- Updated on August 3, 2021
By Dr. Artour Rakhimov, Alternative Health Educator and Author
In order to understand the broad scope of pathological effects of mouth breathing, consider the following titles of recent research studies (click on the title to read abstracts cited below):
Prevalence of malocclusion among mouth breathing children: do expectations meet reality? (Souki et al, 2009)
Etiology, clinical manifestations and concurrent findings in mouth-breathing children (Abreu et al, 2008)
Relationship between mouth breathing and postural alterations of children: a descriptive analysis (Krakauer et al, 2000)
Radiological evaluation of facial types in mouth breathing children: a retrospective study (Costa et al, 2008)
Indicative factors of early facial aging in mouth breathing adults (Oliveira et al, 2007)
Prevalence of oral malodor and the relationship with habitual mouth breathing in children (Kanehira et al, 2004)
A comparative study of effects of mouth breathing and normal breathing on gingival health in children (Gulati, 1998)
The negative effect of mouth breathing on the body and development of the child (Flutter, 2006)
Prevalence of malocclusion among mouth breathing children: do expectations meet reality?
Souki BQ, Pimenta GB, Souki MQ, Franco LP, Becker HM, Pinto JA,
Int J Pediatr Otorhinolaryngol. 2009 May; 73(5): p.767-773.
Federal University of Minas Gerais, Outpatient Clinic for Mouth-Breathers, Belo Horizonte, Brazil
OBJECTIVE: The aim of this study was to report epidemiological data on the prevalence of malocclusion among a group of children, consecutively admitted at a referral mouth breathing otorhinolaryngological (ENT) center. We assessed the association between the severity of the obstruction by adenoids/tonsils hyperplasia or the presence of allergic rhinitis and the prevalence of class II malocclusion, anterior open bite and posterior crossbite. METHODS: Cross-sectional, descriptive study, carried out at an Outpatient Clinic for Mouth-Breathers. Dental inter-arch relationship and nasal obstructive variables were diagnosed and the appropriate cross-tabulations were done. RESULTS: Four hundred and one patients were included. Mean age was 6 years and 6 months (S.D.: 2 years and 7 months), ranging from 2 to 12 years. All subjects were evaluated by otorhinolaryngologists to confirm mouth breathing. Adenoid/tonsil obstruction was detected in 71.8% of this sample, regardless of the presence of rhinitis. Allergic rhinitis alone was found in 18.7% of the children. Non-obstructive mouth breathing was diagnosed in 9.5% of this sample. Posterior crossbite was detected in almost 30% of the children during primary and mixed dentitions and 48% in permanent dentition. During mixed and permanent dentitions, anterior open bite and class II malocclusion were highly prevalent. More than 50% of the mouth breathing children carried a normal inter-arch relationship in the sagital, transversal and vertical planes. Univariate analysis showed no significant association between the type of the obstruction (adenoids/tonsils obstructive hyperplasia or the presence of allergic rhinitis) and malocclusions (class II, anterior open bite and posterior crossbite). CONCLUSIONS: The prevalence of posterior crossbite is higher in mouth breathing children than in the general population. During mixed and permanent dentitions, anterior open bite and class II malocclusion were more likely to be present in mouth breathers. Although more children showed these malocclusions, most mouth breathing children evaluated in this study did not match the expected “mouth breathing dental stereotype”. In this population of mouth breathing children, the obstructive size of adenoids or tonsils and the presence of rhinitis were not risk factors to the development of class II malocclusion, anterior open bite or posterior crossbite.
Etiology, clinical manifestations and concurrent findings in mouth-breathing children [Article in English, Portuguese]
Abreu RR, Rocha RL, Lamounier JA, Guerra AF,
J Pediatr (Rio J). 2008 Nov-Dec; 84(6): p.529-535.
Centro de Patrial fibrillations-Graduaatrial fibrillationatrial fibrillationo, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
OBJECTIVE: To investigate the etiology, main clinical manifestations and other concurrent findings in mouth-breathing children aged 3 to 9 years and resident in the urban area of Abaetatrial fibrillation (MG), Brazil. METHODS: This study was based on a representative random sample of the town population, of 23,596 inhabitants. Clinical diagnosis of mouth-breathing was defined as a combination of snoring, sleeping with mouth open, drooling on the pillow and frequent or intermittent nasal obstruction. Children with a clinical diagnosis of mouth-breathing underwent nasal endoscopy, allergy skin tests and X ray of the rhinopharynx, full blood tests, eosinophil counts, total IgE assay and fecal parasitology. Data were analyzed using SPSS version 10.5. RESULTS: The main causes of mouth-breathing were: allergic rhinitis (81.4%), enlarged adenoids (79.2%), enlarged tonsils (12.6%), and obstructive deviation of the nasal septum (1.0%). The main clinical manifestations of mouth breathers were: sleeping with mouth open (86%), snoring (79%), itchy nose (77%), drooling on the pillow (62%), nocturnal sleep problems or agitated sleep (62%), nasal obstruction (49%), and irritability during the day (43%). CONCLUSION: Certain clinical manifestations are very common among mouth-breathing children. These manifestations must be recognized and considered in the clinical diagnosis of mouth-breathing.
Relationship between mouth breathing and postural alterations of children: a descriptive analysis
Krakauer LH, Guilherme A,
Int J Orofacial Myology. 2000 Nov; 26: p.13-23.
The research within this article seeks to verify and demonstrate the consequences of mouth breathing versus nasal respiration and to view supposed postural alterations in groups of children within specific age ranges. The authors state that children with nasal respiration, age 8 and above, present with better posture than those who continue oral breathing beyond age 8. The importance of picture documentation is stressed in order to provide the most information regarding postural changes. A review of research and literature is provided in the article.
Radiological evaluation of facial types in mouth breathing children: a retrospective study
Costa JR, Pereira SR, Weckx LL, Pignatari SN, Uema SF,
Int J Orthod Milwaukee. 2008 Winter; 19(4): p.13-16.
Federal University of Satrial fibrillationo Paulo, Satrial fibrillationo Paulo, Brazil.
Mouth breathing is a condition often associated with a long face, half-open mouth and increased anterior facial height. We performed conventional lateral and frontal cephalograms of eighty-nine children with nasal and mouth breathing and independently measured Total Facial Height using the analysis technique of Ricketts, and the Morphologic Facial Index employing the technique of Avila. It was concluded that dolicofacial following mesofacial were the most frequent patterns found in mouth-breathing children and this suggests that both analyses can be used independently.
Indicative factors of early facial aging in mouth breathing adults [Article in Portuguese]
Oliveira AC, Dos Anjos CA, Silva EH, Menezes Pde L,
Pro Fono. 2007 Jul-Sep; 19(3): p.305-312.
Associaatrial fibrillationatrial fibrillationo Brasileira de Otorrinolaringologia e Cirurgia Catrial fibrillationrvico-Facial, Brazil.
BACKGROUND: Early facial aging in mouth breathing adults. AIM: To verify the presence of indicative factors of early facial aging and to characterize the measurements of the projection of the nasogeniane fold to the tragus and of the face width in mouth and nose breathing adults. METHOD: Aspects of early facial aging were observed in 60 individuals (presence of dark circles and wrinkles under the eyes, mentual wrinkles and mentual ridges). Measurements of the projection of the nasogeniane fold to the tragus and of the face width (distance between the buccinators) were taken using a digital caliper. Later, the volunteers were submitted to speech-language evaluations (anamneses and orofacial myofuntional assessment) and to an otolaryngology inspection in order to establish the diagnosis of mouth breathing (anamneses, clinical evaluation and video laryngoscopy). The obtained data were analyzed according to descriptive statistics and to the following statistic tests: Kolmogorov-Smirnov, Shapiro-Wilk, Qui-square, Mann-Withney and the T-Student test for independent variables. Differences were considered significant when the p value was inferior to .05 and the accepted beta error was of .1. RESULTS: The research sample consisted only of female volunteers. For the research group (mouth breathers) the age average was of 22.04 +/- 2.25 years and, for the control group (nose breathers) the age average was of 21.94 +/- 2.03 years. The presence of a high percentage of indicative factors of early facial aging was observed for the group of mouth breathers when compared to the group of nose breathers. Greater differences between the projections of the nasogenianos ridges in right and left side of the face was also observed for the group of mouth breathers. However, higher values of face widths were observed for the nose breathing individuals, configuring a discreetly more widened face in the cheek region. CONCLUSIONS: In the present study there was a higher indication of early facial aging for the group of mouth breathers.
Prevalence of oral malodor and the relationship with habitual mouth breathing in children
Kanehira T, Takehara J, Takahashi D, Honda O, Morita M,
J Clin Pediatr Dent. 2004 Summer; 28(4): p.285-288.
Department of Oral Health Science, Hokkaido University, Graduate School of Dental Medicine, Sapporo, Japan.
The prevalence of oral malodor and association of habitual mouth breathing with oral malodor were investigated in children residing in rural areas. One hundred and nineteen children participated in this study. A sulfide monitor and organoleptic method were used to evaluate oral malodor. About 8% of children had a sulfide level in mouth air above the socially acceptable limit (75 ppb). Habitual mouth breathing was a factor contributing to oral malodor. Oral malodor was not significantly correlated with plaque index, history of caries or frequency of tooth brushing.
A comparative study of effects of mouth breathing and normal breathing on gingival health in children
Gulati MS, Grewal N, Kaur A,
J Indian Soc Pedod Prev Dent. 1998 Sep; 16(3): p.72-83.
Department of Pedodontia and Preventive Dentistry, Pb. Govt. Dental College and Hospital, Amritsar.
The present study was conducted to assess the effects of mouth breathing, lip seal and upper lip coverage on gingival health of children. 240 school children aged 10-14 years were selected irrespective of sex race and socioeconomic status. They were divided into two major groups i.e. mouth breathers and normal breathers. These groups were further subdivided into six sub-groups or categories on the basis of lip seal and upper incisor coverage. Gingival index was found to be higher in the mouth breathers than in the normal breathers in the subjects with incompetent lip seal. Increased lip separation and decreased upper lip coverage were all associated with higher levels of Plaque index and Gingival index. No statistical difference existed between mouth breathers and normal breathers with respect to Plaque index.
The negative effect of mouth breathing on the body and development of the child
Flutter J, Int J Orthod Milwaukee. 2006 Summer; 17(2): p.31-37. No abstract available.
