Considerations Before a Tonsillectomy.

A 2022 study shows that rapid palatal expansion can decrease the size of tonsils and adenoids in children. Mouth-breathing causes inflammation throughout the entire body, including the tonsils. Expansion can create room for more airflow, decreasing inflammation, and thus shrinking the size of the inflamed tonsils.

The Importance of Nasal Breathing

Our nose is designed to prepare the air for the lungs. The nose warms, filters, accelerates, humidifies, and cleans the air, which leads to efficient oxygen exchange in the lungs. The mouth does none of this, and actually reduces oxygen absorption (1.4).

Nasal breathing also produces Nitric Oxide (1.1), an anti-inflammatory molecule that aids in immune function. Where as mouth breathing decreases immunity and causes inflammation throughout the body (1.2, 1.3).

Think about hyperventilation…what happens when you hyperventilate? You rapidly breathe through your mouth and do not receive the proper exchange of oxygen, which results in a negative effect all over. When you are mouth breathing (day or night) the body is sent into a constant fight or flight mode, which puts your adrenal glands on max 24/7. 

Mouth Breathing: Concerns

Reduced Oxygen Absorption, Reduced Immunity, & Inflammation

Improper Jaw Development (2.1)

• mouth breathing can lead to an elongated face, resulting in a gummy smile and/or recessed chin

• it creates a narrow palate which leads to crowded and misaligned teeth; and possible airway restriction

• it can change the entire structure of the face, affecting bone growth and causing malocclusion or altered bites

Snoring & Sleep Apnea - mouth breathing is often linked to snoring and can cause or worsen sleep apnea (2.1)

Dry Mouth - increases bad breath, gum disease, and cavities

Poor Posture & Pain - mouth breathing can lead to forward head posture, which puts strain on the neck and spine (2.2)

ADD/ADHD - since mouth breathing is typically associated with a sleep breathing disorder, this is one of the most common symptoms - especially in children. Read more on this HERE.

AND MORE!

Mouth Breathing: Primate Study

Two fascinating studies by Dr. Egil Harvold, published in the American Journal of Orthodontics and Dentofacial Orthopedics, observed young monkeys with plugged noses forcing them to adapt by mouth breathing.

This study found that ALL the monkeys who mouth breathed developed crooked teeth and poor jaws & facial development. Specifically, mouth breathing led to “a lowering of the chin, a steeper mandibular plane angle, and an increase in the gonial angle.” Their faces become long and narrow, with the jaw prominent and the chin recessed. 

Mouth Breathing & Sleep-Breathing Disorders

Most times chronic mouth breathing is a symptom of a deeper problem: an underdeveloped jaw and a sleep-breathing disorder (these typically go hand in hand - improperly developed jaws usually result in SBDs) (3). Thankfully, this is a very correctable deformity and dysfunction in the oral and facial structure - especially if caught and treated early in childhood. 

Other SDB Sypmtoms

• ADD/ADHD

• Bed Wetting

• Delayed Speech

• Overweight/Obesity

• Learning Difficulties

• Vertigo/Clumsiness

• Restless Legs

• Aggression/Defiance 

• Teeth Grinding

• Snoring

• Mouth Breathing

• Daytime Sleepiness

• Nightmares/Night Terrors

• Allergies/Asthma 

• Anxiety

• Frequent Illness

• Stunted Growth

• Crooked Teeth

• Swollen Tonsils/Adenoids

• Forward Head Posture

• Recessed/Stunted Chin

• Dark Circles Under the Eyes

Mouth Breathing: Interventions

Treatment will vary depending on age and severity. If caught early during childhood, the treatment is often much more simple. Early correction for optimal child development will typically involve a TEAM approach of an airway centered & trained dentist, an ENT specialist, speech/myo therapist, body worker, and possibly orthodontist. 

How to Find a Properly Trained Provider

I wouldn't trust just anyone. This is a very nuanced subject matter, and a providers training, knowledge, and philosophy is important.

Two programs who train exceptional dentists are The Breathe Institute and Airway Health Solutions. The Breathe Institute Affiliates are extensively and specifically trained in tongue and lip ties, however the knowledge, understanding, and philosophy of these providers typically go hand in hand with overall development and SBDs.

Both programs have search engines for their providers.

• Airway Health Solutions provider search

• The Breathe Institute provider search

  • Dr. Soroush Zaghi (ENT) is the founder of TBI. He is absolutely phenomenal for all things tongue/lip tie related, to sleep breathing disorders, to jaw development issues, and more. He is located in LA, but does offer telehealth consults if you are not in CA.

*I am sure there are certainly other amazing programs, and doctors outside of these two resources. But these are the two that I can personally vouch for. I cannot vouch for every single doctor who has been trained under these programs, but they are phenomenal programs and produce phenomenal and caring providers.