Mouth Breathing: An often neglected condition with long term health consequences

By: Dr. Amay Tripathi, Asstt. Editor-ICN

LUCKNOW: Breathing provides our body the most important fuel of life- oxygen. It also allows us to release carbon dioxide and waste. Proper breathing ensures good health and vitality. Some people have the habit of breathing from mouth. But mouth breathing is not just another habit as it can lead to a variety of diseases and disorders. We have two air passageways to our lungs — the nose and the mouth.

Healthy people use both their nose and their mouth to breathe. Breathing through the mouth only becomes necessary when you have nasal congestion due to allergies or a cold. Also, when you are exercising strenuously, mouth breathing can help get oxygen to your muscles faster.

Even so, breathing through the mouth all the time, including when you are sleeping, can lead to problems. Not many people might be aware that mouth breathing can cause crooked teeth, facial deformities, or poor growth in children.

In adults, chronic mouth breathing can cause bad breath, gum disease, and can worsen symptoms of other diseases. People might not even be aware of their habit of mouth breathing especially if this happens during sleep.

People who breathe through the mouth at night may have the following symptoms:

Snoring, dry mouth, bad breath (halitosis), hoarseness, waking up tired and irritable, chronic fatigue, brain fog, dark circles under the eyes.

Now, it becomes important to understand why is it good to breathe through nose. What are the advantages of breathing through your nose?

The importance of your nose often goes unnoticed — until you have a bad cold. A stuffed-up nose can reduce your quality of life. It can also affect your ability to sleep well and function in general. Although, both nose and mouth can be used to breathe, the nose produces nitric oxide, which improves the lungs’ ability to absorb oxygen.

Nitric oxide increases the ability to transport oxygen throughout the body, including inside the heart. It relaxes vascular smooth muscles and allows blood vessels to dilate. Nitric oxide is also antifungal, antiviral, anti-parasitic, and antibacterial. It helps the immune system to fight infections. Nitric oxide provides a host of advantages and facilitates efficient respiration.

Apart from this, the nose acts as a filter and retains small particles from the air, including pollen and dust. The nose adds moisture to the air to prevent dryness in the lungs and bronchial tubes. Further, the nose controls air temperature to bring it closer to the body temperature before it gets inside the lungs.

Nose breathing adds resistance to the air stream. This increases oxygen uptake by maintaining elasticity of the lungs. Thus, not only there are chemical benefits as provided by the nitric oxide, the structure and functioning of the nose ensures a cleaner, warmer and suitable respiratory functioning.

Causes of mouth breathing:

There can be several causes of breathing from mouth like nasal congestion caused by allergies, a cold, or a sinus infection, enlarged adenoids, enlarged tonsils, deviated septum, nasal polyps, or benign growths of tissue in the lining of your nose, the shape of the nose, the shape and size of the jaw, obstructive sleep apnea (a medical condition in which breathing stops involuntarily for brief periods of time during sleep), tumors (rare).

Some people develop a habit of breathing through their mouth instead of their nose even after the nasal obstruction clears. For some people with sleep apnea it may become a habit to sleep with their mouth open to accommodate their need for oxygen.

Stress and anxiety can also cause a person to breathe through their mouth instead of their nose. Stress activates the sympathetic nervous system leading to shallow, rapid, and abnormal breathing.

Anyone can develop a habit of breathing through their mouth, but certain conditions increase your risk like hay fever, chronic allergies, chronic or recurring sinus infections, asthma, chronic stress and anxiety. These predispose people to either breath through mouth as a necessity or as a convenience which eventually turns into a habit.

With such bad impact on health, it becomes necessary to spread awareness about the diagnosis and treatment of mouth breathing.

Diagnosis:

There is no single diagnostic test of mouth breathing. A physician might notice the condition duting a physical examination of nostrils or by asking the medical history about sleep, snoring, sinus etc to find out the cause of persistent nasal congestion.

A dentist may diagnose mouth breathing during a routine dental examination if you have bad breath, frequent cavities, or gum disease. If a dentist or doctor notices swollen tonsils, nasal polyps, and other conditions, they may refer you to a specialist, like an ear, nose, and throat (ENT) doctor for further evaluation.

Since children cannot communicate their symptoms like adults, it is important for parents to pay attention to their sleep pattern, snoring or other symptoms slower growth rate, irritability, large tonsils, dry, cracked lips, crying at night, difficulty in concentrating at school and so on. In fact, children who exhibit problems concentrating at school are often misdiagnosed with attention deficit disorder (ADD) or hyperactivity.

In children, mouth breathing can lead to physical abnormalities and cognitive challenges. Children who aren’t treated for mouth breathing can develop long, narrow faces, narrow mouths, gummy smiles, dental malocclusion, including a large overbite and crowded teeth, and poor posture.

Treatment:

Treatment for mouth breathing depends on the cause. Medications can treat nasal congestion due to colds and allergies. These medications include: nasal decongestants, antihistamines, prescription or over-the-counter steroid nasal sprays. Adhesive strips applied to the bridge of the nose can also help breathing. A stiff adhesive strip called a nasal dilator applied across the nostrils helps decrease airflow resistance and helps you breathe more easily through your nose.

If you have obstructive sleep apnea, your doctor will likely have you wear a face mask appliance at night called continuous positive air pressure therapy (CPAP). A CPAP delivers air to your nose and mouth through a mask. The pressure of the air keeps your airways from collapsing and becoming blocked.

Timely treatment of this condition in children is essential to prevent the long term complications. In children, surgical removal of swollen tonsils and adenoids can treat mouth breathing. A dentist might also recommend that your child wears an appliance designed to widen the palate and help open the sinuses and nasal passages. Braces and other orthodontic treatments might also help treat the underlying cause of mouth breathing.

Thus, it becomes important for everyone to be aware of the symptoms and complications of mouth breathing. This habit needs to be identified and attempts to treat its underlying causes in a timely manner with appropriate options must be undertaken. Parents must specially be vigilant about this condition in their children. With timely treatment, mouth breathing can be prevented successfully.

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