My nine-year-old son has been breathing through his mouth while sleeping since the past two years. Should I be concerned, and is there any treatment for this?

Normal breathing is always done through the nose. Mouth breathing by children is normally due to a nasal obstruction or congestion that prevents them from taking in sufficient air through the nose. Chronic allergic rhinitis or nasal polyps are some of the common causes for nasal obstruction.

However, in some habitual mouth breathers this is not the case. Their brain thinks carbon dioxide is being lost too quickly from the nose and stimulates some cells to produce mucus in the nose to slow breathing. This creates a vicious cycle triggering mucus formation and nasal passages’ blocking, leading to more mouth breathing.

Mouth breathing can have dire consequences such as dryness of the mouth leading to inflamed tonsils, dry cough, swollen tongue, bad breath, gingivitis and caries. Plus such breathers take in lesser oxygen.

This reduced intake of oxygen absorption over a period of time leads to a series of problems such as disturbed sleep, low stamina and energy levels, enlarged and inflamed tonsils and adenoids, increased risk of upper respiratory tract infections and even attention deficit hyperactivity disorder problems.

When they grow into adults, they may develop sleep apnoea with more serious consequences. Mouth breathing also can affect the growth of the face. Children who mouth-breathe have an underdeveloped narrow upper arch (maxilla) with a high palate. The lower jaw also drops down and the patient gets a long face.

It is important that mouth breathing should be diagnosed early and treated to prevent long-lasting damage.

Treatment of mouth breathing may involve identification of any causative factor. It may also include myofunctional therapy by pedodontist/orthodontist involving use of appliances to expand the upper jaw and increase the airway passage, and also training the child on correct breathing practice using breathing exercises.