mouth breathing

MOUTH BREATHING HABIT

submitted by

HANSA Roll no.6031

• HABIT-is defined acc. to-

a)Dorland-fixed or constant practice established by frequent repetitions.

b)Buttersworth-frequent or constant practice or acquired tendency, which has been fixed by frequent repetition.

c)Mathewson-oral habits are learned patterns of muscular contractions.

According to WHO-

Habits are routines of behavior which are repeated regularly, tend to occur subconsciously without directly thinking consciously about them…

NORMAL BREATHING AND THE RESPIRATORY SYSTEM

• Breathing is the process by which oxygen in the air is brought into the lungs and into close contact with the blood, which absorbs it and carries it to all parts of the body. At the same time, the blood gives up carbon dioxide, which is carried out of the lungs with air breathed out

UPPER RESPIRATORY TRACT

LOWER RESPIRATORY TRACT

MOUTH BREATHING

–It can be defined as the habitual

breathing through mouth instead of nose.(Sassouni1971)

–Mouth breather is the one who

breathes orally even in relaxed and

stressful situations.

• Mouth breathers snore much more than nasal breathers.the reason being that during mouth breathing tissues are much more vibrated thus produce more sound

CLASSIFICATION

It can be due to following factors

1.ANATOMIC - it is due the short upper lip which doesn’t permit the complete closure of mouth 

 2.PATHOLOGICAL- it is due to complete or partial obstruction of nasal passage ,which can lead to mouth breathing habit….

• **Following are some of the causes of nasal obstruction-

         a. Deviated nasal septum         b.Nasal polyps         c.Chronic inflammation of nasal mucosa         d. Allergic reactions to nasal mucosa         e.Obstructive adenoids 

Short upper lip

• 3.HABITUAL – it can be seen in the persons who continues to breathe from mouth even through the nasal obstruction is removed

GENERAL EFFECTS-

1.Purification of inspired air: the nasal airway filters heat &humidifies the air in

preparation for entry into the bronchi &lungs.

2.Pulmonary development -the functional airway also creates a proper amount of nasal resistance so,that the diaphragm &intercostal muscles must perform work to create negative pressure to promote airflow into the lungs. With oral respiration the resistance is lacking &poor pulmonary compliance is seen. This gives the

appearance of a pigeon chest.

• 3. Lubrication of the oesophagus -since the oesophagus contains no mucous glands,the mucus from the nose & pharynx serves to lubricate the oesophagus.In mouth breathers the oral pharynx is dry &mucus collects often to be expectorated. This denies the oesophagus essential lubrication & can produce a low grade oesophagitis.

Oesophagitis

EFFECTS ON DENTO FACIAL STRUCTURES

1.FACIAL FORM- patients who mouth breathe due to hypertrophied lymphoid

tissue display a tendency towards a more vertical growth pattern.

• 2.ADENOID FACIES- is a particular type of facial configuration characterized by a long ,narrow face with an accompanying narrow nose &nasal passages, flaccid lips with the upper lip being hypotonic.(dolicocephalic)

• The long face is expressionless.

• The buccal segments of the maxilla are collapsed,leading to V shape and high palatal vault.

Adenoid facies

3.DENTAL EFFECTS: Lower incisors are retroclined

Posterior cross bites

are present

Anterior open bite is

present

Maxillary arch becomes constricted

Flaring of upper incisors takes place.

4.SPEECH DEFECTS :Nasal twang

in voice.

• 5.LIP-associated with excessive appearance of maxillary anteriors, is a sign of long face syndrome, producing GUMMY SMILE.

Gummy smile

Before &

After treatment

6. EXTERNAL NARES- atrophy of lateral cartilage.result in slit like external nares with narrow nose.(pinched nose)

• 7.GINGIVA-inflamed& irritated gingiva in anterior maxillary arch. Gingiva is hyperplastic due to continuous exposure of tissues to air,as such the gingiva appears dry.

• 8.CARIES-more chances of caries as the saliva becomes thick and ropey,which leads to decrease in the cleansing and anti-microbial action

DIAGNOSIS

–1.HISTORY– Frequent tonsillitis– Lip apart posture– Repeated respiratory infections

•  

– 2.CLINICAL EXAMINATION- – a. Observe the pateint unknowingly

while he/she is swallowing…… – In cases of nasal breather- lips touch

slightly – in cases of mouth breathers-lips are

kept apart – b. Butterfly Test-  Take a piece of

cotton an shape it in to a butterfly and place  it over the upper lip below the nostrils …if the cotton fibers are moving towards the nostrils ,then the patient can be diagnosed as a mouth breather

–    

–  c.Mirror Test-  A double sided mouth mirror is held between the nose and the mouth…….fogging on nose side of the mirror indicates nasal breathing while fogging towards the oral side indicates oral breathing

–  d. Water Holding Test-  The pateint is asked to fill his mouth with water and retain it for a period of time…..nasal breathers can hold the water for longer period of time then mouth breathers

Water holding test

–Rhinomanometry(inductive plethysmography)

•  

It  is the study  of nasal air flow characterstics using device consisting of flow meters and pressure gauges.The device helps in estimation of air flow through nasal passage and nasal ressistance

Rhinomanometry-

Cephalometrics-

Cephalometric examination helps in estabilishing the amount of nasopharyngeal space,size of adenoids and also helps in diagnosing the long face associated with mouth breathing

• Cephalometrics-

• Infant trainer makes the child breathe through nose,also trains them to swallow &position the tongue properly

Lip trainer helps to strengthen lip closure-

RAPID MAXILLARY EXPANSION-

-These devices are used in pateint with narrow or constricted maxillary arch

–         -These devices are used in mouth breathers because of following advantages

–                 a.Increase in nasal air flow

–                 b. Decreasing the nasal air resistance

–                 c. widening the narrow arches

–             Eg. Quad helix,hyrax type expansion appliance

Phisical exercise-

Playing a wind instrument-

Oral screen-plexiglass or acrylic resin appliance that fits into vestibule of mouth &

prevents mouth breathing.

• Oral shield used to correct class 1 malocclusion-

• Chin cap used to correct class 3 malocclusion-

• Monobloc activator-used to correct class 2 division 1 malocclusion.

Septoplasty-

PRE TREATMENT AND POST TREATMENT VIEW

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