Is your child regularly sleeping with his or her mouth open? Maybe they’re even breathing through the mouth rather than the nose when awake during the day. Perhaps you’re not sure, or are assuming or hoping that the situation is temporary or that your child will grow out of it.
However, habitual mouth breathing in children is not something parents should ignore. It can be both a symptom of an existing issue and a contributor to new ones. What looks like a harmless deviation is not harmless at all, and can actually have a huge impact on your child’s life.
Over time, breathing through the mouth instead of the nose can lead to abnormal facial growth and development. Long-term, chronic mouth-breathing in kids can cause an elongated face, misalignment or crowding of the teeth, tooth grinding and clenching, dental decay, gum disease, throat infections, poor sleep quality, stunted growth and development, behavioral problems, and even trouble in school.
If your child looks to have an ongoing problem breathing through their nose, especially during sleep, make an appointment to see a pediatrician. It is possible to intervene early and prevent side effects that can affect your child’s health and well-being in both the present and future.
9 Signs Your Child Might Be a Chronic Mouth Breather
In addition to seeing mouth-breathing first-hand, other signs may indicate that your child has a chronic issue breathing through their nose. Nine other symptoms of mouth-breathing that you may notice:
- The child’s mouth hangs open. If your child’s lips are parted even during the day—if an open mouth is their natural, resting facial posture—this may be an indication of a facial, dental or airway abnormality that makes nasal breathing difficult for them.
- Dry mouth. A decrease in saliva production can lead to coughing, a hoarse voice, cracking at the corners of their mouth, complaints of mouth stickiness, or trouble chewing and swallowing. Persistently breathing through an open mouth instead of the nose can lead to all these symptoms.
- Bad breath (halitosis). Lack of sufficient saliva in the mouth may prevent it from “self-cleaning” to remove food detritus. Chronic oral dryness can also lead to infections that may produce a bad smell. Take note if your child wakes up with pronounced "morning breath".
- Dry, chapped or cracked lips. Sleeping with the mouth open can lead to drooling and chapping. Excessive dryness in the mouth may also cause your child to lick their lips reflexively during the night, making the chapping worse.
- A forward head position. When a child can’t breathe well through their nose, an airway obstruction may be to blame. To compensate, he or she may hold their head forward to open the airway. Think of a turtle, craning and stretching its neck forward. This posture may lead to other issues down the line, such as orthopedic problems or tension headaches. Forward head position may reflect other issues, but in children mouth breathing is a common cause.
- An elongated, narrow face and palate. Humans have evolved to breathe through the nose, not the mouth, and the shape of the mouth and face have adapted to this evolutionary development. When a child breathes predominately through the mouth, leaving the lips parted, this irregular posture can affect the position of the jaw, cheeks, and chin. Because children grow rapidly, an open-mouthed breathing position changes how the muscles, tendons, ligaments and bone of the lower face grow. Craniofacial deformities can result, leading to a long, skinny face and a narrow, vaulted palate. If you notice your child’s face developing in this way, mouth breathing may be the cause.
- Teeth crowded together. When the face shape and the oral cavity become thinner and longer from mouth-breathing, teeth no longer fit as comfortably within the space allowed. They may crowd or overlap, which can make oral care difficult. Crowding may also cause bite issues. If your child has very crowded teeth, this may be a sign that he or she has a mouth-breathing issue.
- Enlarged tonsils. Oftentimes, children who mouth breathe during sleep have enlarged tonsils or adenoids that block the upper airway. If a doctor has noticed this and your child has some of the other symptoms on this list, he or she may be struggling to breathe easily during sleep. Surgery to remove the tonsils may be necessary.
- Allergic shiners. Shadows or bruise-like pigmentation beneath the eyes may be a sign of allergies. If your child has eye circles that won’t go away, they may have an untreated sinus problem that could be causing nasal breathing difficulties. When allergies make breathing through the nose difficult, children will normally compensate by breathing through the mouth.
Why Might Your Child Be a Mouth Breather? (Causes)
An open mouth during sleep or in the daytime is always a cause for concern, but not always an indicator of something being wrong. Sometimes mouth breathing really is temporary—for example, it may be secondary to a cold or allergies causing congestion in the nose and sinuses. When the illness or allergy passes, your child will be able to breathe easily through their mouth again.
However, if your child is a chronic mouth breather, this may indicate an anatomical issue such as a blockage or craniofacial irregularity. If an issue like this is affecting the mouth, nasal passages, or throat, treatment will be necessary in order to facilitate easier breathing.
An exam by a pediatrician and referral to an allergist, ears-nose-throat specialist, oral surgeon or a dentist (or all four) may help to determine if there’s an underlying cause of the mouth breathing that requires therapy, surgery, or some other treatment. For example, the cause could be:
- Allergic rhinitis. Inflamed and swollen nasal passages.
- Deviated septum. The septum is the bone and cartilage in the center of the nose. If it’s crooked or collapsed, it can create a nasal obstruction, essentially narrowing the tube through which air enters the nose.
- Nasal polyps. Benign growths in the nose may narrow the airway.
- Soft palate deformity. A high or arched palate may cause an airway obstruction.
- Tonsils or adenoids that are too large. If the lymphatic tissue at the back of the throat becomes enlarged or inflamed, it may block the airway, creating breathing problems during sleep and even during waking hours.
Implications of Breathing through the Mouth During Sleep
Should parents be worried if their children breathe through the mouth instead of nose during sleep (and during the day as well)? If your child is a habitual mouth breather, then yes, it’s worth a visit to the doctor to find out what’s causing the issue. Left untreated, mouth breathing can cause some unwanted side effects for children.
Facial deformities may have a negative impact on the child’s looks and self-esteem, and can also negatively affect their oral health, leading to tooth crowding, gum disease and tooth decay. The resulting bruxism (grinding and clenching) from misalignment of the teeth can also lead to headaches, neck and shoulder tension and TMJ disorder.
Failing to breathe through the nose also affects immunity. The nose is lined with mucus and fine hairs designed to trap and filter out allergens, pollutants, and even viruses and bacteria. Mouth breathing does not offer the same protection, which leaves mouth breathers more susceptible to allergic responses and infections.
Lastly, mouth breathing can disturb sleep, and this is where it’s perhaps most destructive to a child’s well-being. Persistently breathing through the mouth is a form of sleep-disordered breathing. It can contribute to fragmented sleep, meaning the children who demonstrate this behavior may not progress through all the sleep phases, including REM and deep sleep.
The resulting sleep deprivation can prevent the body from releasing proper amounts of Human Growth Hormone (HGH), which may impede the child’s physical growth and brain development.
Chronic sleep deprivation in children can also lead to behavioral problems, social problems, mood issues, and a misdiagnosis of ADHD.
Sleep deprivation also lowers immunity and leaves children vulnerable to infections, colds and the flu.
For children to grow properly, stay healthy, and succeed in school, they need to get the proper amount of high-quality, uninterrupted sleep. Breathing through the mouth—and other forms of sleep disordered breathing—robs them of this restorative sleep and leaves them vulnerable to physical and psychological problems.
Treating Mouth Breathing in Kids
How do you stop mouth breathing in children? The approach depends on the cause, of course. The first thing you need to do is take your child to their doctor for an exam and a specialist referral, if necessary.
If the cause is a deviated septum, a palate deformity or the position of the tongue in a small mouth, it’s possible to correct these issues with early intervention and therapy. Children’s faces are still growing, which means that their oral and dental development can be corrected with the help of a good therapist who understands the role facial growth plays in affecting breathing and sleep.
Possible treatments for mouth breathing can include myofunctional therapy (mouth and tongue exercises that can be practiced at home), oral appliance therapy to expand the palate, or CPAP therapy to ease breathing in children who are experiencing obstructive sleep apnea.
If you have further questions about your child's mouth breathing or to schedule an appointment, call Premier Sleep Associates in Bellevue, Washington at (425) 698-1732.