What is Mouth Breathing?
Many of us don’t give a second thought about our breathing, how we do it and how much we do it. The normal manner a person breathes is through the nose, which also keeps the nasal passages warm and moistens the air inhaled(1). However, some of us use our mouths when we inhale and exhale through our mouth resulting in what is known as mouth breathing(4).
There are some people who almost exclusively breathe through their mouths; whereas, there are some who breathe through their mouths because of a medical condition like sleep apnea(2). Mouth breathing is not a good thing for a person’s health.
Some temporary illnesses, like flu can cause occasional mouth breathing and this is not a cause for concern. However, long term mouth breathing should not be ignored as this needs medical attention or re-training on the method of breathing.
What are the Causes for Mouth Breathing?
Breathing through mouth has multiple causes including:
- Chronic colds.
- Sinus polyps.
- Deviated nasal septum(9).
- History of finger or thumb-sucking.
- Enlarged adenoids/tonsils.
- Congenital abnormalities, such as cleft palate, choanal atresia or Pierre Robin syndrome.
Tongue tie is another condition where a person can breathe through mouth. Tongue tie is a condition where the patient’s tongue is attached excessively in the mouth causing difficulty in moving the tongue; hence leading to mouth breathing.
What are the Symptoms of Mouth Breathing?
Dry Mouth and Bad Breath: One of the common symptoms of mouth breathing is bad breath(7). Other than bad breath, dry mouth and teeth are also symptoms of mouth breathing, as breathing through mouth dries out the teeth and mouth and this also increase of bad breath.
Open-Mouthed Appearance: Other common symptom of mouth breathing is that the patient tends to have a slightly open-mouthed appearance.
Noise Makers: People breathing through their mouth can also hear breathing sounds from their mouths. People breathing though mouths are also usually noisy eaters, as mouth breathing makes it difficult when eating.
Worsening of Asthma and Sleep Apnea: According to a research, exercise-induced asthma aggravates with mouth breathing(8). This is because when a person breathes through mouth instead of the nose, the air inhaled does not get moist or warm and causes airway irritation(9).
Mouth breathing also worsens the symptoms of sleep apnea(3, 9). Patients suffering from sleep apnea and who also have chronic mouth breathing will have mouth and jaw positioned in a way that will not support breathing resulting in difficulty in breathing and not getting good sleep at night. People with sleep apnea and who also breathe through their mouth can need continuous CPAP at night(10).
Voice Hoarseness(9): A person who breathes through the mouth will also have hoarse-sounding voice as its symptom.
Dental Problems(9): Poor positioning of the jaw is a problem caused by mouth breathing leading to jaw pain, teeth grinding and irregular bite.
Changes in Speech: Mouth breathing increases the risk of a lisp, which is a speech condition affecting the person’s ability to say the alphabet “S.”
Jaw Malformation: Children who breathe through their mouth also experience developmental changes in their jaws and are likely to have uneven jaws and longer faces.(5, 6)
Overbite: Overbite is also a common symptom seen in a child who is a chronic mouth breather.
Stuffy or Runny Nose: This symptom is only seen in temporary mouth breathing, such as occurring in cold due to blocked the nasal passages.
What are the Complications of Breathing through Mouth?
A chronic mouth breather is at high risk for suffering from various health complications, such as:
- Greater risk of snoring and sleep apnea(9).
- Speech and swallowing difficulties.
- Increased risk of dental complications, such as gum disease and decay.
- Problems with jaw joints.
- Enlarged adenoids and tonsils.
- Over-bite leading to misalignment of teeth.
- Worsening of asthma symptoms(8).
When Should One See A Doctor If One Is Mouth Breathing?
It is important to seek treatment for mouth breathing before worsening of symptoms and getting long-term complications.
Mouth breathing is not a medical emergency; however, a person should seek medical consultation if they are experiencing any symptoms of mouth breathing; particularly chronic bad breath or dry mouth when waking up in the morning(7).
If a child is snoring and is a mouth breather, then the parents should consult with a pediatrician.
How is the Diagnosis of Mouth Breathing Made?
Medical History and Physical Exam: Patient’s complete medical history and symptoms are noted by the doctor. The doctor will examine the patient’s mouth, nose and throat to look for any areas of abnormalities or swelling and also observe the breathing pattern of the patient.
Imaging Studies/Tests: Imaging studies may be ordered to look at the patient’s nasal passages. Lung function tests can be done to see if the patient is suffering from asthma or other disease(8).
Sleep Study: A sleep study is ordered if sleep apnea is suspected. Both adults and children can have sleep apnea.
What is the Treatment for Mouth Breathing?
Depending on the underlying cause, treatment for mouth breathing is done.
Surgery: If mouth breathing is caused by enlarged adenoids and tonsils then the patient is referred to an otorhinolaryngologist(9). The specialist doctor will surgically remove the enlarged adenoids and tonsils that are causing the mouth breathing.
If the shape of the nasal passages or sinuses is causing mouth breathing, then surgery is done for correction so the patients physically breathe out of their nose.
Medications: Medications, such as antihistamines, anti-inflammatory nasal sprays and decongestants will also be of help in relieving the symptoms of mouth breathing.
Breathing Exercises: Other than this, the patient is taught techniques by their doctors and physical therapists to re-train their breathing and focus on breathing through their nose and not their mouth(11).
Exercises to re-train the muscles of the tongue and mouth can be done to get rid of mouth breathing and to do correct nasal breathing(11). However, these exercises for mouth breathing should be done under the guidance of an experienced therapist.
What is the Prognosis of a Person with Mouth Breathing?
Mouth breathing being essentially a highly treatable condition has a good outcome provided that the patient seeks treatment to avoid any long-term complications from mouth breathing.