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