Updated: Sep 3, 2019
Many of our students who struggle at school are chronic “mouth-breathers” – so we offer this information in the hopes that it may enable you to help your child (or yourself) to cure a problem that has massive implications for learning and health:
Mouth Breathing: Symptoms, Complications, and Treatments
We have two air passageways to our lungs — the nose and the mouth. Breathing through the mouth is only necessary when you have nasal congestion due to allergies or a cold, or when exercising strenuously (mouth breathing can help get oxygen to your muscles).
However, breathing through the mouth all the time, including when you are sleeping, can lead to problems.
In children, mouth breathing can cause crooked teeth, facial deformities and poor growth.
In adults, chronic mouth breathing can cause bad breath, gum disease and worsen symptoms of other illnesses.
A stuffy nose can affect your ability to sleep well and function in general.
Advantages of breathing through the nose:
The nose produces nitric oxide to improve the lungs’ ability to absorb oxygen, and increase the ability to transport oxygen throughout the body, including inside the heart. It relaxes muscles and allows blood vessels to dilate. Nitric oxide is anti-fungal, anti-viral, anti-parasitic and antibacterial - helping the immune system to fight infections. The nose:
· Acts as a filter to retains small particles in the air, including pollen.
· Adds moisture to the air to prevent dryness in the lungs and bronchial tubes.
· Warms cold air to body temperature before it reaches the lungs – the delicate tissues of which are adversely affected by cold air.
Nose breathing increases oxygen uptake by maintaining elasticity of the lungs.
You may not realise you are breathing through your mouth instead of your nose, especially while you sleep.
People who breathe through the mouth at night may have the following symptoms:
· dry mouth
· bad breath (halitosis)
· waking up tired and irritable
· chronic fatigue
· brain fog
· dark circles under the eyes
Symptoms in children
It is important for parents to look for signs of mouth breathing in children. Children who are mouth breathers will breathe (and eat) with their mouth open, snore at night and may have the following symptoms:
· slower than normal growth rate
· increased crying episodes at night
· large tonsils
· dry, cracked lips
· problems concentrating at school
· day-time sleepiness
Children who exhibit problems concentrating at school are often misdiagnosed with attention deficit disorder (ADD) or hyperactivity.
Causes of mouth breathing: usually an obstructed (completely or partially blocked) nasal airway - preventing the passage of air into the nose. Causes of a blocked nose include:
· nasal congestion caused by chronic allergies, colds or sinus infection
· enlarged adenoids
· enlarged tonsils
· deviated nasal septum
· enlarged turbinates (nasal ridges to warm air)
· shape of the nose
· shape and size of the jaw
· nasal/sinus polyps or benign growths of tissue in the lining of the nose
· tumours (rare)
· cleft palate
· history of finger or thumb-sucking
Some people develop a habit of breathing through their mouth instead of their nose even after the nasal obstruction clears. For some people with sleep apnoea it is just a habit to sleep with their mouth open.
Stress and anxiety leads to shallow, rapid, and abnormal breathing - through the mouth instead of the nose.
Risk factors for mouth breathing:
· chronic allergies
· hay fever
· chronic or recurring sinus infections
· chronic stress and anxiety
Mouth breathing can lead to health problems:
Mouth breathing is very drying. A dry mouth lacks saliva to wash bacteria from the mouth. This can lead to:
· bad breath (halitosis)
· periodontal disease, such as gingivitis and tooth cavities
· throat and ear infections
· exercise-induced asthma - the breath does not get as warm or moist, required to reduce airway irritation.
· orthodontic work complications
· digestive system issues: mouth-breathing by-passes the nasal dust-and-germ-filtering system, so irritants and germs are swallowed.
Mouth breathing may result in low blood-oxygen concentrations, associated with high blood pressure and heart failure.
Mouth breathing may decrease lung function, worsening symptoms in asthma.
Speech: an open mouth also has a “tongue thrust swallowing pattern” causing the tongue to protrude, or push forward during speaking and swallowing. Open-mouthed children are more likely to struggle with certain speech sounds. The most common associated speech problem is a lisp, or the inability to say “S” sounds correctly.
Speech is also affected because mouth breathing can lead to physical abnormalities and cognitive challenges. Left untreated children can develop:
· long, narrow faces
· narrow mouths
· gummy smiles
· poor posture
· dental malocclusion, including a large over-bite and crowded teeth
· chronically red and inflamed gums, even if their oral health-care is good.
Adults may also find they have bleeding gums, or get frequent cavities.
Facial growth and development: an open-mouthed child will likely grow into an adult with flatter facial features, less prominent cheekbones, a longer face, droopier eyes and lower facial muscle tone, a narrower palate and even a smaller lower jaw (receding chin) in most cases. By closing the mouth and breathing through the nose, these negative growth patterns can be prevented or reversed if the child is young enough.
Sleep and oxygen: people who breathe through their mouths during the day, usually also breathe through their mouths all night long. Mouth breathing at night, combined with an obstructed airway, are directly connected to sleep apnoea and altered levels of carbon-dioxide and oxygen in the bloodstream.
Children who breathe through their mouths often do not sleep well at night. Poor sleep can lead to:
· poor growth
· poor academic performance
· inability to concentrate
· sleep disorders
When less oxygen is able to reach the brain, learning, and the ability to focus at school, becomes difficult.
Adults with a history of sleep apnoea may find their symptoms worsened by mouth breathing, which can cause a person to sleep with their jaw and mouth in a position that does not support breathing, causing difficulty breathing and getting a good night's sleep, leading to chronic fatigue, tiredness and brain-fog.
Treating mouth breathing depends on the cause. Medications can treat nasal congestion due to colds and allergies:
· nasal decongestants
· prescription or over-the-counter steroid nasal sprays
Adhesive strips applied to the bridge of the nose can also help breathing. A stiff adhesive strip called a nasal dilator applied across the nostrils helps decrease airflow resistance and helps breathing more easily through the nose.
For obstructive sleep apnoea, you may need to wear a face mask appliance at night called continuous positive air pressure therapy (CPAP) to deliver air to your nose and mouth through a mask. The pressure of the air prevents airways from collapsing and becoming blocked.
In children, surgical removal of swollen tonsils and adenoids can treat mouth breathing. A dentist may recommend that a child wears an appliance designed to widen the palate and help open the sinuses and nasal passages. Braces and other orthodontic treatments may also help treat the underlying cause of mouth breathing.
Early treatment of mouth breathing in children can reduce or prevent the negative effects on facial and dental development. Children who receive surgery or other intervention to reduce mouth breathing show improvement in energy levels, behaviour, academic performance and growth.
Untreated mouth breathing can lead to tooth decay and gum disease. Poor sleep caused by mouth breathing can reduce quality of life and exacerbate stress.
Chronic mouth breathing caused by the shape of a face or nose cannot always be prevented.
If your nose is frequently congested due to allergies or respiratory infections, there are ways to prevent making mouth breathing becoming a habit.
Address nasal congestion or dryness right away.
Tips for preventing mouth breathing include:
· using a saline mist during long flights or cruises
· using saline nasal mists and sprays and nasal decongestants or allergy reliever medications at the first sign of allergy or cold symptoms
· sleeping on your back with your head elevated to open up the airways and promote nasal breathing
· keeping your house clean and free of allergens
· installing air filters in heat and air conditioning (HVAC) systems to prevent the spread of allergens in the house
· consciously practicing breathing through your nose during the day to help force yourself into a habit of nose breathing
· removal of tonsils and adenoids
Some foods contribute to inflammation of the airways, so should be avoided by those who are prone to nasal or lung congestion:
Foods to Avoid:
· Capsicum – which contain capsaicin (red, green or gold peppers, also known as chili pepper, jalapeno [chipotle] or paprika.) The only pepper without capsaicin is the bell pepper (and pimiento spice).
· Processed (refined) carbohydrates: pasta, white rice, white flour – and all the products made form them: bread, cakes, biscuits, crackers, pizza dough, baked desserts, pastries, pancakes, waffles, etc.
· Salty foods
· Dairy products
· Fried foods
· Processed meat
Helpful foods (which lower inflammation):
· Fresh fruit and vegetables (especially: green, leafy vegetables, kumara, citrus, tomatoes, asparagus)
· Berries: strawberries, blueberries, cherries
· Oily fish: salmon, mackerel, tuna, sardines, swordfish, trout
· Spices: black pepper, turmeric, ginger, cinnamon
· Olive oil
· Nuts and beans
· Whole grains