You quietly enter into your child’s bedroom while they are asleep and notice them laying on their back with their mouth wide open. In the following days, you notice they are feeling more fatigued, maybe experiencing some congestion, and appearing to be more irritable than normal. Unsure why this is happening, you notice more and more than they are breathing through their mouth when asleep or possibly while awake as well. Could it be connected? As board-certified pediatric dentists in McKinney, Dr. Justin and Dr. Sage answer 4 of the most frequently asked questions about children and problems that can occur as a result of mouth breathing. Early recognition, evaluation, and treatment if necessary are important as mouth breathing can be a symptom of sleep disordered breathing.

1. How Do You Designate a “Mouth Breather?”

For healthy individuals, breathing through the nose is natural and normal. When watching your child as an infant, you probably never noticed them lying in their crib with their mouth open. This change from breathing through the nose to the mouth happens when an obstruction is present in the nasal passage. If your child is unable to receive enough oxygen through the nose, survival instincts kick in and mouth breathing occurs.

To designate someone as a “mouth breather,” one of the following reasons might be to blame:

• An obstruction exists within the nasal passage
• Your child has a deviated septum, polyps, or enlarged bones, vessels, or tissue in the nasal passageway (also known as turbinates)
• Tongue-tie (also known as ankyloglossia)
• It is a habitual way to breathe

2. What Signs Are Most Prevalent When Determining if Your Child is a Mouth Breather?

If you’ve been observing your child’s sleeping patterns and whether they breathe with their mouth open or closed, you’re already taking the first step. This is the earliest and easiest way to find out if your little one is, in fact, a “mouth breather.” Some other signs to look for include:

• Is your baby snorting when they cry?
• Do they snore when asleep?
• Is their breathing silent?
• Do they grind their teeth at night?
• Do you tend to find your child breathing through their mouth while awake?

If you notice that your child’s breathing is loud or seems labored, they are likely having difficulty receiving enough oxygen. It is not uncommon for infants and toddlers to become congested from allergies or sinuses. If this is the case, make sure to talk to their doctor about proper treatment to reduce mucus and postnasal drip. Proper nasal hygiene prior to sleep can reduce symptoms of mouth-breathing.

Is There Such a Thing as a Partial Mouth Breather?

Yes, it is possible to be a partial mouth breather. During, the day, you may notice your child experiences no issues breathing through the mouth; however, the moment they lie down, it all changes. This is usually due to the sinuses and whatever might exist within the nasal passage moving toward the back of the mouth. Even the tongue or lower jaw (mandible) position while laying down can effectively obstruct your child’s airway. The presence of tethered oral tissues, such as tongue-ties can also create issues with breathing during the day and night time due to possible airway restriction.

3. What Can Happen if Mouth Breathing is Left Untreated?

The moment you notice your child is a mouth breather, you should seek an evaluation from a qualified healthcare professional, such as Dr. Justin or Dr. Sage to determine what steps or interventions are recommended. The sooner these airway and breathing issues are diagnosed and addressed, the greater the ability to minimize long term effects on a child’s overall health and wellness. Waiting to see if they “grow out of it” or for the issues to go away on their own may result in lost precious time and more serious issues in the future, such as:

• Slow growth: Your child’s ability to enter deep, non-REM sleep is important for the body’s natural release of growth hormone. Mouth breathers are more susceptible to sleep arousals preventing them from reaching a deep rejuvenating sleep state. This can also negatively impact the release of growth hormone and preventing a child from reaching their full genetic growth potential.
• Bed-wetting: When your child enters the sleep stage that causes their muscles to fully relax, their tongue may fall back and obstruct the airway. As a result, their body will try to move to unblock the obstruction and come out of deep sleep. When this happens, they may experience regular bed-wetting when taking a breath.
• Cavity formations: If your child is suffering from dry mouth, this can cause plaque to accumulate and cause decay to form within the mouth. Saliva is not only helpful in washing away bad bacteria and food particles, but it also helps to protect the teeth. When there isn’t enough saliva in your child’s mouth, they will not have the protective buffering and remineralizing effects of saliva that inhibit cavity formation.
• Behavioral problems: Should your child become restless throughout the night because they cannot breathe properly, you will likely notice changes in their behavior. Whether it is chronic fatigue or irritability, this is a clear sign that something is happening while they are asleep. Deep sleep is the brain’s time to rest, recharge, and rejuvenate. Shallow sleep or frequent sleep arousals leave the brain fatigued, which can result in symptoms of attention deficit, hyperactivity, and irritability.
• Changes in facial shape: You may notice that your child’s inability to breathe well causes their jaw to become elongated and narrower. Chronic mouth breathers may have a more narrow and elongated facial shape with a retruded lower jaw when viewing their profile. Changes to the skeletal growth pattern of a child can lead to exacerbating the symptoms of sleep disordered breathing.

4. How Can Your Baby’s Mouth Breathing Be Treated?

It is possible to help your little one begin to breathe through their nose again, but it does take close observance and being proactive in your efforts. If you are still breastfeeding, consider if there are foods or beverages you are consuming that may cause congestion to develop in your baby. It is also helpful to keep your baby’s nose clean as the presence of allergens can cause decreased nasal breathing. Many available products effectively rinse, suction, and remove any pollutants your baby may breathe in throughout the day and night.

An evaluation from a board-certified McKinney pediatric dentist with advanced training, such as Dr. Justin and Dr. Sage can determine the presence of tethered oral tissues, such as a tongue-tie, that may be contributing to mouth breathing. You may also wish to speak to your child’s doctor about helpful myofunctional therapy, breathing techniques, or recommended treatments that will help your little one begin to breathe more easily while asleep.

It is important to check for any airway/breathing issues for children early on. By recognizing these problems in the early stages, you can take appropriate steps to get their health and wellbeing back on track. Sleep disordered breathing can have long lasting negative effects on physical, mental, and emotional growth, development, and wellness of children.

About the Authors
Dr. Justin Chan and Dr. Sage Yoo are both fathers who are also board-certified pediatric dentists. Combining their passions for holistic and children’s dentistry, they provide a breadth of comprehensive services designed to meet the needs of your child. Whether they need preventive care, laser dentistry, or restorative services, their mission is to ensure the growth and development of your little one’s smile and overall wellbeing. Both Dr. Justin and Dr. Sage are proud to be kid’s dentists in McKinney and providing the highest quality comprehensive pediatric dentistry in Collin County. To learn more about our services or how we can help your child improve their health and wellbeing, visit our website or call (469) 301-3212.