Department of Paediatric Dentistry

MOUTH BREATHING HABIT

IN CHILDREN

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 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)

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 Pedodontist
Parents
Orthodontist

ORAL HABIT

Speech
Pathologist
Pediatrician
Psychologist
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MOUTH BREATHING HABIT

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 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)

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 CLASSIFICATION

Obstructive Anatomic Habitual

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 ETIOLOGY

1.Nasal Obstruction due

to –
-Enlarged turbinates
-Deviated nasal septum.
-Allergic rhinitis
-Nasal polyps
-Enlarged adenoids
-Chronic inflammation of
nasal mucosa

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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
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 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

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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.

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 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.

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 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.

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 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

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 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

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4. Rhinomanometry (inductive
Plethysmography)
5. Cephalometrics

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 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
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 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.

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

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 • 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.

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 REFERENCES
Textbook of Orthodontics :
Gurkeerat Singh

Textbook of Pedodontics : Shobha

Tandon

Orthodontics : The Art & Science

- S.I. Bhalajhi

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