Why Not to Ignore Nasal Breathing vs Mouth Breathing in Children
Time to read 8 min
Time to read 8 min
At times, the simplest and most vital aspects of our existence get overlooked. Breathing is an automatic process, yet, how we breathe affects all of us. Mouth breathing is a serious threat, meanwhile, nasal breathing proportions enormous benefits. Despite the scientific evidence, most parents aren't aware of the affects to their children's growth, sleep, and overall health. In this article, we will be shedding light on mouth breathing, its impact, and why it deserves your immediate attention.
Often, when Dr. Salazar identifies a chronic mouth breather in his practice, parents are confused and at times dismissive. This challenge arises because mouth breathing has been normalized in our media and the immediate effects are not always evident. To make diagnosis and parent acknowledgment more complicated is the fact that, technically, it only requires 25%−30% of breathing via the mouth rather than the nose to classify an individual as a mouth breather (1). However, once a child meets the requirements of this categorization they are consequently exposed to all of the potential hazards linked to mouth breathing.
What may surprise you is that studies reveal mouth breathing prevalence in children ranges from 11% to 56%, making it the most common oral habit and a major risk factor of sleep-disordered breathing (1). In the next sections, we'll compare nasal breathing vs mouth breathing and uncover the advantages of one and the avoidable but far reaching consequences of the other - and we are talking as severe as poor bone development in the face and skull leading to a myriad of complications later in life (2).
Nasal breathing is the body's best method for air intake. The nose filters, humidifies, and warms the air while cilia trap allergens and pollutants. Mouth breathing in children means missing these benefits:
One of the most significant benefits of nasal breathing vs mouth breathing is the improved quality of air it provides. Breathing through the nose allows for the air to be properly filtered, humidified, and warmed before it reaches the lungs. This leads to better oxygenation of the blood and improved energy levels.
Children of all ages are at risk for snoring at night, which interrupts their sleep quality. Nasal breathing not only optimizes airflow, it is less forceful than mouth breathing. Studies show nasal breathing vs mouth breathing reduces throat tissue vibrations responsible for snoring. A study conducted at the Department of Otorhinolaryngology, Central Hospital, Skövde, Sweden found a direct link, showing that "diminution of snoring correlated with less tiredness in patients in the morning (3).
Nasal breathing increases the supply of oxygen to the brain, improving cognitive performance, concentration, and memory. It also stimulates the production of nitric oxide (a vasodilator), which has been found to enhance learning and neuroplasticity. By breathing through the nose, your child can unlock their full cognitive potential. Recent studies show that increased Nitric Oxide could be significant for treating age-related diseases like Alzheimer's (AD). Also, Nitric Oxide, which comes from L-arginine, might help prevent cognitive problems linked to epilepsy, epilepsy drugs, and diabetes (4).
Nasal breathing has a profound effect on the immune system and respiratory health. The nasal passages are lined with tiny hairs called cilia, which act as a natural filter, trapping bacteria, viruses, and other harmful particles. Additionally, the promotion of nitric oxide, which has antimicrobial properties, helps to further protect against respiratory infections which our children are so prone to in communal daycare settings.
Lastly, nasal breathing has a powerful calming effect on the body and mind, leading to reduced stress and anxiety levels. Breathing through the nose activates the parasympathetic nervous system, which helps to counteract the effects of the sympathetic nervous system, responsible for the body's stress response. This activation promotes relaxation, lowers heart rate and blood pressure, and reduces feelings of stress and anxiety (5).
Children who breathe through their mouths are more likely to experience sleep disorders, including snoring and sleep apnea. Mouth breathing during sleep can result in a narrower airway, leading to partial or complete obstruction of airflow. This obstruction can cause disruptions in breathing, leading to snoring, gasping, and pauses in breathing during the night. These sleep disturbances can significantly impact a child's quality of sleep, leading to daytime sleepiness, fatigue, and difficulty concentrating during the day.
Mouth breathing can increase the risk of respiratory infections and allergies in children. When children breathe through their mouths, they bypass the natural filtration system of the nose, allowing allergens, pollutants, and other harmful particles to enter the respiratory system more easily. This can lead to frequent respiratory infections such as colds, sinusitis, and throat infections. Additionally, mouth breathing can exacerbate allergy symptoms and increase sensitivity to allergens, leading to chronic nasal congestion, sneezing, and post-nasal drip.
Mouth breathing can also have an impact on speech and language development in children. Nasal breathing plays a crucial role in the production of certain sounds, particularly nasal consonants such as "m," "n," and "ng." In a study of 498 mouth-breathing children aged 9-17, researchers found that 81.7% of these children had speech disorders (6). When children breathe through their mouths, it can affect their ability to produce these sounds accurately, leading to speech difficulties and potential delays in language development. Addressing mouth breathing early significantly reduces long-term impacts on children. Parents can help prevent potential speech and developmental issues in their children by taking action promptly.
Researchers have confirmed that children who are mouth breathers compensate with postural changes such as leaning their heads forward to aid air passage. This results in neck and shoulder muscle changes. The forward head shifts weight away from the entire body, burdening only the neck and shoulders, not only leading to chronic neck tension but observable spine curvature (7).
Mouth breathing can also affect a child's cognitive function and academic performance. The disruption of sleep caused by mouth breathing can lead to daytime sleepiness, fatigue, and difficulty concentrating during the day. This can impact a child's ability to focus, learn, and perform well academically. Sleep deprivation and poor-quality sleep have been linked to decreased cognitive function, memory problems, and difficulties with attention and concentration (8).
In a study spanning over six years and involving more than 11,000 children, researchers at Albert Einstein College of Medicine discovered that young children experiencing sleep-disordered breathing, secondary to mouth breathing, have a higher risk of developing behavioral problems like hyperactivity and aggression. Additionally, the physical appearance changes associated with facial deformities caused by mouth breathing can contribute to low self-esteem and poor body image, further impacting a child's emotional well-being (9).
The term "mouth breather" has been used in the past as an unfair way to label someone as unintelligent. It's essential to remember that how someone breathes doesn't reflect their intelligence.
It's evident that our natural state is to be nasal breathers, and when we compare nasal breathing vs mouth breathing, the advantages of nasal breathing become overwhelmingly clear. Neglected mouth breathing in children can significantly elevate the risk of chronic health issues in adulthood such as high blood pressure, heart disease, allergies, and asthma. By addressing mouth breathing early on, we can reduce the risk of these chronic health conditions and promote long-term well-being.
In subsequent articles, we will delve into the details of prevention and treatment, including myofunctional exercises, to provide comprehensive insights into addressing and overcoming mouth breathing concerns.
Lin, L., Zhao, T., Qin, D., Hua, F., & He, H. (2022). The impact of mouth breathing on dentofacial development: A concise review. Frontiers in Public Health, 10, 929165. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9498581/
Moss, M. L., & Salentijn, L. (1969). The primary role of functional matrices in facial growth. American Journal of Orthodontics, 55(6), 566-577. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/0002941669900347
Löth, S., & Petruson, B. (1996). Improved nasal breathing reduces snoring and morning tiredness: A 6-month follow-up study. Archives of Otolaryngology–Head & Neck Surgery, 122(12), 1337-1340. https://doi.org/10.1001/archotol.1996.01890240045010
Paul, V., & Ekambaram, P. (2011). Involvement of nitric oxide in learning & memory processes. Indian Journal of Medical Research, 133(5), 471-478. PMID: 21623030. PMCID: PMC3121276. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3121276/
Ecologic. (2021, June 17). Parasympathetic Breathing: Why Nose Breathing is Better for You. Chew on This, Holistic Dentist, Sleep Apnea Solutions. https://ecologicdentistry.com/the-importance-of-parasympathetic-breathing/
Alhazmi, W. A. (2022). Mouth Breathing and Speech Disorders: A Multidisciplinary Evaluation Based on The Etiology. Journal of Pharmacy & Bioallied Sciences, 14(Suppl 1), S911–S916. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9469305/
Sabatucci, A., Raffaeli, F., Mastrovincenzo, M., Luchetta, A., Giannone, A., & Ciavarella, D. (2015). Breathing pattern and head posture: changes in craniocervical angles. Minerva Stomatologica, 64(2), 59-74. https://pubmed.ncbi.nlm.nih.gov/25747427/
Kuroishi, R. C. S., Garcia, R. B., Valera, F. C. P., Anselmo-Lima, W. T., & Fukuda, M. T. H. (2015). Deficits in working memory, reading comprehension, and arithmetic skills in children with mouth breathing syndrome: Analytical cross-sectional study. Sao Paulo Medical Journal, 133(2), 78-83. https://doi.org/10.1590/1516-3180.2013.7630011