Mouth Breathing Habits
What causes a mouth breathing/open-lips resting posture?
When an open-lips posture or mouth breathing habit is identified it is important to determine if this posture is a habit, possibly due to past airway issues or if there are currently unresolved airway problems. Correcting chronic nasal airway problems does not guarantee that the lips will come together automatically. The lips may still be programmed to remain open or there may be reduced muscle tone in the lips making it difficult to keep the lips closed at rest.
It cannot be assumed that a person who rests with the lips apart is a “mouth breather”. Mouth breathing occurs when the mouth is the primary mode of inhaling and exhaling air during resting posture. A careful assessment of the airway by an ENT specialist is beneficial to confirm the diagnosis of mouth breathing and identify other medical conditions contributing to the pattern.
Medical conditions that can partially or totally obstruct the nasal airway and contribute to mouth breathing and open-lips resting posture include:
• Enlarged tonsils and/or adenoids
• Nasal allergies
• A markedly deviated septum (the plate of bone and cartilage which divides the nose into two chambers)
• Rhinitis (inflammation of the mucous membrane of the nose)
• Nasal polyps
What are the concerns about mouth breathing?
• Breathing through the nose warms and humidifies the air. The nasal passages provide a natural filtering system for airborne polluted particles and allergens. Mouth breathing bypasses a valuable filtering system.
• Nasal breathing produces a gas called nitric oxide which facilitates an increased oxygen absorption by the blood. Mouth breathers deliver less oxygen to their blood than nasal breathers.
• Mouth breathing habitually dries the tissues of the mouth and irritates the gum tissue causing inflammation. The habitual drying from mouth breathing creates an environment where the plaque becomes very sticky, the bacteria becomes abundant and calculus formation is enhanced.
• With mouth breathing the lips are apart causing the tongue to be placed low in the mouth, impacting proper dental and craniofacial development.
• Mouth breathers are more likely to have a maxilla (roof of mouth) that is deep and narrow, reflecting the lack of molding action from the tongue. They are also more prone to developing anterior open bites (upper and lower teeth do not meet when back teeth are together) and crossbites (a misalignment of teeth, where upper teeth fit inside of lower teeth).
• A habitual open lips posture may contribute to other unwanted tooth movement before, during and after orthodontic treatment.
• When the lips habitually rest apart, the lips have reduced muscle tone. The upper lip may appear short and elevated over the upper teeth, while the lower lip may droop downward, giving a “puffy” appearance to the lip.
• When the gap between the upper and lower lips becomes excessive, habitual lip closure becomes difficult and may contribute to functional changes in the muscle patterns for chewing, swallowing and speech.
• A breathing problem at night when sleeping can be indicated by snoring, long pauses between breaths, audible mouth breathing, dry mouth in the morning, clenching/grinding of teeth, sweating during sleep, bedwetting, and night terrors.
What should be done if there appears to be a habitual open-lips or mouth breathing habit?
If you suspect a chronic condition does exist, a visit to our office should be a step in the right direction. We assess oral muscle function and after obtaining a case history and completing the initial examination a plan will be implemented to improve oral muscle function. This office works closely with other professionals that are part of the team model including Pediatric Dentists, Orthodontists, Ear-Nose-Throat (ENT) Specialists-, Sleep Physicians, Oral Surgeons, Allergists and other related professionals. It is important before beginning a therapy program to correct an open-lips resting posture or mouth breathing habit that a patient nasal-oral-pharyngeal airway has been assessed (ENT consultation) to help direct the overall therapy plan.
What is oral rest posture therapy?
Oral Rest Posture Therapy focuses on promoting the correct tongue resting posture, teaching a closed lips and nasal breathing pattern, correcting eating, drinking and swallowing patterns and any speech articulation problems which may be related to the habitual open-lips resting posture and low tongue posture.
Correcting tongue resting posture and lip relationships can be instrumental in aiding the development of normal patterns of dental eruption, alignment and restoring normal processes of orofacial growth and development and optimizing sleep patterns. Therapy can also help in stabilizing the orthodontic result, improving the clarity of speech and enhancing a person’s appearance.
It is critical for parents to identify mouth breathing habits early in their young children and seek intervention to help promote proper dental/craniofacial growth and sleep patterns.