Mouth Breathing

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Does it matter how we breath?

Obviously, there are two main entrance options for breathing - the mouth or the nose. Does it matter which one we intake air through? The answer is a definite "yes!" It affects our health, learning, sleep, and the development of our mouth and face.

Advantages to Nasal Breathing

Nasal breathing has many advantages not achieved when we breathe through our mouth. 

- Humidifies the air

- Filters and warms the air, decreasing the chance of developing colds, sinus & ear infections, croup and asthma.

- Creates Nitric Oxide (see below)

- Helps in proper jaw and facial development

- Directs air to the lower lung area, where more blood is oxygenated

- Reduces the production of stress hormones and brings about relaxation. Breathing through the mouth, according to Physician Christine Northrup (author of several books which discusses this physiological reaction), causes a stress response and release of stress hormones within the body. 

- Metabolism improves because better oxygen consumption in the body allows better metabolism of food. 

-Maintains rib cage flexibility, allowing for maximum lung capacity and can achieve ideal oxygen flow to the body and brain. 

- Stimulates the vagus nerve in the upper abdomen, which allows a lower heart rate, even during vigorous activity. 

All of these are great benefits at any age, but recognizing the pivitol role that nasal breathing plays during a baby and child's development will have tremendous health benefits on that individual throughout their life. See TIPS on how to help start this habit right from birth. 

*From Diane Bahr, MS, CCC-SLP, CIMI, author of Nobody Ever Told Me (or My Mother) That!

Nitric Oxide has anti-bacterial properties, helping to decrease "the bad guys" as they enter your body - right at the entrance! Usually, this means that you get sick less. According to Dr. Page in his book, Your Jaws - Your Life, nitric oxide helps dilate blood vessels, inlcuding those in the lungs, and has an anti-inflammatory effect. It also helps oxygen to be absorbed by the lungs and transported throughout the body.

 

Functional, controlled, nasal diaphragm breathing also leads to better transfer of oxygen from the hemoglobin to the cells. (taught through the Buteyko Breathing Method, https://buteykoclinic.com/the-buteyko-method/)

 

When tonsil and/or adenoids are enlarged, due to increased size of the lymphoid tissue, this can cause the airway to become smaller. If the body can't get a good supply of oxygen, it will revert to whichever entrance will give it the most air, which is typically the mouth. It will also make accommodations to allow as much air as possible to enter the system. This can lead to postural changes, such as a forward head position. This position increases the likelihood of a poor oral posture and can lead to chronic tension/pain in the neck and shoulders. 

Enlarged tonsils and adenoids are typically more common in children than adults. The lymphoid tissues usually start to decrease in size after age 9, shrinking rapidly in the teen years. The problem with a "wait and see" approach is that crucial development occurs during those early years! A restricted airway can result in negative growth patterns of the face, mouth, and even brain development. According to research from Dr. Edmund Lipskis, Director at the Centre for Integrative Orthodontics, IQ scores are lowered when children experience restricted airway issues. If the underlying airway issues are eliminated prior to the age of 8, the effects on the brain appear to be reversible, and IQ scores increase. Unfortunately, the effects in the older test subjects appear to be more permanent. Dealing with these issues are not a one size fits all, research has shown that 67% of kids who are treated with a removal of their tonsils/adenoids relapse within 5 years, as the issue is with the nasal passage, not the tonsils and adenoids. The better able we are at determining all the underlying issues, the better able we are to properly address and treat, and then re-educate the muscles to achieve proper function.

 

If you take a moment to breathe through your mouth versus breathing through your nose, what do you notice? Most people experience a "dry" feeling in their mouth. Mouth breathing also leads to an increase in the amount of plaque, gum inflammation, and the bacteria that cause cavities in your mouth. Your chances for developing cavities are further increased due to the lack of saliva, which neutralizes the acidic by-products of bacteria.

Mouth Breathing and Sleep

Breathing through your mouth at night can cause sleep problems, usually progressive in nature: heavy breathing, snoring, sleep disordered breathing, upper airway resistance, and eventually, obstructive sleep apnea. Sleep apnea is a very dangerous condition where the airway becomes completely blocked off. Enlarged lymphoid tissues aren't the only thing that can cause a decreased airway space. Particularly in the case of obstructive sleep apnea, the tongue and other soft tissues fall back, blocking the path of air. The body needs some kind of mechanism to keep itself alive and will often move around, gasp, or begin to grind the teeth in an attempt to open the airway. In many of these conditions, the body rarely progresses into the deeper restorative states of sleep. Although someone may be getting adequate quantity of sleep, they may not be achieving the quality of sleep their body requires to perform at it's best during the day.

 

Some common signs and symptoms to watch out for are:

 

AT NIGHT

-Snore

-Stop Breathing

-Have their mouth open

-Breathe heavily

-Grind their teeth

-Sleep walk

-Sleep talk

-Wets the bed or gets up to use the bathroom during the night

-Experiences night terrors

-Sweat excessively

-Nose bleeds

-Drool

-Toss and turn significantly 

-Wake up through the night

-Difficulty falling asleep

 

DURING THE DAY (are there concerns about...)

-Concentration

-Behaviour

-School performance

-Emotional fragility

-Asthma

-Outbursts of anger

-Excessive energy levels (hyper activity)

-Tired in the morning

-Tired during the day

-Hay fever or runny nose

-Choking on food

-Dark circles under their eyes

-Speech problems

-Hearing loss

-Difficulty losing weight 

-Tonsillitis

-Sinusitis

-Bad breath

-Dry mouth

-Blocked nose

-Headaches, especially in the morning

 

*Checklist for sleep disordered breathing, based on work by Dr. David McIntosh, author of Snored to Death, and Dr. Howard Hindin and Dr. Michael Gelb, authors of GASP: Airway Health: The Hidden Path to Wellness. Some of the points listed above may be part of the underlying problem, others may be the result of poor sleep quality.

It is not in my scope of practice to diagnose sleep disordered breathing, upper airway resistance, or obstructive sleep apnea. During the assessment appointment, I will investigate problems you may be experiencing. When appropriate, a referral will be recommended. 

Website with more resources: https://amerisleep.com/blog/obstructive-sleep-apnea-in-children/

 

Other problems...

When mouth breathing occurs, the tongue is in a low position in the mouth. This low position, elongates the tongue and it protrudes into the airway, further causing a decrease in airway space. (work based on Dr.Zaghi, ENT, Sleep Surgeon)

 

In order to decrease the tongue taking space in the airway, the tongue will often move forward, resulting in pressure against the teeth, at rest and/or while swallowing. This is commonly called "Tongue Thrust," but the accurate term is a reverse swallow pattern. 

Another reason the tongue can be in a low position, causing mouth breathing and/or sleep issues, is if the tongue is physically tethered down due to restricted tissue under the tongue. 

Not only does mouth breathing cause health, learning, and sleep problems, but it can alter the way the face and mouth develops. 

What if I have difficulty breathing through my nose?

There are various reason an individual may have difficulty breathing through their nose. Some examples are: allergies, narrow nasal cavity, nasal septum deviation, enlarged turbinates, sinus difficulties, frequent congestion, enlarged lymphoid tissue (tonsils and/or adenoids). It is not in my scope of practice to diagnose these. During the assessment, I will investigate potential problems and recommend appropriate referrals when necessary. We will work on techniques you can do at home to assist in your nasal breathing efforts. 

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