Mouth breathing, also known as oral breathing, is a relatively common finding in children.
Intermittent oral breathing during episodes of nasal congestion is very frequent and does not necessarily require a visit to the ENT specialist. However, if your child habitually breathes through their mouth, it’s advisable to consult a specialist.
In cases of consistent oral breathing, it is recommended to visit a pediatric ENT in Madrid. consulta de otorrino pediátrica en Madrid
One of the most complex questions to answer when a child breathes through the mouth is whether this is due to an inability to breathe through the nose or if it’s simply a habit. To determine this, the ENT will perform an examination to identify any anatomical abnormalities that might block nasal breathing, such as turbinate hypertrophy, deviated nasal septum, or enlarged adenoids (commonly known as adenoidal tissue). If these abnormalities are present, treatment can be initiated. Otherwise, we may conclude it is an oral habit that must be corrected through reeducation.
It is crucial to determine whether nasal breathing is physically obstructed or if it’s just a behavioral habit.
The way we breathe is especially important during childhood, as it greatly influences facial growth. Proper facial development requires nasal breathing, with the mouth closed at rest, lips sealed, and the tongue resting against the palate.
This posture promotes proper facial growth and normal airway development, potentially preventing disease in adulthood.
Facial development refers to changes in the shape and proportions of the craniofacial structure, not just an increase in size.
Proper craniofacial development is vital because any anatomical alteration of these structures is associated with conditions in adulthood such as obstructive sleep apnea, temporomandibular joint dysfunction, and other musculoskeletal issues.
Facial growth disturbances can lead to diseases in adulthood.
Facial bone growth depends heavily on the forces exerted by the attached musculature. Therefore, correct use of facial muscles is essential for proper development. The functions of the tongue and orofacial muscles during breathing, chewing, and swallowing determine how the craniofacial structure develops.
To promote healthy facial development, children should:
Proper breathing, chewing, and swallowing are fundamental to healthy facial growth.
The correct way to breathe is through the nose. Nasal breathing should be accompanied by a closed mouth and the tongue resting on the palate.
Mouth breathing not only bypasses the nose’s air-filtering and humidifying functions, but also alters facial muscle usage. When a child breathes through the mouth, the tongue drops to the floor of the mouth instead of resting on the palate, losing its role in maxillary expansion. Keeping the mouth open alters the facial growth vector, leading to a downward and backward pattern and a more recessed chin, known as retrognathia. Retrognathia is associated with airway narrowing due to a reduced anteroposterior diameter.
If mouth breathing persists over time, it hinders proper airway development, leading to a high-arched (ogival) palate, and children may adopt compensatory postures like extending the neck and bending the spine to maximize airway space.
Mouth breathing is associated with retrognathia, high-arched palate, and compensatory postural changes.
Chewing is one of the pillars of proper facial development.
Children with nasal obstruction tend to chew only on one side, keeping the other side free to ensure they can continue breathing. Over time, this leads to uneven development of the masticatory muscles, causing facial asymmetry and bite issues like crossbite. In more severe cases, children may develop a compensatory head tilt, which in turn alters the posture of the entire body to maintain balance — resulting in shoulder, hip, or knee asymmetries, and potentially causing long-term anatomical consequences.
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For correct craniofacial development, age-appropriate swallowing is essential.
Newborns exhibit visceral swallowing, a pattern involving tongue protrusion to collect milk. As a child grows and starts eating solids and developing teeth, this pattern must change to adult swallowing. In adult swallowing, the tongue moves the food bolus by sweeping it along the palate from the front of the mouth backward.
Atypical swallowing is the persistence of visceral swallowing beyond 5–6 years of age. This condition compromises the tongue’s role in maxillary expansion.
We swallow around 2,500 times per day, meaning 2,500 opportunities daily for the tongue to exert lateral pressure on the teeth — helping counterbalance facial muscle forces and promote maxillary growth. In atypical swallowing:
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We recommend consulting an ENT if your child exhibits: