A person’s ability to breathe properly through his or her nose, without obstruction, is critical to their health and vitality in many ways; it cannot be overemphasized as a health or quality-of-life issue. Obstructions, however they occur, need to be evaluated and eliminated. Without the elimination of the obstruction, mouth breathing can result and lead to many problems, including poor facial and dental development.It is important to recognize that, although a child may not see an orthodontist until age seven or even later, many of the problems associated with airway obstruction begin much before that age. Perhaps the most obvious of these problems is when a baby or very young child makes excessive noise while breathing during either waking or sleeping hours. This is a sign that there could be an obstructed nasal passageway. This problem, at whatever age it’s detected, is entirely treatable and must be addressed.
OXYGEN: THE BODY’S NUMBER 1 NUTRIENT!
Oxygen is the body’s number-one nutrient, and a person will die when deprived of it for even a few minutes. Because of this, the body has a built-in protection mechanism. When air can’t effectively be drawn in through the nose, the body moves to plan B and draws it in through the mouth. For all intents and purposes, that would seem to solve the problem, except there’s a catch: the body isn’t meant to breathe through the mouth except in an emergency situation requiring a high level of oxygen, such as in athletics.When a person breathes through his or her mouth in a normal, everyday, non-stressful situation, the body’s knee-jerk solution triggers an avalanche of unintended consequences. Left unchecked, these consequences ripple outward to include many conditions and disorders that can impact the person’s entire body health.Unless the nasal obstruction is addressed when the patient is a child, it begins to lay the groundwork for future health conditions, such as obstructive sleep apnea, TMJ Dysfunctions and even spinal misalignments. Upper airway obstructions have been linked to sudden infant death syndrome (SIDS), attention deficit disorder (ADD and ADHD) and even bedwetting.
WHAT CAUSES NASAL OBSTRUCTIONS?
As we’ve seen, obstructions of the nasal passageway create a domino effect and impact the entire health of the patient. So what are the causes of nasal obstruction?
ALLERGIC RHINITIS
A very common cause is an obstruction produced by allergies (allergic rhinitis). Inflammation caused by the presence of an allergen results in swelling of the mucus membranes on the inside of the nasal passageways. This swelling reduces the opening of the nasal passageway, potentially causing an obstruction leading to nasal stuffiness or mouth breathing. Darkening under the eyes is a condition called allergic shiners and is a warning that a person is challenged by allergies.
TONSILS AND ADENOIDS
Tonsils are those little sacs of lymphatic tissue that can be seen hanging at the back of the throat, and adenoids are hidden just above them. They are the first scrubbing filters against the bacteria and viruses that enter the mouth and nasal passages. Chronically inflamed tonsils are a breeding ground for colds, hoarseness, bad breath, sore throat and can obstruct the upper airway if they become too large due to inflammation from repeated infections.
This illustration shows the relationship of structures that can obstruct the nasal passageway. Enlarged adenoids are a main culprit of childhood earaches. If a child suffers from persistent pain inside the ear, it’s a red-flag warning to look for enlarged adenoids. When they become oversized, adenoids can encroach on the Eustachian tube, the conduit to the middle ear that regulates ear pressure and balance. This allows bacteria to puddle up in the tube, and from there the bacteria back up into the middle ear, causing painful ear infections.DEVIATED SEPTUMThe condition results when the septum, which consists of the bone and cartilage separating the nose into two nostrils, deviates from one side to the other and is a common cause of nasal obstruction and mouth breathing. A deviated septum is exceptionally common in people with narrow upper jaws.
Specialists in otolaryngology will frequently recommend surgery to eliminate a deviated septum, however the deviated septum may be the result of poor development of the upper jaw. When we orthopedically expand the upper jaw in the orthodontic field, the septum may become straighter, and with the improvement of the airway, the patient no longer needs this surgery.Narrow, underdeveloped upper JawA narrow upper jaw can also contribute to an airway obstruction leading to mouth breathing. The condition of deviated septum can be the result of the narrow upper jaw as explained before. The narrow upper jaw is the chicken and egg situation begging the question “Which came first, the narrow jaw or the airway obstruction?” The answer to this question is less important than what to do about it if it is underdeveloped. Fortunately, we can expand the upper jaw to ideal at an early age, but this expansion can be completed at any age. Expansion of the upper jaw can help to open the airway, eliminate the need for extraction of permanent teeth during orthodontic treatment and help to prevent many future developmental problems such as TMJ dysfunction, obstructive sleep apnea and even spinal alignment problems.What to do?If you suspect that a family member or friend has a problem with normal breathing, please contact our office to set them up for a complimentary evaluation.
Mouth Breathing: A Serious Health Problem
S. Kent Lauson, DDS, MS Orthodontist, Aurora, Colorado