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Breathe Less, not More

Do not waste your Breath

As you are reading this blog, quickly scan your breath. Is your mouth open? Are you breathing through your nose or your mouth. Are you breathing through your abdomen or your upper chest? Have you ever wondered if we breathe slowly and smoothly, a sense of calmness descends and if we breathe frantically and rapidly we get tensed and anxious? Breathing is such a critical function that we rarely think much of and is often neglected. Breathing is not only a matter of life and death (literally), it is also connected to the states of our mind. How well we breathe pretty much determines the quality of our life. Breathing correctly, that is through our nose, lightly and slowly; is the secret to better health, fitness and overall well-being. Every breath we take can have a positive or negative impact on our bodies depending on how it is performed.

Our nose is designed for breathing, and our

mouth for eating and talking.

So it would surprise most to learn how important and influential breathing, more precisely nasal breathing is in growth and development, and a healthy productive life. Other than giving us a sense of smell, our noses facilitate a lot of physiological functions that is directly linked to our overall health and well-being. Some of these functions are:

  • It warms and humidifies the air we breathe in before it reaches the lower airway, and helps filter impurities from the air.

  • It enhances oxygen absorption by our lungs via nitric oxide production from the sinuses.

  • Proper craniofacial development and tempero-mandibular joint function.

  • Anatomic facial deformities, such as a septal deviation, alar collapse, turbinate hypertrophy.

These are just some of the critical roles nasal breathing plays and the negative effects can be attributed to dysfunctional breathing practices like mouth breathing.

Pitfalls of Mouth and Dysfunctional Breathing Habits

The importance of breathing through the nose tends to receive very little attention from the medical profession. Occasional mouth breathing due to a temporary illness, such as a blocked nose, is not much of a cause for concern. However, chronic mouth breathing can signal that a person needs additional medical intervention or some re-training on how to breathe more easily through their nose. Habitual mouth breathing has serious implications on an individual’s lifelong health, including the development of the facial structures.

A human face grows most in the first five years and up to

90% of facial structure is formed by the age of 12.

The window of opportunity for the development of the child’s face is relatively small. So, if one is suffering from any of the conditions discussed below, the longer you leave it, the more challenging the process will be to address it and the host of physiological and psychological conditions that comes with it.

Breathing and Facial structuring

There is a close relationship between mouth breathing during childhood and abnormal facial growth. Mouth breathing or leaving the mouth hanging for extended periods of time leads to gravity exerting its pressure thereby pulling the face downward, resulting in narrow jaws and overcrowded teeth. This may affect, directly and indirectly, chewing, swallowing, speech, occlusion, oral hygiene, facial aesthetics, and facial skeletal growth. Considering all of this starts right from our childhood, bad breathing habits for extended periods of time, can set the stage for lifelong respiratory, dental, psychological problems not to mention a less attractive face.

Mouth Breathing and Oral Health

Mouth breathing dries out the mouth, leading to an increased risk of developing cavities, bad breath, and gum disease. How one breathes not only shapes the airways but also mouth and facial structures (orofacial structures, various morphological changes to the orofacial structures; and consequently, Orofacial Myofunctional Disorders (OMDs)).

Low Tongue Position and Dental Health

Breathing through the mouth forces the tongue in a low downward position to enable air flow. This exerts an excessive force upon the dentition during swallowing, contributing to malocclusions (misaligned teeth) in children; and leading to increased tooth mobility, advancing periodontal disease and pain in adulthood. Lowered tongue position leads to an open mouth posture which results in a long narrow face, high vaulted palate and crowding due to an inadequately developed maxilla.

Restricted Airflow

The positioning of our tongue has a major impact on how we breathe. Breathing through our mouth tends to close the nasopharyngeal airway due to how the tongue sits in the mouth. The resting posture of the tongue plays a pivotal role in controlling the flow of the airflow. Mouth breathing encourages incorrect positioning of the tongue (on the floor of the mouth), while nasal breathing naturally places the tongue in its proper resting position (on the roof of the mouth). A proper tongue resting posture is essential for achieving orofacial balance. Problems with the adenoids and tonsils can be a good indicator, if one has a small airway.

Airway size plays a fundamental role in healthy breathing.

Asthma and Mouth Breathing

Lungs require a warm, moist environment and therefore it is imperative that the air drawn into the lungs meets this condition. When we breathe through our nose, it warms, filters and humidifies the air before it gets to our lungs.

“On any one day, a person with asthma may inhale from 10,000 to 20,000 liters of air laden with foreign particles including many triggers. Whereas the nose can remove these deposited particles within fifteen minutes, it takes 60–120 days for them to be removed from the small air sacs (alveolus) within the lungs.”

Asthmacare, Ireland

This shows the quantity of allergens inhaled by a person with asthma is far greater than that of a person with healthy breathing.

Physical Manifestations of Mouth Breathing

According to this study, Brazilian researchers investigating the prevalence of mouth breathing in children aged three to nine reported mouth breathing related implications like: allergic rhinitis (81.4%), enlarged adenoids (79.2%), enlarged tonsils (12.6%), and obstructive deviation of the nasal septum (1.0%).

Breathing and Psychological Ramifications

The long-term changes to facial structure caused by seemingly benign chronic mouth breathing has in fact both immediate and/or latent cascading effects on multiple physiological and behavioural functions. Mouth breathing can have a tremendous impact on the mental and physical health of children; as it can be associated with the restriction of the lower airways, poor quality of sleep, reduced cognitive functioning and a lower quality of life.

Mouth Breathing and Sleep Apnea

The Craniofacial alterations associated with mouth breathing can significantly aggravate or increase the risk of snoring and obstructive sleep apnea in both children and adults. Mouth opening, even in the absence of oral airflow, has been shown to increase the propensity for upper airway collapse leading to lack of quality sleep.

Children are not meant to snore. So any child snoring might potentially have

sleep disordered breathing or obstructive sleep apnea.

ADHD, Sleep and Breathing

According to the National Sleep Foundation, attention deficit hyperactivity disorder (ADHD) is linked to a variety of sleep problems. Children and adults behave differently as a result of sleepiness. Adults usually become sluggish when tired while children tend to overcompensate and speed up. For this reason, sleep deprivation is sometimes confused with ADHD in children. Children may also be moody, emotionally explosive, and/or aggressive as a result of sleepiness.

Daytime tiredness caused by poor sleep means poor concentration in school, and over time, this difficulty focusing can lead to problems with cognition, learning disability, working memory and ADHD. In a study involving 2,463 children aged 6-15, children with sleep problems were more likely to be inattentive, hyperactive, impulsive, and display opposing behaviors.

Breathing and Cognition

This study shows, if a child under the age of eight is left with untreated snoring, there is an 80 percent chance that he or she will develop a 20 percent lifelong reduction in mental capacity. Mouth breathing, sleep apnea and snoring in early childhood increase the risk of neurocognitive and behavioural problems by the age of four according to this study. Chronic mouth breathing can even cause fatigue, poor performance in school, or behavioral issues in children.

In the next blog we will look into what can be done to address habitual dysfunctional breathing.

- Jignasha Bhatt BSc.OT, OTR

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