This document discusses mouth breathing habit in children. [1] It defines mouth breathing as prolonged exposure of the anterior mouth tissues to inspired air. [2] Mouth breathing can be obstructive, anatomic, or habitual. Common causes include nasal obstruction from enlarged turbinates, deviated septum, allergies, or enlarged adenoids. [3] Clinical features include effects on facial form like a long narrow face, dental defects like retroclined incisors and crossbites, and speech defects like a nasal voice. Diagnosis involves history, clinical exam including lip competence and nasal size/shape, and tests like mirror test. Management focuses on eliminating causes, symptomatic treatment, and intercepting habits through

1. Department of Paediatric Dentistry
MOUTH BREATHING HABIT
IN CHILDREN

2. WHAT IS HABIT?
Habit can be defined as -
 Fixed or constant practice established by
frequent repetition -DORLAND (1957)
 Frequent or constant practice or acquired
tendency, which has been fixed by
frequent repetition –BUTTERWORTH
(1961)
 Oral habits are learned patterns of
muscular contractions-MATHEWSON(1982)

3. Pedodontist
Parents
Orthodontist
ORAL HABIT
Speech
Pathologist
Pediatrician
Psychologist

4. MOUTH BREATHING HABIT

5. DEFINITION
 Defined as a prolonged or continued
exposure of the tissues of anterior
areas of mouth to the drying effects
of inspired air .(CHACKER,1961)
 Defined as habitual respiration
through the mouth instead of the
nose. (SASSOUNI, 1971)

6. CLASSIFICATION
Obstructive Anatomic Habitual

7. ETIOLOGY
1.Nasal Obstruction due
to –
-Enlarged turbinates
-Deviated nasal septum.
-Allergic rhinitis
-Nasal polyps
-Enlarged adenoids
-Chronic inflammation of
nasal mucosa

8. 2.Abnormally short upper lip preventing
proper lip seal
3.Obstruction in the bronchial tree or
larynx
4.Obstructive sleep apnoea syndrome
5. Genetically predisposed individuals
-Ectomorphic children having a genetic
type of tapering face & nasopharynx
are prone for nasal obstruction
6. Thumb sucking or other oral habits
can be the instigating agent

9. CLINICAL FEATURES
General effects-
-Pigeon chest
-Low grade esophagitis
-Blood gas constituents
Effects on dentofacial
structures-
 Facial form –
- A large face height
- Increased mandibular plane
angle
- Retrognathic mandible &
maxilla

10. Adenoid facies –Characterized By
-Long narrow face
-Narrow nose & nasal passage
-Flaccid lips with upper lip being short
-Dolicocephalic skeletal pattern
-Nose is tipped superiorly in front
-Expressionless face
-V shaped maxillary arch & high
palatal vault.

12.  Dental defects :
• Upper & lower incisors
are retroclined.
• Posterior cross bite
• Anterior open bite
• Narrow palatal & cranial
width.
• Flaring of incisors
• Decrease in vertical
overlap of anterior
teeth.

13.  Speech defects:
- Nasal tone in voice
 Lips:
- Short thick incompetent upper lip.
- Voluminous curled over lower lip.
- Gummy smile
 External Nares:
- Slit like external nares with a narrow nose
due to atrophy of lateral cartilage.

14.  Gingiva:-
• Inflammed & irritated
gingival tissue in the
anterior maxillary arch.
• Classic rolled marginal
gingiva and enlarged
interdental papilla.
• Inter proximal bone loss
and presence of deep
pockets.
Other Effects:-
• Otitis Media
• Dull sense of smell and loss
of taste

15. DIAGNOSIS
1. History
2. Clinical Examination
Look for lip competency
Size and shape of external nares.
3. Clinical Tests
- Mirror test
- Butterfly test
- Water test

16. n Rhinomanometry (inductive
Plethysmography)
n Cephalometrics

17. MANAGEMENT
 Elimination of the cause
 Symptomatic treatment
 Interception of the habit :- If the
habit continues even after removal of
obstruction, then it should be
corrected. Correction can be done by:
• Physical exercise
• Lip exercises
• Maxillothorax myotherapy
• Oral screen

18.  Oral Screen:-
• Most effective way to reestablish nasal
breathing is to prevent air from entering the
oral cavity.
• Oral screen should be constructed with a
material compatible with the oral tissues.
• Reduction in the anterior open bite is
obtained after treatment for 3-6 months.

19. PRE ORTHODONTIC TRAINER
 It is used in mouth breathers, tongue
thruster & thumb suckers.

20. • Construction of the membrane
• Construction of the cast
 Correction of the malocclusion
• Mechanical appliances
a. Children with class I occlusion and anterior
spacing – oral shield appliance.
b. Class II div. I dentition without crowding-
Monobloc Activator can be used.
c. Class III malocclusion – chin cap can be
used.

21. REFERENCES
Textbook of Orthodontics :
Gurkeerat Singh
Textbook of Pedodontics : Shobha
Tandon
Orthodontics : The Art & Science
- S.I. Bhalajhi