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Mouth Breathing

Posted Sep 12 2012 4:52am

Does your child feel tired or sleepy easily in the day?

Is your child hyperactive and has poor concentration in school?

Does your child wet the bed at night although he or she is toilet trained in the day?

Mouth breathing occurs when a child suffers from nasal congestion or allergies which lead to difficulty in breathing through the nose.  It can have an adverse effect on a child’s facial growth, behaviour and general health as important nasal functions are bypassed.

As air passes through the nose, it is filtered and cleansed of dust particles, bacteria and other impurities. It is also moistened and warmed. Children who breathe through the mouth, on the other hand, take in less oxygen, causing them to sleep poorly, tire more easily and suffer from concentration and behavioural issues.


Facial Growth:

Research has shown that about half of the growth of the face takes place during the first 4 years of life and the majority are completed by 12 years old. Development of the lower jaw continues until about 18 years old.

The shape of a child’s face may be overly long and narrow with protruding upper teeth due to a high-arched palate.  This typically occurs in people who habitually breathe through their mouth, resulting in an open mouth posture at rest.  With an open mouth posture, the tongue cannot rest against the palate, leading to a narrower constricted upper jaw and increasing the length of the face.

A narrower constricted upper jaw and potential teeth shift may affect the bite of a child.  Where the upper teeth no longer fits over the lower teeth, a “cross-bite” will develop. This malalignment, besides looking bad, can affect jaw functions, causing problems with chewing and swallowing.


Physical and Behavioural Problems:

Due to poor sleep patterns, the growth hormones production in children are affected. Typically, these children appear small and short. They also have dark circles beneath the eyes and have altered body posture with a reflex forward head position.

In some children, a severe upper airway blockage can cause breathing to stop during sleep. This is called sleep apnea.  Hence, a lack of proper sleep can lead to excessive daytime sleepiness and fatigue.  These children may have problem with concentration, resulting in learning difficulties and behavioural issues. Other signs associated with mouth breathing include headaches, snoring and enuresis (bedwetting).


Primarily, it is important to consult your GP or ENT surgeon to ascertain the causes of mouth breathing in your child. They may have enlarged tonsils, deviated nasal septum, nasal polyps, allergies, etc.

To have proper facial growth, early intervention with nasal breathing and tongue posture is essential.  The undesirable effects of nasal obstruction are virtually complete by puberty so the window of opportunity is rather short. Treatment involves expansion of the upper jaw with an orthodontic appliance, which also often improves breathing.

If a child develops a “crossbite” where the forces on the teeth are not even, asymmetry in the development of the jaws can also occur. Delay in intervention may result in less successful orthodontic (braces) treatment which may require orthognathic (jaw) surgery at an older age.

As a father of two, i can understand the concern of parents. So, see your dentist for a proper evaluation of your child’s mouth and jaw development. Early diagnosis and intervention can help your child’s face to grow more attractive, sleep better and do better in school. It is life changing.

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