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Bad breath (halitosis)

When one primarily breathes through the mouth, he or she is more likely to have a dry mouth. Not only does this lead to increased levels of oral bacteria, but also there is less saliva to wash it away, which leads to halitosis.

Crowded teeth

Crowded teeth are a manifestation of poor oral posture (no lip seal, tongue not resting on palate, incorrect swallowing patterns), and that the face and jaws have not been developing properly. In fact, crowded teeth are the last indication of a collapsed airway.

Deep overbite

This refers to either the upper front teeth coming down too far over the lower front teeth, or the upper front teeth sitting too far in front of the lower front teeth. In some instances, the lower front teeth are not even visible when the teeth are together. This occurs when a person holds their tongue between their back teeth, a sign they may not have enough room in their mouth for their tongue. Left untreated a deep bite may restrict the lower jaw from growing forward resulting in a smaller airway.

Grinding or clenching of teeth/tooth wear

Clenching and grinding during sleep is an adaptive mechanism that pulls the tongue forward and away from the throat, thereby bringing the lower jaw forward to open the airway.

Large tonsils/adenoids or previous tonsillectomy/adenoidectomy

Enlarged tonsils often result from habitual mouth breathing. If there is a blocked nasal airway unfiltered air is brought in through the mouth. This unfiltered air will have more bacteria, allergens, and pollutants which bombard the tonsils and adenoids sometimes causing them to become inflamed. Enlarged tonsils and adenoids cause the airway to narrow. (Think rocks in a garden hose!) A smaller airway makes it harder to breathe and much more likely that the mouth breathing will continue.

Mouth breathing

Mouth breathing is a consequence of the upper jaw, or the maxilla, not developing properly. Most of the nasal airway is made up of the maxilla, which provides the floor of the nasal cavity. An individual with a narrow or improperly formed maxilla will have extremely narrow nasal passages with crowded soft tissue, making nasal breathing difficult. Chronic allergies can also contribute to chronic mouth breathing. A mouth breather will not be humidifying the air, or slowing it down to allow it to properly mix with nitric oxide. The lungs will have difficulty providing maximum oxygenation for the body with this un-humidified, unfiltered and, most importantly, NO-lacking air. Thus mouth breathing has a negative effect on every cell in the body as it deprives them of oxygen.

Narrow dental arches

A narrow or underdeveloped upper jaw (maxilla) can prevent the lower jaw (mandible) from developing fully forward. This “retrusion” causes a lack of physical space for the tongue and the surrounding tissues, which again will provide an impedance to the airways, causing breathing difficulties and lowered oxygen uptake by all of the tissues.

Recessive chin

A recessive or weak chin is a sign that the lower jaw (mandible) has not grown far enough forward. This physical feature is a telltale sign that one has a compromised pharyngeal airway, as the mandible is partially blocking or pinching it. Scalloped tongue: A scalloped tongue is the impressions or ridges on the sides of the tongue, which indicates that the jaw is too small to accommodate the tongue, even if it is normal-sized. In addition, if one has chronic acid reflux from mouth breathing, the swelling of the tongue can exacerbate these ridges on the sides.

Speech problems/tongue thrust

Also known as a “lisp,” a tongue thrust occurs when the tongue is forced to sit low in the mouth because the upper palate is too narrow to accommodate it. A moderate to severe tongue thrust cannot be resolved with speech therapy alone because this does not address the root cause of the narrow upper palate.

Teeth removed (other than wisdom teeth)

A history of teeth extractions likely indicates that one’s dental arches did not develop properly and therefore were too narrow to accommodate all of the adult teeth. When there is not enough room for the teeth, the appropriate solution is to expand the arches to create the necessary space.

Tongue tie and/or problems nursing during infancy

Also known as a restricted lingual frenum, a tongue tie is when the line of tissue (frenum) under the tongue is too tight or too short. This restricts the movement of the tongue, forcing it to sit low instead of on the upper palate. This impacts an infant’s ability to breastfeed easily, and in older children, tongue ties are often associated with mouth breathing, chronic jaw/facial pain, headaches, clenching and grinding, and other dental issues.

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Foundation for Airway Health, 355 Lexington Avenue, 15th Floor New York, New York 10017-6603 - (212) 297-2193 - - 1/18/2022