Does your child often keep his mouth open while being engaged in activities or sleeping? While breathing from both nose and mouth may be considered normal in some scenarios when the body has an increased oxygen demand, breathing from the mouth on a regular or habitual basis is not normal.
Why does it happen?
It could be habitual or due to some obstruction in the nose or throat (tonsils, adenoids, etc.). If your child has recurrent throat infections, stuffy nose or sleep disturbances chances are the breathing pattern may be irregular. This could be a cause or a sign of opening the mouth to breathe to compensate for the compromised nasal breathing.
What could happen if this is ignored?
Breathing through the nose ensures that the air is cleaned, warmed, and humidified before it reaches the lungs which ensure effective oxygen absorption. While breathing from the mouth, none of these happen and the dry, impure air can reduce the oxygen absorption.
There can also be changed in the growth pattern of the jaws. The children tend to have a long face (adenoid facies), narrow upper jaw with or without protruding teeth, dryness in the mouth, bleeding or red gums in the upper front teeth area.
Keeping the mouth open for prolonged periods to facilitate breathing can alter the position of the tongue as well. Ideally, the tongue is supposed to rest on the palate which is the roof of the mouth. This constriction of jaws due to muscles around the mouth can lead to a lack of space for the tongue in the mouth, thereby forcing the tongue to assume a lower position in the mouth. When this happens, the tongue tends to push through the gaps in between the upper and lower teeth, which in turn can lead to a secondary habit development, tongue thrusting, and a severe alteration in the swallow pattern.
How can you check at home?
Look to check if your child unconsciously keeps the mouth open most of the time. If yes, try a simple activity with the child, use a micropore tape, and try sealing the Childs mouth for a while and notice if the child complains or removes the tape. Be cautious to keep an eye on the child to notice any discomfort and remove it at the slightest sign of discomfort. If the child is comfortable with the tape, he/she is most likely predominantly a nasal breather, with habitual mouth breathing. If there is absolute discomfort in breathing while the mouth is taped, it could be a sign of a possible nasal pathway obstruction. Before trying any of the above-mentioned techniques, please do consult a pediatric dentist.
Alternatively, you can ask the child to hold water in his/her mouth, if the child is a mouth breather, he will quickly spit out the water.
What to do next?
If you notice any of the aforementioned symptoms, you must visit a Pediatric Dentist.
The Pediatric Dentist will help you in diagnosing the root cause of the problem. A few small tests and a couple of X-rays can help give a correct diagnosis. If there is any nasal obstruction, you might have to consult with an ENT specialist who will give you the treatment options for correcting the obstruction.
Treatment options
Once the ENT specialist gives clearance on the patency of the nasal passage, the Pediatric Dentist can help you correct any abnormal changes in the growth pattern of the child.
At first, there will be a few exercises taught to the child to strengthen the lips to try and establish a closed mouth posture and a lip seal. Along with this, a few tongue exercises may have to be done to correct the position and placement of the tongue. This will improve the swallow pattern and help to guide the child towards a correct swallow pattern.
Following this, fixed or removable appliances can be given for the correction of the teeth alignment and altering or promoting the growth of the jaws as per the need. If caught early, the right growth spurt can be utilized for modifying the growth pattern.
How long does the treatment last?
The duration of treatment can vary depending on the cooperation of the patient and the parent. The frequency and regularity of following the myo-functional exercises and the appliance wear greatly determines the outcome and duration of the treatment.
After the negative influences of the muscles around the mouth are removed, the child may or may not need to go ahead with braces for further fine alignment of the teeth.
About the author –
Dr K Saranya
(Bangalore) visit her profile – click here