The Health Impacts of Mouth Breathing vs. Nose Breathing

Did you know that frequent mouth breathing instead of nose breathing can lead to a variety of health problems for you or your child? Holistic dentist Dr. Ann Nguyen-Chung shares how you can equip your child with the many benefits of proper breathing for a lifetime of good health.

image of mouth breather vs nose breather via The Breathe Institute

Unless there is congestion, nose breathing is the ideal way to breathe. To be even more specific, the best and most natural way to breathe is diaphragmatic breathing via the nose.

As soon as we are born, this is how our body naturally takes in oxygen. Diaphragmatic breathing and belly breathing are sometimes used interchangeably, but there is a distinction between the two.

Diaphragmatic breathing uses the diaphragm to take in deeper breaths than belly breathing. Unfortunately, unhealthy breathing habits can develop over time due to various reasons.

The Benefits of Breathing Through the Nose

There are many benefits to nasal breathing, which is how the body is designed to breathe. 

• The air you inhale through the nose filters out dust and potential allergens. 
• Nose breathing regulates the temperature of your breath.
• The air that moves through your nose gets humidified and keeps your throat moist and prevents dry mouth.
• It helps maintain normal blood oxygen levels.
• Proper diaphragmatic breathing reduces stress hormones and improves sleep.

So, if nose breathing is natural and ideal, why have so many people – including kids – developed the habit of mouth breathing? One of the biggest changes in lifestyle that contributed to mouth breathing was our collective move from outdoors to indoors.

Dr. Sandra Kahn and Paul Ehrlich explain in their book JAWS: The Story of a Hidden Epidemic, “Since the agricultural revolution, people freed of the need to move frequently in search of food, began to construct more elaborate places to live.

Enclosed spaces are where allergens tend to concentrate. In turn, these allergy-friendly environments increased the odds that children would develop upper respiratory problems.”

The Health Risks of Mouth Breathing

Occasional mouth breathing is normal, but long-term mouth breathing can result in many negative health, cognitive, and developmental consequences. 

Systemic Health Effects

It can weaken lung function and reduce blood oxygen concentration.

Lack of adequate amounts of oxygen can increase the risk for heart attack and stroke. It can increase levels of cortisol. Increased stress hormone levels can cause weight gain and difficulty in losing weight. 

Adults and children who breathe through their mouths can develop a deficiency in nitric oxide, a molecule that plays a role in regulating blood pressure and stimulates the release of certain hormones. Decreased levels of nitric oxide has been clinically shown to increase blood pressure, cause depression and anxiety, increase inflammation, and weaken immunity. 

Oral Health Effects of Mouth Breathing

Each person has a microbiome in the mouth. The oral microbiome consists of both good and bad bacteria. Saliva is the body’s natural defense against bad bacteria, because saliva naturally flushes the teeth and contains buffers that keep the teeth at a healthy pH.

When an individual breathes via the mouth instead of the nose, this can cause dry mouth. Dry mouth can cause hoarseness and pain of the throat. Dry mouth decreases saliva flow, resulting in a higher risk for tooth decay. 

With decreased saliva, bad bacteria can take over in the mouth, causing bad breath.

Long term mouth breathing can result in obstructive sleep apnea. There is strong a correlation between sleep apnea and GERD or acid reflux. When an individual with obstructed airway stops breathing while sleeping, this causes a change in pressure in the lungs, which forces acids from the stomach to come up into the esophagus.

These stomach acids are harmful to the teeth and can cause permanent damage to the teeth by “melting” away enamel and dentin. This eventually leads to other dental problems, such as tooth sensitivity, TMJ pain, shortened teeth, and yellow appearance of teeth due to the exposed inner dentin layer when the outer enamel layer has eroded away.

Other Risks of Mouth Breathing

Speech: Children who mouth breathe can develop swelling of the tongue, which can cause flaring of the teeth. Consequently, this can cause difficulty in enunciating “s” sounds and cause lisping. 

Concentration and Brain Development: The lack of oxygen levels going to the brain from mouth breathing can cause irritability, decreased energy levels, and difficulty in concentrating in school. In adults, common symptoms of this issue are chronic fatigue and brain fog.

Skeletal Development: Mouth breathing can also cause abnormalities in development of the head skeletal features in children. Forces play a significant role in the movement of teeth and development of the jaw. In children, as the jaw is growing and the teeth are shifting, forces from the lip, cheek, tongue, and opposite teeth help the jaw and teeth align the way that they are programmed to do.

Unfortunately, long-term mouth breathing can negatively affect the alignment of teeth and growth of the jaw. Without proper forces acting on the skull, mouth-breathing children can develop flatter facial features, longer face, smaller chin, flared out teeth, open bite, narrowed upper oral arch, and TMJ issues.

What Causes Mouth Breathing?

Some common reasons that can cause mouth breathing include:

Large Tonsils or Adenoids

Large tonsils or adenoids can also block the airway and result in a mouth breathing habit. During exams, holistic dentist Dr. Nguyen-Chung performs a thorough head and neck exam to look for any unusual findings, including potential airway issues.

If she notices that the patient has a small airway, she will ask the patient or parent if they snore or wake up gasping for air. She says she often sees other signs associated with small airway, such as signs of teeth grinding or acid erosion on the teeth.

These patients are advised to consult with their primary physician to be referred to do a sleep study, which is a test to evaluate if the patient is getting enough oxygen while sleeping. Some of these referrals result in surgical removal of the tonsils and/or adenoids to improve airway space.

Obstructed Nasal Passages

Obstructed nasal passages, such as from a deviated septum or nasal congestion from sinus infection, allergies, or colds. When nose breathing does not result in getting oxygen, the only other way to obtain air is to breathe through the mouth.

Thumb-sucking or Prolonged Pacifier Use

Thumb-sucking, finger-sucking, or use of pacifiers for a prolonged period can cause the teeth to flare outwards. The flaring of the teeth can prevent the lips from forming a seal, which may result in mouth breathing.

For these reasons, Dr. Nguyen-Chung advises parents to take away the binky and to discourage thumb or finger-sucking before the child turns 4 years old (preferably sooner). 

Tongue Tie

A tongue tie is a medical condition in which the lingual frenum (the fold of tissue membrane located under the center of your tongue) tethers the tongue to the floor of the mouth. This causes difficulty in swallowing and speech.

A simple surgical procedure, called frenectomy, may be recommended by a physician or dentist to release a tongue tie.

Signs a Child is Mouth Breathing

In addition to noticing your child breathing with their mouth open (while awake or sleeping) these are other indicators your child may be at risk for chronic mouth breathing:

In Infants: 

• Difficulty in latching during breastfeeding
• Poor bonding between the mother and infant 
• The infant has difficulty in transitioning to solid foods

In Children:

• The child’s lips are open to breathe most of the time 
• Snoring
• Signs of teeth grinding
• Frequent gagging, vomiting
• Continual tossing and turning at night
• Difficulty with speech 
• Redness and inflammation at the sides of the lips from drooling

How to Prevent Mouth Breathing

Watch for lip posture during inhalation and exhalation. Keep track of the frequency of nasal breathing versus mouth breathing. Consult with a physician or holistic pediatric dentist who is trained in airway in sleep if you suspect mouth breathing.

This health professional would be able to evaluate and find any underlying medical issues, such as asthma, tongue tie, large tonsils or any of the other listed conditions mentioned above.

Based on the findings, the health professional will recommend any appropriate procedures (such as removal of adenoids or releasing tongue ties) or other treatments, including myofunctional therapy, to help prevent future problems. 

If you or your child have allergies, a decongestant may be recommended to loosen any mucous in the sinus. If you are unsure of the cause of the allergies, consult with your physician about getting an allergy test to determine potential allergens you can avoid when possible.

Holistic and Alternative Approaches to Mouth Breathing

Fortunately, you have options when it comes to encouraging proper nasal breathing. One is simply to be more conscious of your breathing habits.

Pay attention throughout the day to see if you are breathing through your nose. Notice yourself if you walk past a mirror. Is your mouth open? Pay attention to your child at different times of the day and night to see if their mouth is open or closed.

Mouth Taping

Mouth tape may encourage nose breathing to improve sleep and to help prevent many of the health consequences listed above. There have been limited studies that show taping the mouth closed can help promote nose breathing. Please note that mouth tape may not be safe for everyone.  

Do not use mouth tape on infants or small children. It could cause suffocation in babies and very young children who are unable to remove the tape if the nose is congested. 

Use a gentle tape, such as surgical tape or a brand like SominFix which is specifically for mouth taping, to make sure the tape can still be easily removed by hand or when the mouth is opened. Somnifix tape features a slit that allows for a small amount of air to enter through the mouth if the lips are parted. It can offer peace of mind for anyone nervous to try mouth taping.

It may take several months to adjust and train the body to breathe via the nose. If you or your child consistently wake up without the tape in place, there may be an underlying issue. In this case, consult with a physician.

Breathing Exercises

Alternate nostril breathing is a breathing exercise that has been clinically shown to improve the function of the heart and lungs to help the body get enough oxygen.

When doing this exercise, sit upright. Start by exhaling through the mouth. Then, cover the right nostril and breathe through the left nostril for a given amount of time, such as 2 minutes. Then release the right nostril and cover the left nostril to breathe through the right nostril for another 2 minutes. Repeat this exercise as often as you’d like. It does not matter which nostril you start with for this inhale and exhale exercise.

To help your child learn how to breathe mindfully, try this guided Figure 8 breath meditation script before bedtime.

As with mouth tape, this exercise may not be safe for everyone. If you feel any nausea or dizziness from this exercise, stop immediately. If you have any lung or heart conditions, such as asthma or COPD, please consult your health care provider.

Proper diaphragmatic breathing is one of the best ways to improve sleep and set yourself up for good health. Mouth breathing may be a challenge to overcome, but it’s certainly worth the effort.