Mouth breathing

Mouth breathing, medically known as chronic oral ventilation, is long-term breathing through the mouth. It often is caused by an obstruction to breathing through the nose, the innate breathing organ in the human body.[3][4] Chronic mouth breathing may be associated with illness.[5] The term "mouth-breather" has developed a pejorative slang meaning.

"Mouth breather" redirects here. For the album, see Mouth Breather.
Mouth breathing
Other namesChronic oral ventilation
SymptomsSnoring, dry mouth, hoarse voice, bad breath, fatigue, sleep apnea[1][2]
CausesChronic nasal congestion
TreatmentTreatment of the underlying cause of nasal congestion if present, building a habit to breathe through the nose

Etymology
1911 photograph of mouth breathing child
Image 23 from the 1903 book by William F. Barry, M.D., The Hygiene of the Schoolroom. Barry describes this child as having "the typical face of a mouth-breather."

In the early 20th century, "mouth-breather" was a technical term used by doctors to describe children who were breathing through their mouths due to an underlying medical condition. English lexicographer Jonathon Green notes that by 1915, the phrase "mouth-breather" had developed a pejorative connotation within English slang, defined as a "stupid person."[6] Currently, the Macmillan Dictionary defines the term "mouth breather" as a pejorative noun that is used to mean "a stupid person."[7][5]

Cause of inability for nasal breathing

Jason Turowski, MD of the Cleveland Clinic states that "we are designed to breathe through our noses from birth — it's the way humans have evolved."[3][4] Infants for example in the first six to twelve months of postnatal can only use their noses to breathe unless crying is involved.[8] Thus, the impact of chronic mouth breathing on health is a research area within orthodontics (and the related field of myofunctional therapy)[9] and anthropology.[10] It is classified into three types: obstructive, habitual, and anatomic.[11]: 281 

There is a noted order of cause and effect leading to airway dysfunction related to mouth breathing. This first starts with an inflammatory reaction then leading to tissue growth in the area which leads to airway obstruction and mouth breathing and then finally an altered face structure.[12]

Nasal breathing produces nitric oxide within the body, while mouth breathing does not.[4][13][14] In addition, the Boston Medical Center notes that the nose filters out particles that enter the body, humidifies the air we breathe and warms it to body temperature.[15] In contrast, however, mouth breathing "pulls all pollution and germs directly into the lungs; dry cold air in the lungs makes the secretions thick, slows the cleaning cilia, and slows down the passage of oxygen into the bloodstream."[15] As a result, chronic mouth breathing may lead to illness.[13][16][17][18][19] In about 85% of cases, it is an adaptation to nasal congestion,[11]: 281 [17] and frequently occurs during sleep.[16] More specialized causes include: antrochoanal polyps;[20]: 350  a short upper lip which prevents the lips from meeting at rest (lip incompetence);[11]: 281  and pregnancy rhinitis which tends to occur in the third trimester of pregnancy.[21]: 435 

Potential effects

Conditions associated with mouth breathing include cheilitis glandularis,[20]: 490  Down syndrome,[22]: 365  anterior open bite,[21]: 225  tongue thrusting habit,[21]: 225  cerebral palsy,[23]: 422  ADHD,[24][25] sleep apnea,[26] and snoring.[26] In addition, gingivitis,[21]: 85  gingival enlargement,[21]: 85  and increased levels of dental plaque[21]: 108  are common in persons who chronically breathe through their mouths. The usual effect on the gums is sharply confined to the anterior maxillary region, especially the incisors (the upper teeth at the front). The appearance is erythematous (red), edematous (swollen) and shiny. This region receives the greatest exposure to airflow during mouth breathing, and it is thought that the inflammation and irritation is related to surface dehydration, but in animal experimentation, repeated air drying of the gums did not create such an appearance.[21]: 85 

Breathing through the mouth decreases saliva flow. Saliva has minerals to help neutralize bacteria, clean off the teeth, and rehydrate the tissues. Without it, the risk of gum disease and cavities increases.[27]

Chronic mouth breathing in children may affect dental and facial growth.[19] It may also lead to the development of a long, narrow face, sometimes termed long face syndrome.[28] Conversely, it has been suggested that a long thin face type, with corresponding thin nasopharyngeal airway, predisposes to nasal obstruction and mouth breathing.[17]

Additional approaches to mouth breathing

George Catlin

George Catlin was a 19th-century American painter, author, and traveler, who specialized in portraits of Native Americans in the Old West. Travelling to the American West five times during the 1830s, he wrote about, and painted portraits that depicted, the life of the Plains Indians.[29] He was also the author of several books, including The Breath of Life[30] (later retitled as Shut Your Mouth and Save Your Life) in 1862.[31][32] It was based on his experiences traveling through the West, where he observed a consistent lifestyle habit among the Native American communities he encountered: a preference for nose breathing over mouth breathing. He also observed that they had perfectly straight teeth.[33] He repeatedly heard that this was because they believed that mouth breathing made an individual weak and caused disease, while nasal breathing made the body strong and prevented disease.[33] He also observed that mothers repeatedly closed the mouth of their infants while they were sleeping, to instill nasal breathing as a habit.[34]

Yoga

Yogis such as B. K. S. Iyengar advocated both inhaling and exhaling through the nose in the practice of yoga, rather than inhaling through the nose and exhaling through the mouth,[35][36][37] using the phrase, "the nose is for breathing, the mouth is for eating."[35][36][38][39]

Mouth taping

Mouth taping is the practice of keeping the lips shut while sleeping with a strip of surgical tape. This is intended to prevent mouth breathing during sleep. The health effects of mouth taping have been little researched.[40]

In non-human animals

Lambs are noted to only switch to mouth breathing when the nasal passages are completely obstructed, with hypoxaemia having developed also as a result.[8]

References
  1. Suzuki, Masaaki (2022). "Obstructive sleep apnea -consideration of its pathogenesis". Auris Nasus Larynx. Elsevier BV. 49 (3): 313–321. doi:10.1016/j.anl.2021.10.007. ISSN 0385-8146. PMID 34763987. S2CID 243976270.
  2. Kotecha, B. (1 August 2011). "The nose, snoring and obstructive sleep apnoea". Rhinology Journal. Stichting Nase. 49 (3): 259–263. doi:10.4193/rhino10.165. ISSN 0300-0729. PMID 21858254.
  3. Turowski, Jason (29 April 2016). "Should You Breathe Through Your Mouth or Your Nose?". Cleveland Clinic. Retrieved 28 June 2020.
  4. Glazier, M.D., Eve (4 November 2019). "'Nose breathing has more benefits than mouth breathing". The Times and Democrat. Retrieved 9 July 2020.
  5. Wollan, Malia (23 April 2019). "How to Be a Nose Breather". New York Times. Retrieved 31 May 2020.
  6. Kelly, John (23 August 2016). "How '80s Is the Slang in Stranger Things?". Slate. Retrieved 2 July 2020.
  7. "Macmillan Dictionary: Mouthbreather". The Macmillan Dictionary. Retrieved 31 May 2020.
  8. R, Harding (1986). "Nasal obstruction in infancy". Australian Paediatric Journal. 22 Suppl 1: 59–61. ISSN 0004-993X. PMID 3539080. Retrieved 19 January 2023.
  9. Frey, Lorraine (November 2014). "The Essential Role of the Com in the Management of Sleep-Disordered Breathing: A Literature Review and Discussion". The International Journal of Orofacial Myology. Int J Orofacial Myology. 40: 42–55. doi:10.52010/ijom.2014.40.1.4. PMID 27295847.
  10. Gross, Terry (27 May 2020). "How The 'Lost Art' Of Breathing Can Impact Sleep And Resilience". National Public Radio (NPR)/Fresh Air. Retrieved 23 June 2020.
  11. Phulari BS, ed. (2011). Orthodontics : principles and practice. New Delhi: Jaypee Bros. Medical Publishers. ISBN 9789350252420.
  12. Stupak, Howard D.; Park, Steven Y. (2018). "Gravitational forces, negative pressure and facial structure in the genesis of airway dysfunction during sleep: a review of the paradigm". Sleep Medicine. Elsevier BV. 51: 125–132. doi:10.1016/j.sleep.2018.06.016. ISSN 1389-9457. PMID 30165336. S2CID 52134548.
  13. Dahl, Melissa (11 January 2011). "'Mouth-breathing' gross, harmful to your health". NBC News. Retrieved 28 June 2020.
  14. Berman, Joe (29 January 2019). "Could nasal breathing improve athletic performance?". Washington Post. Retrieved 31 May 2020.
  15. "Your Nose, the Guardian of Your Lungs". Boston Medical Center. 7 August 2017. Retrieved 29 June 2020.
  16. Martel, Jan; Ko, Yun-Fei; Young, John D.; Ojcius, David (6 May 2020). "Could nasal nitric oxide help to mitigate the severity of COVID-19?". Microbes and Infection. 22 (4–5): 168–171. doi:10.1016/j.micinf.2020.05.002. PMC 7200356. PMID 32387333.
  17. Rao A, ed. (2012). Principles and Practice of Pedodontics (3rd ed.). New Delhi: Jaypee Brothers Medical Pub. pp. 169, 170. ISBN 9789350258910.
  18. Nall, Rachel (22 September 2017). "What's wrong with breathing through the mouth?". Medical News Today. Retrieved 31 May 2020.
  19. Valcheva, Zornitsa (January 2018). "THE ROLE OF MOUTH BREATHING ON DENTITION DEVELOPMENT AND FORMATION" (PDF). Journal of IMAB. Retrieved 31 May 2020.
  20. Barnes L, ed. (2009). Surgical pathology of the head and neck (3rd ed.). New York: Informa healthcare. ISBN 978-1-4200-9163-2.
  21. Newman MG, Takei HH, Klokkevold PR, Carranza FA, eds. (2012). Carranza's clinical periodontology (11th ed.). St. Louis, Mo.: Elsevier/Saunders. ISBN 978-1-4377-0416-7.
  22. Regezi JA, Sciubba JJ, Jordan RK (2011). Oral pathology : clinical pathologic correlations (6th ed.). St. Louis, Mo.: Elsevier/Saunders. ISBN 978-1-4557-0262-6.
  23. Cawson RA, Odell EW (2008). Cawson's essentials of oral pathology and oral medicine (8th ed.). Edinburgh: Churchill Livingstone. ISBN 978-0-7020-4001-6.
  24. Won, Dana (February 2017). "It Is Just Attention-Deficit Hyperactivity Disorder…or Is It?". Journal of Developmental and Behavioral Pediatrics. J Dev Behav Pediatr. 38 (2): 169–172. doi:10.1097/DBP.0000000000000386. PMC 5401711. PMID 28079611.
  25. Sano, Masahiro (October 2013). "Increased oxygen load in the prefrontal cortex from mouth breathing: a vector-based near-infrared spectroscopy study". NeuroReport. 24 (17): 935–940. doi:10.1097/WNR.0000000000000008. PMC 4047298. PMID 24169579.
  26. Pacheco, Maria Christina Thome (July–August 2015). "Guidelines proposal for clinical recognition of mouth breathing children". Dental Press Journal of Orthodontics. 20 (4): 39–44. doi:10.1590/2176-9451.20.4.039-044.oar. PMC 4593528. PMID 26352843.
  27. Graves, Elizabeth (4 September 2022). "Mouth Breather vs Nose Breather: Understanding the Differences and Why it Matters". Take Home Smile.
  28. Basheer, Bahija (November 2014). "Influence of Mouth Breathing on the Dentofacial Growth of Children: A Cephalometric Study". Journal of International Oral Health. 6 (6): 50–55. PMC 4295456. PMID 25628484.
  29. "Catlin Virtual Exhibition". Smithsonian American Art Museum. Archived from the original on 25 September 2014. Retrieved 28 October 2014.
  30. The breath of life, or mal-respiration, and its effects upon the enjoyments & life of man. HathiTrust. 1862. Retrieved 28 June 2020.
  31. Nestor, James (2020). Breath: The New Science of a Lost Art. Riverhead Books. p. 48. ISBN 978-0735213616.
  32. "George Catlin on Mouth Breathing". PubMed. Retrieved 2 July 2020.
  33. Nestor, James (2020). Breath: The New Science of a Lost Art. Riverhead Books. p. 49. ISBN 978-0735213616.
  34. Nestor, James (2020). Breath: The New Science of a Lost Art. Riverhead Books. p. 50. ISBN 978-0735213616.
  35. Yoga Journal Editors (12 April 2017). "Q&A: Is Mouth Breathing OK in Yoga?". Yoga Journal. Retrieved 26 June 2020. {{cite web}}: |last= has generic name (help)
  36. Payne, Larry. "Yogic Breathing: Tips for Breathing through Your Nose (Most of the Time)". Yoga For Dummies, 3rd Edition. Retrieved 26 June 2020.
  37. Himalayan Institute Core Faculty, Himalayan Institute Core Faculty (13 July 2017). "Yogic Breathing: A Study Guide". Himalayan Institute of Yoga Science and Philosophy. Retrieved 26 June 2020.
  38. Krucoff, Carol (2013). Yoga Sparks. New Harbinger Publications. ISBN 9781608827022. Retrieved 31 May 2020.
  39. Jurek, Scott (2012). Eat and Run. Houghton Mifflin. ISBN 978-0547569659. Retrieved 31 May 2020.
  40. Blum, Dani (17 November 2022). "Can a Piece of Tape Help You Sleep?". The New York Times. ISSN 0362-4331. Retrieved 29 September 2023.

Further reading
Look up mouth breather in Wiktionary, the free dictionary.
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