Mouth breathing, also known as oral respiration, occurs when a child primarily breathes through their mouth instead of their nose. Chronic mouth breathing disrupts natural physiological processes established through nasal airflow. Nasal breathing is the preferred and healthier route, as it filters, warms, and humidifies the air before it reaches the lungs. When a child regularly breathes through their mouth, it can significantly affect their physical development, cognitive function, and the overall quality of their sleep. Addressing this common issue is important because it can impact facial growth and a child’s ability to focus during the day.
Identifying the Common Causes
A child’s tendency to breathe through their mouth almost always originates from a physical inability to draw sufficient air through the nasal passages. The most common physical obstruction is the enlargement of the adenoids and tonsils, which are lymphoid tissues located at the back of the throat and nose. These tissues can swell due to recurrent infections or chronic inflammation, physically blocking the upper airway and forcing the child to breathe orally, particularly during sleep.
Another frequent cause is chronic nasal congestion stemming from environmental or seasonal allergies. When the nasal lining becomes inflamed and swollen in response to allergens, the nasal passageway narrows, making it difficult to breathe through the nose. Conditions like chronic sinusitis or nasal polyps can also lead to a similar obstruction, forcing a switch to oral breathing.
In some cases, the original physical cause may have resolved, but the mouth-breathing pattern remains as a deeply ingrained habit. This habitual pattern can be reinforced by prolonged use of a pacifier or thumb-sucking, which encourages an open-mouth posture. Additionally, structural issues like a deviated septum or narrow nasal passages can restrict airflow, leading to this compensatory breathing behavior.
Observable Signs of Mouth Breathing
Parents can observe several clear indicators that their child is primarily breathing through their mouth. The most obvious sign is an open-mouth posture while the child is resting, or waking up with noticeably dry lips and a dry mouth. This dryness occurs because constant airflow evaporates saliva, which normally protects the oral tissues.
During the night, auditory signs often become apparent, such as loud snoring or consistently noisy breathing. This disruption leads to restless sleep, frequent awakenings, and a lack of restorative rest. Consequently, the child may display behavioral signs during the day, including morning fatigue, difficulty concentrating in school, or increased irritability. Some children may also develop dark circles beneath their eyes, sometimes referred to as “allergic shiners,” due to venous congestion.
Simple Strategies to Encourage Nasal Breathing
Simple, non-medical adjustments can help encourage a return to healthy nasal breathing patterns. Environmental management is an effective first step, particularly for children with mild congestion or allergies. Using a high-efficiency particulate air (HEPA) filter in the child’s bedroom and regularly washing bedding can minimize exposure to common indoor allergens and irritants. Maintaining appropriate humidity levels with a humidifier, especially during dry seasons, can also help keep nasal passages moist and less prone to congestion.
Positional changes during sleep can significantly improve airflow in the upper airway. Elevating the head of the bed slightly, perhaps by placing a pillow or wedge underneath the mattress at the head end, can help reduce congestion and make nasal breathing easier while lying down.
Behavioral and Breathing Exercises
Behavioral strategies focus on increasing the child’s awareness and muscle control during the day. Gentle, non-critical reminders to “close your lips” can help re-establish a lip seal and prompt a shift to nasal breathing.
Simple exercises strengthen the diaphragm and promote deeper nasal breaths. For example, “Belly Breathing” involves the child lying down and focusing on expanding their abdomen while inhaling through the nose. Other exercises involve blowing bubbles or cotton balls across a table using a slow, steady nasal exhale, which helps train facial muscles and reinforce a sealed-lip posture.
Professional Evaluation and Treatment Pathways
When home strategies do not resolve persistent mouth breathing or if the child exhibits severe sleep disruption, a professional evaluation is necessary. The first point of contact is often a pediatrician, who may refer the child to an Otolaryngologist (ENT) for an airway assessment. The ENT specialist determines if structural blockages are present, such as significantly enlarged tonsils or adenoids. If these tissues are the primary cause of the obstruction, surgical removal through an adenoidectomy and/or tonsillectomy may be recommended to clear the airway.
Orthodontic Interventions
For issues related to the development of the jaw and dental arch, consultation with an Orthodontist is important. Chronic mouth breathing can restrict the proper growth of the upper jaw, leading to a narrow palate and crowded teeth. Orthodontic interventions, such as palatal expansion devices, can physically widen the upper arch of the mouth, often resulting in a corresponding increase in nasal airway space.
Myofunctional Therapy
Myofunctional Therapy (or orofacial myology) is a specialized, non-invasive treatment that focuses on retraining the muscles of the face, mouth, and tongue. This therapy uses specific exercises to correct improper resting tongue posture, improve lip seal strength, and establish a consistent nasal breathing pattern. It addresses the habitual component of mouth breathing, helping ensure the child maintains nasal breathing long-term.