe after surgery, the glandular tissue can swell again. I’ve had patients whose tonsils and adenoids had to be removed again because of this.

The myofunctional therapy exercises are easy and painless, and once the patient learns them they can do them at home on their own.

It may seem odd that, as natural as breathing is, many people still need to learn to do it correctly. If you’re a mouth breather — or your child is — there’s no time like the present to start practicing The Big Three.