THE NEGATIVE IMPACTS OF MOUTH BREATHING ON HEALTH AND WELL-BEING

Breathing is essential for life, and how you breathe can make a big difference to your health. We breathe through either the nose or the mouth, yet it is not often considered which might be best. Mouth breathing can seem harmless, yet if done on a chronic basis, it has a negative impact on breathing that detracts from overall well-being.

In this article, we will explore nose breathing vs mouth breathing, including why nose breathing is important for health, the side effects of mouth breathing, why it happens, and how to stop mouth breathing. Breathing techniques are also discussed that can help you prioritize nasal breathing.

Why Nose Breathing is Important for Health

The nose isn't just a cosmetic feature. It serves many vital health functions that the mouth is unable to fulfill. When we breathe through the nose, we are filtering out dust, allergens, and pollutants from the air, which prevents lung irritation and infection. As opposed to drying out the airways, as with mouth breathing, nasal breathing moistens and warms the air, protecting the throat and lungs from dryness and inflammation.

Aside from protecting the airways, breathing through the nose is also vital for optimal lung function and higher oxygen uptake. It adds airflow resistance, which works the diaphragm, improves the posture and helps us to take deeper breaths. The paranasal sinuses in the nose produce nitric oxide thought to supply the lungs^[1]. Nitric oxide increases oxygen uptake by promoting blood vessel relaxation and dilation. It also contributes to the immune system’s defense against airway infection and helps to facilitate lung regeneration after damage.^[2]

Side Effects of Mouth Breathing

The effects of mouth breathing can be bad for your health in a number of ways:

• Respiratory Symptoms. Mouth breathing can cause a sore throat, bad breath, throat irritation that leads to coughing, and infections of the throat, nose, ears and airways.
• Reduced Oral Health. A dry mouth is common with mouth breathing, which reduces saliva production, changes the pH of the mouth and interferes with the oral microbiome. This increases the risk of toothache, tooth decay, gum disease, and oral infections.^[3]
• Lower Sleep Quality. Mouth breathing is associated with breathing-related sleep disorders such as sleep apnea. It can disrupt sleep and reduce sleep quality by promoting shallow breathing, snoring, and frequent awakenings. Poor sleep affects mood, memory, concentration, learning, immunity, metabolism, and overall health.
• Disease Risk. Lower blood oxygenation due to shallow mouth breathing can promote heart disease and the risk for metabolic conditions.

Does Mouth Breathing Change Your Face?

Yes. The growth and development of the face can be negatively impacted by mouth breathing^[4], due to the way in which it changes the alignment and shape of the jaw and position of the tongue. This can further compound respiratory issues by narrowing the airways, as well as affect facial expression, speech, appearance, and dental health.

Mouth breathing in children is especially noticeable in terms of facial development, commonly giving rise to^[5]:

• Narrow jaws with crooked teeth
• An overbite or underbite
• Long face syndrome
• Flat cheeks and a receding chin
• Droopy eyes and dark circles

Causes of Mouth Breathing

After contemplating the negative effects of mouth breathing on health, it might be a wonder as to why mouth breathing occurs in the first place. Mouth breathing is a temporary replacement for nasal breathing when the nose is blocked.

The nose can be congested due to:

• Allergies or hay fever, resulting from pollen, food sensitivities, dust mites or pet dander
• Colds or flu
• Sinus infection or irritation
• Structural problems including a deviated septum, nasal polyps, or enlarged turbinates (nasal structures)

If one displays symptoms of nasal congestion, it is important to try clearing the nose and if unsuccessful, to seek medical attention.

Exercise

Most people breathe through the mouth during intensive exercise. This is normal and not ordinarily a cause for concern. Studies suggest that nasal breathing during exercise may be more efficient than mouth breathing, yet may lead to higher cardiovascular stress.^[6]

Obesity and Nasal Congestion

Excessive weight gain increases the risk of respiratory problems, such as sleep apnea, and is often associated with general breathing difficulties. Studies have shown that obesity is associated with chronic nasal congestion^[7], possibly due to enlarged turbinates (nasal structures)^[8], more pressure around the lungs, and a higher risk of sinus irritation.

Habitual Mouth Breathing

Mouth breathing can also become an unconscious habit after a flu, sinus infection or allergic reaction. Stress, anxiety, and poor posture also contribute to perpetual mouth breathing by promoting shallow breathing and compressing the airways. All of these factors show how easy it is to make the mistake of habitual mouth breathing, highlighting how becoming conscious of breathing is important for everyone.

Mouth Breathing in Infants and Children

Infants can start mouth breathing for various reasons, such as:

• Breastfeeding Difficulties. Certain infantile conditions prevent the infant from latching on the breast and swallowing properly. These include tongue-tie (ankyloglossia), lip-tie (ankylocheilia) or nipple confusion. Affected infants are inclined to breathe through the mouth instead of the nose during feeding, which may develop into chronic mouth breathing.
• Finger or Thumb-Sucking. This behavior is known to alter the structure of the teeth, narrow the airways and promote mouth breathing.^[9]
• Respiratory Irritants. Environmental factors that irritate or inflame an infant’s nasal passages, such as smoke, dust or dry air, can cause the infant to breathe through the mouth to avoid the discomfort.
• Over-Heating. Infants battle to regulate their temperature and may begin to mouth breathe if overly hot.

In children, mouth breathing is also attributed to nasal congestion as well as unconscious biting and chewing habits. Tonsillitis, or having enlarged tonsils or adenoid glands, may impact the airways and lead to mouth breathing.

How To Stop Mouth Breathing: Tips and Exercises

Mouth breathing is often a habit that can be changed with awareness and practice. Here are some tips and exercises to help you stop mouth breathing and practice nose breathing for better health:

• Tackle Known Causes. If you have nasal congestion due to allergies or infection, use a saline nasal spray or neti pot to clear your nasal passages. It can be helpful to eliminate known allergy triggers in your diet or environment as well. For sleep apnea or structural issues such as a deviated septum or enlarged adenoids/tonsils, consult your doctor for the best possible treatment.
• Practice Diaphragmatic Breathing. This is a deep breathing technique that helps one to practice breathing through the nose with the right muscles in the diaphragm. You can try to practice this technique by laying on your back, with one hand on your chest and one on your belly. Breathe in slowly through your nose and feel your belly rise as you fill your lungs with air. Breathe out slowly through your nose and feel your belly fall as you empty your lungs. Repeat this for 10 minutes every day until nasal breathing becomes an unconscious habit.
• Get Physically Fit. As fitness levels improve, individuals often find it easier to maintain nasal breathing. Exercising can significantly enhance nose breathing by strengthening the respiratory muscles and improving its efficiency. Aerobic exercise and core muscle building are important aspects to focus on to stop mouth breathing.
• Enhance Your Sleeping Posture. Using supportive pillows or adjusting your sleep position can help alleviate mouth breathing symptoms, particularly for those with sleep apnea or chronic snoring. Specialized pillows, like those for body, knee, and neck support, address posture issues for all sleeping positions. For sleep apnea, elevating the upper body at a 45-degree angle can aid fluid drainage from the lungs and enhance breathing.
• OTC Jaw Support. Over-the-counter jaw support devices can help with mouth breathing caused by jaw misalignment, such as overbites or underbites. These include mouth tape, jaw straps, palatal expanders, mandibular advancement devices, which hold the jaws correctly like a double gum guard, and tongue retainers that hold the tongue in place to keep the airways open. While these have proven to be beneficial, it is important to choose good quality devices that fit well and do not unintentionally block the airways.^[10] If suffering from severe respiratory issues, it is crucial to consult your doctor instead of relying solely on these devices.

Medical and Surgical Interventions

There are many medical and surgical treatment options for those with physical problems that detract from their ability to breathe through the nose. Some of the most common ones are discussed below.

Myofunctional Therapy

Myofunctional therapy is an exercise training program for improving oral muscle function, emphasizing tongue posture, swallowing, and breathing. It retrains and strengthens these muscles, promoting proper alignment and function of the jaw and airway. Myofunctional therapy can improve speech, sleep, and oral health.

Examples of myofunctional exercises include:

• Tongue posture correction, which trains the tongue to rest on the roof of the mouth.
• Lip strength exercises, which enhance lip closure.
• Swallowing retraining, which helps correct swallowing patterns in a way that facilitates nasal breathing.

Adenoid or Tonsil Removal

It is usual for children to have their adenoids or tonsils removed at a young age to prevent chronic tonsillitis. If your child snores, tends to mouth breathe more often than not, and still has their tonsils or adenoids, you may want to consult with a doctor about having them removed.

Corrective Jaw Surgery

Corrective jaw surgery, or orthognathic surgery, corrects upper and lower jaw size and alignment. This often improves airflow through the nose and alleviates mouth breathing associated with jaw misalignment and similar problems. It also helps enhance facial aesthetics and the patient's quality of life.^[11]

Indications for this surgery include:

• Severe overbites or underbites
• Facial asymmetry
• Chewing or speaking difficulties
• Chronic jaw pain
• Obstructive sleep apnea

Nasal Surgery

Nasal surgery involves various procedures that focus on correcting structural abnormalities within the nose. It improves nasal breathing and reduces the need to breathe through the mouth.

Types of nasal surgery that can help improve symptoms of mouth breathing include:

1. Septoplasty is a common surgical procedure used to correct a deviated septum, where the wall of cartilage and bone that separates the two nostrils is misaligned. A deviated septum can obstruct airflow and lead to nasal congestion. The surgery involves straightening and repositioning the septum for improved airflow.^[12]
2. Turbinoplasty is a surgery designed to address enlarged nasal turbinates, structures inside the nose that help humidify and filter the air we breathe. When the turbinates become swollen or enlarged, they can block the nasal passages and impede breathing. Turbinoplasty reduces the size of the turbinates, allowing for better airflow.
3. Endoscopic Sinus Surgery aims to remove obstructions, polyps, or infected tissue from the sinuses, improving drainage and reducing nasal congestion.^[13]
4. Nasal Valve Surgery^[14] refers to nasal valve repair or reconstruction. These help improve nasal breathing in those who have weakened or narrowed nasal valves that obstruct the airways.

Conclusion

Mouth breathing may seem like an innocuous habit, but it can lead to serious consequences. Nose breathing is important for conditioning and oxygenating the air you breathe, which contributes to improved respiratory, dental and overall health. It also affects facial development, appearance and sleep quality. To trade mouth breathing for nasal breathing, you can keep your nose clear, practice diaphragmatic breathing, get fit, and make use of corrective aids. If you have any respiratory symptoms or concerns, you should consult with your doctor to discuss other treatment options or surgery.

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