Mouth Breathing in Children: Clinical Considerations for Parents

Mouth breathing in children is sometimes regarded as a benign habit. However, persistent mouth breathing may be associated with patterns of craniofacial growth, dental development, and sleep-related breathing concerns that warrant clinical evaluation. In orthodontic practice, children who present with dental crowding, narrow maxillary arches, or crossbites may also demonstrate altered breathing patterns. These findings may coexist but do not establish causation in isolation.

Understanding Mouth Breathing and Its Clinical Context

Consider the example of an eight-year-old child who presented for orthodontic assessment with dental crowding and an anterior crossbite. In addition to occlusal findings, altered breathing patterns were noted during the clinical examination.

Observed findings included chronic mouth breathing associated with nasal obstruction, a narrow maxillary arch with transverse discrepancy, and an orofacial functional pattern characterized by altered tongue posture and increased perioral muscle activity.

These findings were not interpreted as cosmetic concerns alone. They were evaluated in the broader context of airway function, sleep quality, and orofacial muscle coordination, all of which may influence dentofacial development over time.

Potential Associations of Mouth Breathing

Persistent mouth breathing in children has been associated with several clinical considerations, though individual presentation and severity vary.

Altered jaw and facial growth patterns may be observed in some children with chronic open-mouth posture, including maxillary constriction, increased lower facial height, and dental crowding.

Mouth breathing, snoring, and nasal obstruction are commonly reported clinical signs associated with sleep-disordered breathing in children. Sleep-disordered breathing may affect sleep quality and has been associated with growth, behavioral, and attentional concerns. Medical diagnosis and management of sleep-disordered breathing are directed by a physician.

Sleep disruption related to breathing patterns has been associated with difficulties in attention, behavior regulation, and academic performance in some children.

From an oral health perspective, mouth breathing may contribute to oral dryness, increased plaque accumulation, dental caries risk, and gingival inflammation.

Chronic airway and sleep-related disturbances may also be associated with broader systemic health considerations over time, though outcomes vary widely among individuals.

Clinical Approach to Care

When mouth breathing is identified in a child undergoing orthodontic evaluation, care is approached conservatively and in coordination with other healthcare providers when indicated.

Medical coordination may involve communication with the child’s primary care physician or referral to an otolaryngologist to assess nasal or upper airway factors.

Orthodontic care may be directed toward addressing maxillary constriction, transverse discrepancies, or crossbites using growth-appropriate orthopedic or orthodontic appliances. These interventions are intended to support dentofacial development and function, not to diagnose or treat medical sleep disorders.

Orofacial myofunctional therapy may be considered to address tongue posture, lip competence, swallowing patterns, and nasal breathing habits as part of a coordinated care approach.

Growth and development are monitored periodically to assess changes over time and to guide treatment timing and progression.

Why Timing Matters

Early identification of altered breathing patterns and associated dentofacial findings allows for monitoring and, when appropriate, intervention during periods of active growth. Earlier care may reduce treatment complexity later; however, treatment decisions remain individualized and dependent on clinical findings, growth status, and medical considerations.

When Further Evaluation May Be Appropriate

Children who snore regularly, breathe primarily through the mouth, demonstrate dental crowding or transverse discrepancies, or show signs of disrupted sleep may benefit from clinical evaluation. Orthodontic assessment focuses on dentofacial development and function and may form part of a broader, interdisciplinary evaluation when airway or sleep-related concerns are present.