Ashley Larson, PT, C/NDT

Airplane rides are now the worst for me.

I inevitably sit next to the person who sleeps with their mouth wide open. A few weeks ago, I thought it was going to be different as this beautiful high school girl was sitting next to me. Within 15 minutes, she drifted off to sleep, of course... with her mouth wide open.

We all know this person. This has become so common that no one even gives mouth breathing a second thought.

The only thing we HAVE to do in life is breathe, right? I often say to my patients, “the nose is for breathing and the mouth is for eating and talking - never the two should be confused.” Let’s face it, breathing is the most important thing we do throughout the day, and we all take it for granted... until we have a cold and cannot breathe through our nose. We then prepare ourselves for a poor night’s sleep and a cloudy head or short temper the next day. Well, what happens if this type of breathing pattern is our norm?

Seriously, what’s the big deal if someone sleeps with their mouth open or chronically keeps their mouth open during the day?

The answer is: it’s a BIG deal! It can be quite dangerous to your health. Yet, many health care providers are often inundated with simply treating the immediate issue at hand. Mouth breathing can be overlooked. So, I’ve decided to play my part and connect some dots for you. Let me explain some of the common consequences of mouth breathing.

Sleep Problems

This is a big one and deserves it’s own spotlight (stay tuned). Bottom line: mouth breathing is very much linked with sleep impairments for people of all ages. Sleep experts now recognize that poor sleep increases our risk of chronic disease. Chew on that for a second.

Sleep is the reason I dove down this rabbit hole. I saw my dad on CPAP at an early age, and I have watched my younger 2 kiddos struggle with sleep issues. An important study found that mouth breathing and snoring in kids as young as 6 months can lead to a significantly increased risk of behavioral and social problems by the age of seven. Kids are not little adults; as such, they behave differently when sleepy. Adults usually are tired and groggy, whereas kids tend to overcompensate and speed up. People can be moody, emotionally explosive, and/or aggressive when sleepy. Many prominent researchers believe that a sleep disorder should be ruled out before an ADHD diagnosis is made. Hmmm… food for thought!

Poor Posture

Are you constantly telling your kids to “sit up straight?” Maybe you yourself slouch a little more than you would like? Question… what does your mouth look like? Mouth breathing and forward head posture go together like peanut butter and jelly. Mouth breathing forces the head to bend forward and the neck to extend to help the flow of air through the oral cavity. Over time, this leads to significant muscle fatigue, poor recruitment of the diaphragm for breathing, neck pain, tension in the temporomandibular joint area, tension headaches, and the list goes on.

Unattractive Features

Ever heard: “Wow, he looks tired,” or “I’m losing my jawline!”? Mouth breathing can change jaw development and the look of your face. There is actually a name for this: “Adenoid Facies” or “Long Face Syndrome.” Faces lengthen, the jaw becomes less defined, teeth become crooked, and often kids and adults that chronically mouth breathe present with a “gummy smile” and dark circles under their eyes. Mouth breathers often have dry, chapped lips.

Not to mention… research has shown that an open lip resting posture leads others to gain the impression of the person “not being very bright.” Just take a look at actors in movies, and you will see what I’m talking about. Best example: Jim Carrey in the movie “Dumb and Dumber”... enough said!

Dental Misalignment

This could be a post of its own, but let's just take one example. Mouth breathing has been shown to significantly change dental alignment. You know those people who wore braces and had perfectly aligned teeth, and then one day their teeth “moved?” Sure you do. Why, do you ask? Stay with me… an awesome orthodontist will tell you this. The tongue is a group of incredibly strong muscles. And muscle trumps bone any day and twice on Tuesday. When a person breathes through their mouth, their tongue isn’t in the right position at rest, or when they swallow. Thus, if you “fix” the teeth but haven’t fixed the reason why the teeth are impaired or moving in the first place, you may notice rather quickly that the teeth go right back to where they were.

Poor Athletic Performance

Much has been said about this in recent years - very exciting! Recent studies show that athletes perform better when nasal breathing is utilized. In summary, it has everything to do with oxygen and carbon dioxide utilization. Mouth breathing adversely affects respiratory biomechanics and exercise capacity. Mouth breathing also limits a person’s ability to utilize the diaphragm effectively. AND, it limits the ability for the person to place the tongue in its correct resting posture, which has recently been shown to improve isokinetic knee performance in strength testing.

Smacking While Eating

Generally, noisy eaters are mouth breathers. We all know “that” person we hate to sit across from at dinner because they chew like a cow and smack throughout dinner. As it turns out, often these people are simply attempting to figure out how to breathe and chew food at the same time.

Bad Breath

Mouth breathers have increased bacteria accumulation, which can lead to bad breath. Maybe we should tell our kids to shut their trap instead of brush their teeth?!

Gum Disease

Mouth breathers typically have a dry mouth with reduced salivary production. This can allow bacteria to perpetuate. Long term gum disease has been linked to some serious stuff, including heart disease, stroke, and even dementia. Yet another reason to learn how to close your trap!

Allergies and Sinus Issues

A LOT more is to be said regarding this issue than what this simple post can cover; but, if your mouth is open, the palate and nasal passages narrow over time. This contributes to sinus issues, increased nasal obstruction, and inability of the body to combat allergies. Simply stated, if you don’t use your nose, you lose it!

Asthma

Mouth breathing increases asthmatic complications and decreases lung function. Asthma symptoms can be significantly decreased if the sufferer learns how to breathe through their nose and not through their mouth. I have seen this to be true with so many patients who no longer need their asthma action plans or inhalers..

The bottom line is that often times, we are not even aware of our breathing - and we certainly don’t realize that we are doing it well, or perhaps not so well.

Check out our attached list of symptoms associated with mouth breathing. Do any of these signs or symptoms ring true for you?

Is there a way to change mouth breathing habits?

Well, certainly I wouldn’t write a blog of doom without offering a solution!

If you are experiencing any of the symptoms above, or simply want to learn strategies to improve the above issues, contact our office for a physical therapy evaluation!

Together, we can begin to help each other breathe better, exercise better, eat better, and sleep better so that we may all the the best versions of ourselves!

Nothing will change if nothing changes.

References

Barocas, R., & Karoly, P. (1972). Effects of Physical Appearance on Social Responsiveness. Psychological Reports,31(2), 495-500. doi:10.2466/pr0.1972.31.2.495
Guilleminault, Christian, and Shannon S. Sullivan. "Towards Restoration of Continuous Nasal Breathing as the Ultimate Treatment Goal in Pediatric Obstructive Sleep Apnea." Enliven: Pediatrics and Neonatal Biology 01.01 (2014): n. pag. Print.
Hallani, Mervat, John R. Wheatley, and Terence C. Amis. "Enforced Mouth Breathing Decreases Lung Function in Mild Asthmatics." Respirology 13.4 (2008): 553-58. Print.
Izuhara, Y., H. Matsumoto, T. Nagasaki, Y. Kanemitsu, K. Murase, I. Ito, T. Oguma, S. Muro, K. Asai, Y. Tabara, K. Takahashi, K. Bessho, A. Sekine, S. Kosugi, R. Yamada, T. Nakayama, F. Matsuda, A. Niimi, K. Chin, and M. Mishima. "Mouth Breathing, Another Risk Factor for Asthma: The Nagahama Study." Allergy 71.7 (2016): 1031-036. Print.
Jefferson, Yosh. "Mouth Breathing: Adverse Effects on Facial Growth, Health, Academics, and Behavior." General Dentistry: Growth and Development (2009): 18-25. Print.
Kukwa, W., C. Guilleminault, M. Tomaszewska, A. Kukwa, E. Migacz, and A. Krzeski. "Prevalence of Upper Respiratory Tract Infections in Habitually Snoring and Mouth Breathing Children." Sleep Medicine 40 (2017): n. pag. Print.
Lee, Seo-Young, Christian Guilleminault, Hsiao-Yean Chiu, and Shannon S. Sullivan. "Mouth Breathing, “nasal Disuse,” and Pediatric Sleep-disordered Breathing." Sleep and Breathing 19.4 (2015): 1257-264. Print.
Okuro, R. T., Morcillo, A. M., Ribeiro, M., Sakano, E., Conti, P., & Ribeiro, J. D. (2011). “Mouth breathing and forward head posture: Effects on respiratory biomechanics and exercise capacity in children.” Jornal Brasileiro de Pneumologia, 37(4). http://dx.doi.org/10.1590/S1806-37132011000400009
Purwanegara, Miesje Karmiati, and Bambang Sutrisna. "Mouth Breathing, Head Posture, and Prevalence of Adenoid Facies in Patients with Upper Respiratory Tract Obstruction." Journal of Dentistry Indonesia 25.1 (2018): n. pag. Print.
Torre, Carlos, and Christian Guilleminault. "Establishment of Nasal Breathing Should Be the Ultimate Goal to Secure Adequate Craniofacial and Airway Development in Children." Jornal De Pediatria 94.2 (2018): 101-03. Print.

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