Do NOT turn a blind eye to your child’s mouth breathing
Mouth breathing in children impacts the whole facial structure
Restoring correct resting tongue position & nasal breathing in your child is THE most impactful thing you could do for their future health.
Mouth breathing in children & adults | Restoring nasal breathing in children & adults
WHAT IS THE CORRECT RESTING TONGUE POSITION?
In my clinic I place huge emphasis on the correct resting position of the tongue.
You might ask what has the tongue got to do with physiotherapy and why do you keep going on about it?
Let’s go right back to what happens in childhood...
Firstly we need to understand what I mean by the correct resting tongue position. Simply put - the tongue should rest gently in the roof of the mouth at all times apart from when you talk and eat.
Correct resting position of the tongue, required for nasal breathing - the tongue should sit in the roof of the mouth when not talking and eating.
During bouts of colds and virus’ with a blocked nose, we all appreciate the need to mouth breathe at times. However, we SHOULD go back to normal nasal breathing with our tongue resting in the roof of the mouth once we return to health.
I’d encourage all parents to NOT turn a blind eye to your young child’s inability to keep their tongue in the roof of their mouth and breathe through their nose. To me this is a sign that warrants further investigation. The sooner the better. Children from as young as 6 years old when they start to lose their baby teeth are at an optimum age to tackle any issues preventing normal nasal breathing and early signs of dental malocclusion (bad bite).
We’re rediscovering something that’s always been known, that used to be mainstream, nose-breathers are healthier than mouth-breathers.
I would go as far as saying that restoring correct resting tongue position and nasal breathing in your child is THE most impactful thing you could do for their future health.
WHAT HAPPENS IF WE CONTINUE TO MOUTH BREATHE FOR LONGER PERIODS?
As the tongue grows during childhood, whilst resting in the roof of the mouth it exerts a force on the upper jaw that supports its growth up and forward. This outward force from the tongue also counteracts the inward force of the cheeks/upper lip. Without the tongue in the roof of the mouth exerting this force, the upper jaw doesn't fully develop.
Look at any child who has adopted an open mouth posture for a lengthier period of time and you may notice that the tongue appears to outgrow their “small” mouth and the tongue becomes “too big” to fit in the roof of the mouth. The child now has an under-developed upper jaw and this will result in significant overcrowding and malocclusion once the adult teeth come through, which may lead to the need for extractions and braces in the teenage years.
Mouth breathing in children affects jaw development and facial structure. As a direct result of reduced forward growth of the jaw, the airway is compromised and the body will correct this with compensations including forward head posture, which can have a knock-on effect on ribcage and pelvis position.
Photo: The Breathe Institute
Here are a few obvious reasons why a child would have difficulty maintaining correct tongue position for longer periods of time:
Allergies, asthma, deviated septum - can affect nasal breathing and so mouth breathing becomes the norm.
Tongue-tie - the child physically can’t lift their tongue flat to the roof of the mouth, the upper jaw won’t develop, the child will often develop a lisp and bad bite (malocclusion) which can lead to extraction orthodontics.
Sucking a dummy, sucking a thumb - this puts a physical barrier in the way of the tongues correct resting position. Not only that, but it can often lead to more complex malocclusion issues. The earlier a child stops sucking their thumb or dummy, the better.
In these examples the allergies and asthma could fluctuate allowing periods of normal nasal breathing. This doesn’t mean that their inability to nasal breathe can’t be and shouldn’t be addressed. The more nasal breathing becomes the norm, the better.
In the UK whilst we consider tongue tie to be a major issue if it affects a mother’s ability to feed her young baby, a tongue tie in an older baby or child can often be left untreated. I routinely assess my patient’s ability to nasal breathe and adopt a proper resting tongue position. In many cases patients will require surgery to address their posterior tongue tie along with an expansion dental appliance to create room for the tongue in the roof of the mouth.
WHY IS THIS SO IMPORTANT?
What are the implications of chronic (long-term) mouth breathing?
Skeletal remains show that just 300 years ago, humans commonly displayed straight, perfectly aligned teeth, wide jaws, flat palates and the large nasal passages that signal habitual, healthy nasal breathing.
But more recently, our faces have begun to deform. When children lose their baby teeth, there’s typically inadequate room for the adult teeth, which leads to crowding and misaligned teeth. Worst of all, this change encourages mouth-breathing, which can, in turn, lead to under-the-radar sleep difficulties and a whole array of problems ranging from behavioural challenges, anxiety and depression to cognitive issues. These conditions can have wider reaching implications and can cost thousands of pounds to correct through orthodontics, dentistry, therapy, and even surgery to remove tonsils and adenoids.'
In children who, between the key ages of 2-8, mouth breathe, the jaw will never reach its true position naturally and they will have narrower dental arches than they would otherwise have had as a nasal breather.
This affects the whole facial structure, which can impact aesthetically, but more importantly, as the jaw has not developed in the correct upwards and forward trajectory, the airway is compromised. The body “corrects” this compromised airway with a “compensation” - a forward head posture to open the restricted airway.
Many adults reading this will identify themselves or their child as a chronic mouth breather. As well as the changes in facial structure and forward head posture outlined above, many also report clenching and grinding of teeth - a symptom of your jaw being out of position; snoring (and sleep apnoea) - without enough room for the tongue in the smaller mouth, it falls back on lying flat and further restricts the already compromised airway.
In mouth breathing children the jaw does not develop properly and grow forward as it should. The airway becomes compromised. Mouth breathing children may snore as without enough room for the tongue in the smaller mouth, it falls back on lying down flat and further restricts the already compromised airway.
WHAT DOES THIS HAVE TO DO WITH THE REST OF THE BODY & PHYSIOTHERAPY?
A strong forward head posture due to airway restriction will influence a person's ability to shift and move the lower body correctly. This will result in further compensation strategies and abnormal patterns of movement in the rest of the body.
This is where a tongue position and nasal breathing crosses over into my physiotherapy clinic.
We all know the tongue plays a fundamental role in several functions including swallowing, breathing, speaking and chewing. However, not everyone will know it also plays a vital role in balancing the nervous system and can improve balance, stability and strength via the trigeminal nerve connections.
Adult patients who present at the clinic are often more difficult to treat than children, as they have developed years of compensation patterns as a result of their restricted airway. They often have very narrow dental arches and are physically unable to fit their tongue in the roof of their mouth.
I work very closely with some of the most forward thinking airway-conscious dentists in the world to help adults and children to grow the jaw and improve tongue space.
In addition to correcting tongue position, it's vital to get to the root cause of any factors affecting normal nasal breathing. There may well be allergies causing inflammation in the nasal passages that require a referral for allergy testing or structural issues that require referral to dentists and ENT specialists to assess airway function.
Interventions to address nasal breathing issues and tongue position restriction should be done as early as possible, to minimise the risk of compensations and faulty movement patterns occurring.
Alongside correct tongue position and nasal breathing I utilise a range of techniques to address pain and injury caused by faulty movement patterns as a result of chronic mouth breathing and restricted airway, to improve body alignment and function.
SUMMARY - MOUTH BREATHING IN CHILDREN & ADULTS
I’m hopeful that this blog will help you start to connect the dots between fundamentals such as the way we breathe and the position of the entire body from the head down.
From a very early age, the position of our tongue and how we breathe, impacts the development of our adult facial and dental structure and the position of our entire body from the head down.
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