Mouth breathing and the risks associated with COVID-19

Risks associated with mouth breathing

Mouth breathing and the risks associated with COVID-19

We swallow hundreds of times a day and mouth breathers swallow air every time leading to stomach bloating. The pressure is sufficient to weaken the esophageal sphincter and allow an acid reflux. This constant acid causes the pharynx to lose elasticity, causing it to collapse, as seen in mild to moderate obstructive sleep apnea. In serious apnea, the whole pharynx collapses. Mouth breathers are likely to draw saliva, food and bacteria into the lungs. This explains the lack of elasticity in the lungs of those who have chronic obstructive pulmonary disease (COPD). As evidently seen we face a myriad of interrelated issues.

Mouth breathers generally inhale 10 to 15 liters of air per minute, compared to 4 to 6 liters for a nasal breather. This increased volume of unfiltered air devoid of nitric oxide significantly increases the risk of COVID-19 infection for mouth breathers. Given the current COVID-19 focus on face masks in order to prevent infection, it is essential to breathe correctly even when wearing the mask. Many have now developed the habit of Mouth respiration as they speak wearing their masks. Keeping short conversations helps to maintain nasal breathing.

Signs and Symptoms of Mouth Breathing:

There is a plethora of signs and symptoms that could indicate the presence of mouth breathing – Nasal congestion, dry cough, sleep disturbances, fatigue, ADHD, tongue thrust, poor palatal development, altered speech patterns, burping, hiccups, bronchitis, allergies, enlarged tonsils, bad breath, snoring, sleep apnea, failure to thrive, abnormal swallowing habits, forwardly placed teeth, recessive chin, bloating, flatulence, acid reflux, Long Face Syndrome, gingivitis, silent aspiration, orthodontic relapse, weak lips, slouched posture, frequent urination at night and pneumonia.

Management of Mouth Breathing:

It is important to identify the presence of Mouth breathing in patients and to inform them of the risks they face. A complete medical history would be essential as well as an evaluation of the mouth, nose and throat for abnormalities. It may be necessary to imagine the nasal passages, examining lung function and studying sleep.

The treatment of Mouth breathing is based on its underlying cause. 

An ENT specialist would be required if a person has enlarged tonsils and adenoids to remove tonsils and adenoids to assist in breathing. If the shape of their nasal passages is a problem, widening these pathways is required so that the person can breathe physically through the nose.

A physiotherapist may teach techniques that emphasize breathing through the nose rather than the mouth. Among the most common are the Buteyko method, the Papworth method and the Pranayama.

Temporary use of anti-inflammatory nasal sprays, antihistamines and decongestants is undoubtedly useful.

Dr. Premila Naidu, an eminent paediatric dentist from Bangalore says “Mouth breathing in children could be anatomical, obstructive or habitual. The first step is to refer the child to an ENT specialist or pediatrician to find the cause for the mouth breathing. In case of anatomical or obstructive reasons, the mouth breathing has to be sorted accordingly. Children with mouth breathing typically have long, narrow faces with narrow nasal passages, V-shaped jaws and high vault palate. History of  chronic allergies, failure to thrive, behavior issues, forwardly placed and spaced out teeth and even having open bites are some of the classic features.

If the mouth breathing is a pure habit, lip exercises to improve lip tonicity and barriers such as the oral screen to restrict mouth breathing or a tongue crib to counter the tongue thrust are needed. Orthodontics to expand the dental arches is necessary to better accommodate the tongue and better align the teeth.” 

The harmful effect of oral respiration affects early cranial-facial development. Children develop narrow dental arches, a high palatal arch and misaligned teeth. A correctly positioned tongue has the capability to shape the palate of a growing child. A well-developed upper jaw is essential for normal skull and facial development. The teeth are not too big for the jaws, but the jaws are usually small for the teeth.

In adults without any obstructive or anatomic interference, by placing the tongue on the roof of the mouth, a lip seal is created. It favours breathing via the nose. A tongue repositioning device positions the tongue in the palate just above the upper front teeth rather than against the back of the front teeth. This also prevents the tongue from falling down the back of the throat. It efficiently reduces snoring and mild sleep apnea as well. Respiration is more relaxed and the diaphragm is now used for respiration. It controls the push of the tongue, encourages appropriate swallowing patterns, trains athletes to stamina and prevents them from overexerting themselves. 

Thankfully, our profession is about making a positive impact on people’s lives: aesthetically, psychologically, functionally, biologically, and systematically. Mouth breathing is a highly treatable condition for which a person should not hesitate to seek treatment. The earlier a person seeks treatment, the less likely he or she is to experience chronic and long-term complications of oral breathing, including the repositioning of the jaw. Once you understand the importance of nasal respiration, you will realize that the advantages are overwhelming.

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