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Mouth Breathing?

Five important reasons why your child shouldn’t.

By: Dr. Maribel Santos-Cordero

The nose is for breathing, and the mouth is for eating. Pretty simple, right? So, why don’t we all use the nose to breathe? I was once evaluating a child with sleep apnea and asked him if he was a nose or mouth breather. He said: “Both! When my nose is not working, my mouth helps.” He was not wrong. Nasal breathing requires lips together, tongue on the palate and a nose free of obstruction. The inability to breathe normally through the nose forces your mouth to do the job.

The nose is “the filter” of your body. The cilia (little hairs) inside your nose help keep dust and microbes away from your lungs. Nitric oxide is produced in the nose to improve your lung’s ability to increase and transport oxygen throughout your body. It also helps the immune system fight infections. When you mouth-breathe, your tonsils are forced to “clean-up”. Unfortunately, they can’t purify the air and often become inflamed. Inflammation makes it more difficult to breathe. As impurities make their way to the lungs, allergies, asthma and eczema may be triggered. Many children with recurrent allergies and congestion resort to mouth-breathing as a habit and a necessity. And the cycle begins again.

What can interfere with proper breathing?

  • An obstruction in the form of enlarged turbinates, deviated septum, swollen tonsils or adenoids will not allow air to fully pass through the nose.

  • Nasal congestion from chronic allergies, asthma, recurrent colds, or sinus infections builds up mucus and creates inflammation making it difficult to clear your nose.

  • A tongue-tie may restrict movement by keeping the tongue low in the mouth and preventing it from placing forces against the palate (roof-of-mouth) when swallowing. This will make the palate grow high and narrow making the nasal cavity smaller.

  • Stress and anxiety activate the sympathetic nervous system (fight or flight) and promotes rapid, shallow breathing through the mouth.

Why shouldn’t your child use their mouth to breathe routinely?

  1. Facial deformities - In a growing child, the growth of the head and face gets affected by forces applied by the soft tissue against the bone. When the mouth is open, the lower jaw brings the tongue down with it and does not allow it to put pressure on the palate. Unable to counteract the forces of the cheek muscles, the upper jaw becomes high and narrow, the face grows long, and the jaws set back.

  2. Cognitive challenges – Sleeping with the mouth open can cause the tongue and the jaw to hang back into the airway when your child relaxes into a deeper sleep. The brain interprets this reduced airflow as a threat and continues to wake up your child at night. Restless sleep, snoring, dark circles around the eyes, grinding, nightmares, and bed-wetting are a few signs of sleep breathing disorders. A child that is not able to get proper sleep at night may not be able to focus and concentrate properly; thus, struggling with academic performance, anxiety, and uncooperative behavior.

  3. Crooked teeth - Crowding and cross bites are common in mouth-breathing children. As the upper jaw grows higher and narrower, it can’t fit like a lid on a box on the lower jaw. Consequently, teeth can’t fit in the space. Open bites and bucked teeth are also seen when children thrust the tongue forward because of a lack of space in the mouth.

  4. Difficulties with eating and speaking – Children with limited space for the tongue or compromised tongue mobility may show a delay in speech or speech errors beyond typical development. Restricted tongue movement and an open mouth posture can create an incorrect swallowing pattern and impact children as they progress to pureed food, cup-drinking, straw-drinking and solid foods.

  5. Chronic health issues – Children who mouth-breathe tend to have a slower than normal growth rate, chronic allergies, eczema, recurrent asthma, sleep apnea and a higher number of dental cavities. Over the years, if left untreated, they may develop high blood pressure and heart problems.

An easy way to know if your child is a chronic mouth-breather is by observation. Does he have dry chapped lips all the time? Is she keeping the mouth open when watching TV? Is sleeping with your child almost impossible?

Mouth-breathing can affect your child’s quality of life. Children who receive early intervention can show significant improvement in growth, development, behavior, and academic performance. The key is to identify the root cause of the mouth-breathing. Treatment may require multiple specialists to deal with nasal and airway obstructions and/or dental issues. By identifying the source early in life, and eliminating it, we allow children to become the best version of themselves. Breathe better to live better!


Dr. Maribel Santos-Cordero is a board-certified & laser certified pediatric dentist in Lakewood Ranch dedicated to the oral health of children, adolescents, and children with special needs. She believes in helping children achieve their full potential by providing all the necessary tools to guide their growth and development. Visit www.sarasotachildrendentistry.com or call 941-907-7762 to learn more about her practice.


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