Danger to teeth when a child breathes through their mouth

Do you often see your child breathing through their mouth? Do you hear them snoring every night? If yes, it is a good idea to have an orthodontist examine them, as chronic mouth breathing can seriously affect the development of their teeth and face.

Mouth breathing is very common. Studies have shown that nearly one in four children breathe through their mouth either due to pathological and anatomical reasons, or because they got used to it during, for example, a respiratory infection. However, since the child is a developing organism, this seemingly innocent dysfunction can have devastating consequences.

As explained by Dr. Katerina Douma-Michelaki, DDS, PhD, Pediatric & Adult Orthodontist (http://www.greatsmiles.gr), mouth breathing, which can begin in childhood and continue unnoticed into adulthood, has two main types: pathological and habitual.

“Pathological mouth breathing is usually due to hypertrophic adenoids (tonsils) or a deviated septum, or allergies such as asthma and allergic rhinitis. These conditions cause blockage of the nasal airway, forcing the child to breathe through their mouth day and night to get the oxygen their body needs,” she says.

In contrast, habitual mouth breathing develops when the child gets used to breathing through their mouth after a severe respiratory infection that caused nasal congestion (stuffiness), or after an allergic crisis that forced them to breathe through their mouth until they recovered. Intense orthodontic abnormalities that prevent the child from closing their mouth properly can also play a role, worsening the mouth breathing.

“A parent can tell if their child has this dysfunction by observing them from a distance when they are watching TV alone or playing,” continues Dr. Douma-Michelaki. “If the child does not have their lips completely closed but constantly keeps them slightly open, it is likely that they are breathing through their mouth. Other suspicious signs include snoring (which is never normal or expected in children), dark circles under the eyes, crooked teeth, and chronic bad breath.”

Unfortunately, mouth breathing has serious physical and psychological consequences, which are not widely known. “Mouth breathing is associated with many problems in the development of the face and mouth, which were first described by Hippocrates,” says the specialist. She adds that many studies have shown that children who breathe through their mouth over time show specific craniofacial changes, such as:

* Elongated face (becomes long and narrow).

* Narrow palate. Normally, the tongue presses the palate when swallowing, but in individuals with mouth breathing, the tongue learns to stay low in the mouth to allow the person to breathe while eating. Thus, throughout the day, the tongue’s position is disturbed.

* Rotation of the lower jaw backward and downward, and very narrow upper jaw.

* Poor dental occlusion with severely crooked teeth.

* Overgrowth of the gums, which is especially visible when the person smiles.

Additionally, children have reduced saliva production and dry mouth, which in turn can lead to demineralization of the teeth and increased risk of chronic gingivitis, periodontitis, fungal infections like candida, and bad breath.

The developmental deformities are mainly due to the effects that mouth breathing has on the muscular system, especially the muscles of the face, tongue, and neck. In fact, the development of the face and mouth can be affected so much that the child may later need corrective jaw surgery. If mouth breathing continues into adulthood, the individual may develop other problems, such as unexplained headaches or temporomandibular joint syndrome due to issues in the joint that connects the upper and lower jaw (temporomandibular).

Consequences can also affect the respiratory system. Under normal conditions, when we breathe through our nose, the air is cleaned and processed before reaching the lungs, but with mouth breathing, all airborne particles enter directly into the lungs. Furthermore, because the air reaching the lungs is dry and cold as it hasn’t passed through the nose to be warmed, oxygen intake is slowed down, while inhaled allergens can easily reach the lungs, potentially triggering an asthma attack, for example.

Additionally, children may not sleep well at night due to airway obstruction, and the lack of sleep negatively affects not only their development but also their performance in school. Very often, these children are wrongly diagnosed with attention-deficit hyperactivity disorder (ADHD), while in reality, their difficulties in concentration, nervousness, and other symptoms are due to poor sleep quality and the other consequences mouth breathing has on their brain and body development.

“For all these reasons, it is very important to diagnose the problem early so that the obstruction in nasal breathing can be addressed and the orthodontic problems corrected as soon as possible. Even in children as young as 6 years old, we can detect mouth breathing and provide simple devices that encourage normal nasal breathing and thus good alignment and occlusion of the teeth,” emphasizes Dr. Douma-Michelaki. She concludes: “Of course, the assessment and final treatment plan for children with chronic mouth breathing requires collaboration between the orthodontist, the pediatrician, and possibly the otolaryngologist to provide the child with the best possible care.”