Posted by on Oct 21, 2018 in Uncategorized

Children’s dental & facial development


Negative impact of mouth breathing on children’s facial growth

“The vast majority of health care professionals are unaware of the negative impact of upper airway obstruction (mouth breathing) on normal facial growth and physiologic health. Children whose mouth breathing is untreated may develop long, narrow faces, narrow mouths, high palatal vaults, dental malocclusion, gummy smiles, and many other unattractive facial features. ……………….”

“These children do not sleep well at night due to obstructed airways; this lack of sleep can adversely affect their growth and academic performance. Many of these children are misdiagnosed with attention deficit disorder (ADD) and hyperactivity.”

“It is important for the entire health care community (including general and paediatric dentists) to screen and diagnose for mouth breathing in adults and in children as young as 5 years of age. If mouth breathing is treated early, its negative effect on facial and dental development and the medical and social problems associated with it can be reduced or averted”.

The above quotes are from an article by Dr. Yosh Jefferson titled ‘Mouth breathing: adverse effects on facial growth, health, academics, and behavior’. It was published in the journal General Dentistry. You may access this article here.

Studies report that over 50% of children persistently breathe through an open mouth. This can cause disrupted sleep, adversely impact on academic performance, and negatively affect facial features and teeth. It is vitally important for children to breathe through their nose with their tongue resting in the roof of the mouth.

A good-looking face is determined by a strong, sturdy chin, developed jaws, high cheekbones, good lips, correct nose size and straight teeth. When a face develops correctly, it follows that the teeth will be straight. Straight teeth do not create a good-looking face, but a good-looking face will create straight teeth.

If the mouth is hanging open, the tongue is not in the correct resting position. Instead the forces of gravity pull the face downwards. The jaws become narrow, causing overcrowding of teeth and become set back in the face, reducing the size of the upper airway. The result is increased risk of lifelong sleep disordered breathing including obstructive sleep apnoea, poor academic performance, behavioural issues and a less attractive face.

It is vitally important for good health and for the development of an attractive face, that parents of children understand the importance of nose breathing during childhood.

Immediately below, is a link to a very interesting 16 minute video produced by the Dental Foundation. It features orthodontist Dr. John Flutter at a Breathing Conference where he is presenting on how mouth breathing has a negative impact on children’s teeth and facial development.

There is an increasing awareness in the dental profession of the importance of avoiding mouth breathing at an early age for the proper development of healthy teeth and jaws.

Children who mouth-breathe are more prone to enlarged adenoids/tonsils, glue-ear, respiratory infections, asthma, allergies and chronic cough. If the incorrect breathing habits are not corrected, it can lead to crooked teeth, receding chin, protruding nose, narrow airway and a high risk of developing obstructive sleep apnoea, respiratory disorders and cardiovascular risk as adults.

Signs and symptoms of mouth breathing may include:

  • Open-mouth posture, especially while sleeping
  • Dry lips
  • Crowded teeth
  • Increasingly long and narrow face (long face syndrome)
  • Gums show when smiling
  • Bad breath (halitosis)
  • Dark circles under the eyes “allergic shiners”
  • Snoring or audible breathing during sleep
  • Sleep apnoea (breathing stops for short intervals)
  • Daytime sleepiness
  • Frequent respiratory infections (colds, ear infections, sinusitis)

Before and after mouth breathing

The first photograph below shows a 10 year old boy, as he was, as a nose breather. He has a good looking broad face with everything in proportion. He exhibits well defined cheekbones and chin. On his 14th birthday he received a gerbil as a present. Shortly afterwards his nose began to block, causing him to breathe through his mouth. Within 3 years his face had changed its shape considerably. The second and third photographs are of the same boy at age 17.

Because he mouth breathed for 3 years, his face grew downwards instead of in width. His face became narrow and long. His jaws became set back from their natural position. He developed a double chin and his jaws came back on his airways, resulting in smaller airways. This can result in health problems such as sleep apnoea. His nose appears much larger because his jaws have moved backwards and his cheeks are sunken. This face is typical of the large number of children who habitually breathe through their mouths.

The information and accompanying photographs above are courtesy of Patrick McKeown (Buteyko Clinic International) and Dr. John Mew (London School of Facial Orthotropics).

Chronic mouth breathing is increasing being recognised as a concern by dentists. Some of the problems it causes or contributes to are listed below:

  • Forward head posture (neck muscle pain, stiffness, fatigue and cervical joint damage)
  • Headache
  • Elongated face
  • Malocclusion, anterior open bite
  • TMJ dysfunction
  • Gum disease
  • Reduced dental arch space and increased crowding of teeth
  • Dental decay and infection
  • Dry mouth and throat
  • Dry lips
  • Increased allergen/infection entry to lungs
  • Chronic tonsil swelling
  • Enlarged adenoids, polyps
  • Gums shown when smiling
  • Noisy breathing
  • Noisy eating
  • Bad breath
  • Snoring, apnoea
  • Greater potential for relapse of orthodontic correction
  • Increased mucus production
  • Hypocapnia
  • Dark circles under the eyes “allergic shiners”
  • Daytime sleepiness
  • Frequent respiratory infections (colds, ear infections, sinusitis)By learning to correct breathing patterns with Buteyko Breathing Method, a child can prevent many of these problems occurring and in some cases they can begin to be reversed (age dependent).