Chronic mouth breathing, the habit of habitually inhaling and exhaling through the mouth instead of the nose, can significantly influence facial development and appearance. This pattern is associated with physical changes often called “mouth breather face” or “adenoid facies.” These structural alterations arise from the constant open-mouth posture, which disrupts the natural forces shaping the jaw and facial bones. Addressing this requires a comprehensive approach that targets both the underlying cause of the breathing pattern and the resulting changes to the craniofacial complex.
Understanding the Causes of Chronic Mouth Breathing
The physical changes associated with mouth breathing are caused by underlying physiological issues that force the mouth open for sustained airflow. The primary cause is typically some form of nasal obstruction that prevents sufficient air intake through the nose. When the nasal passages are blocked, the body’s natural response is to default to oral respiration to meet oxygen demands.
One of the most common physical blockages, particularly in children, is the enlargement of the adenoids and tonsils, which are masses of lymphatic tissue. When these tissues become chronically inflamed or enlarged, they physically obstruct the airway behind the nose. Chronic allergies, leading to persistent sinus congestion and inflammation, also contribute significantly to nasal blockage.
Structural issues within the nasal cavity can also necessitate mouth breathing. A deviated septum, where the thin wall separating the right and left nasal passages is displaced, can severely restrict airflow. Nasal polyps, which are soft, noncancerous growths on the lining of the nasal passages or sinuses, represent another common physical impediment.
How Facial Structure is Affected by Mouth Breathing
Chronic oral respiration alters the biomechanical balance that guides craniofacial development, especially during childhood growth periods. When the mouth is consistently open, the tongue is forced to drop from its correct resting position against the roof of the mouth, or the palate. The tongue’s proper placement acts as a natural expander, exerting outward pressure that encourages the upper jaw, or maxilla, to widen.
Without this continuous outward pressure, the maxilla develops too narrowly and too high, resulting in a high, arched palate. This structural change also narrows the nasal floor, which further perpetuates the difficulty of nasal breathing. The resulting skeletal imbalance often presents as a vertical growth pattern of the face, sometimes referred to as “long-face syndrome.”
The downward and backward rotation of the lower jaw, or mandible, coupled with the lack of facial muscle tone, contributes to a recessed chin and a less defined jawline. Dental consequences are also common, including malocclusion, where the teeth do not align properly. This often manifests as crowding, an excessive overbite, or an open bite.
Therapeutic and Orthodontic Correction Methods
Fixing a mouth breather face requires a collaborative, multi-disciplinary approach that first addresses the underlying cause of the breathing problem before correcting the structural damage.
Airway Clearance
The first intervention step typically involves an evaluation by an ear, nose, and throat (ENT) specialist to remove the physical barrier to nasal airflow. This may involve medical treatment for chronic allergies or, in cases of severe obstruction, surgical procedures like an adenoidectomy to remove enlarged adenoids or a septoplasty to correct a deviated septum.
Myofunctional Therapy
Once the airway is clear, the focus shifts to correcting the dysfunctional muscle habits through myofunctional therapy. This specialized therapy uses targeted exercises to retrain the oral and facial muscles, specifically encouraging the tongue to return to its proper resting spot on the palate. Successful therapy establishes a firm lip seal at rest, which is essential for maintaining long-term nasal breathing and preventing the relapse of structural issues.
Orthodontic Correction
Orthodontic treatment is then employed to correct the skeletal and dental changes. Palatal expanders, such as a Rapid Palatal Expander (RPE), are frequently used to physically widen the narrow maxilla and create space for the tongue and proper tooth alignment. Following expansion, traditional braces or clear aligners may be necessary to finalize the alignment of crowded or misaligned teeth. For severe skeletal discrepancies in adults, where jaw growth is complete, orthognathic surgery may be considered as a last resort to reposition the upper and lower jaws into a functional and aesthetically balanced relationship.
The Role of Age in Reversibility and Treatment Success
The success and ease of correcting facial changes related to mouth breathing are highly dependent on the age at which treatment is initiated.
Childhood Intervention
During childhood and pre-puberty, the facial bones are still actively growing and are malleable, offering the best window for significant change. Since facial growth is approximately 60% complete by age six, early intervention allows practitioners to use appliances like palatal expanders to modify and guide skeletal development. This process, known as growth modification, can yield substantial improvements in facial balance and airway capacity by promoting forward and horizontal growth.
Adult Treatment
For adults, the prognosis for complete structural reversal is more limited because the facial bones have fused and are no longer growing. Treatment must rely on more aggressive orthodontic mechanics or surgical intervention to address existing skeletal discrepancies. While adult treatment primarily focuses on relieving symptoms, improving the airway, and correcting dental alignment, myofunctional therapy remains beneficial at any age for establishing the correct breathing habit and muscle function.