The way you breathe determines how you look. It’s also the most important part of your breathing routine. One of the most overlooked things when talking about breathing is that your primary breathing pattern is through the nose or the mouth. It makes a difference. Chronic, mouth-breathing affects your face, your teeth, and your health. “Mouth breather face” is a face description that clinically defines the unique traits formed by this condition. This is a very common condition. One study found that 61% of Americans breathe through their mouths most of the time. This knowledge makes us understand this condition much more.
Introduction: Unmasking the “Mouth Breather Face” Phenomenon
The mouth breather face description is just the face. This condition is about much more than appearance. This is a mouth-breathing face’s biomechanics, and this condition also affects the health of the body overall, with several morbidity issues. We will discuss how to identify this condition, how to understand the multifactorial origins of the condition, and how to reestablish the important health benefits of nasal breathing.
What is Mouth Breather Face?
People sometimes say, “mouth breather” as an insult, referring to someone who is foolish. Medical professionals describe “mouth breather face” as a mouth that has been closed for too long.
Perhaps it’s a joke, but experts say that the oral posture of someone who has their mouth closed for too long undergoes certain chronic mouth breathing, or “hypoxic” breathing, if you will, over a long period of time. The breathing creates a physiological phenomenon that alters the structure of a person’s face from normal to something that is defined as “mouth breather face.” It is not just an insult, but a descriptor of a condition that, unfortunately, is increasingly prevalent these days.
Mouth breathing for long stretches, as well as closed mouth posture, creates a condition that disrupts the normal mechanism that motorizes the face as the lower jaw and mouth are moved during speech. It creates a jaw that has grown to accommodate a closed posture. The face does not define the mouth from the lower jaw. The lower jaw also closes with the mouth.
These symptoms also alter speech. Breathing with a closed mouth mechanically alters and, as a consequence, will define the speech, especially with the tongue, to a point that the speech will also become defective.
The careful oral enclosure also creates a narrowing of the upper jaw, which will also interfere with normal breathing.
Getting rid of the mouth breather face condition starts with addressing the health problems that can be associated with the symptoms.
Why Understanding Chronic Mouth Breathing Matters for Your Health
Breathing through your mouth may indicate that you have airway issues. Mouths should never breathe. Air should be inhaled through the nose. Air that is inhaled through the mouth is dried out, unfiltered, and leaves the body vulnerable to infection and irritation. Chronic mouth breathing is an infection and has numerous serious conditions, like obstructive sleep apnea, which cuts the oxygen levels in the body and disrupts sleep. The face is not the only body part that is affected, and neither are the long-term issues. The importance of this problem becomes even more serious with issues like unresolved cognitive issues. The list of serious health concerns grows, and the problem must be taken seriously.
What Exactly is “Mouth Breather Face”? The Biomechanics Behind the Appearance
There are reasons that mouth breathing is associated with changes to the appearance of the face. Mouth breathing children and people are not anomalies, but a result of breathing through the mouth, which alters how the body changes and grows in a predictable way. When a child is growing, and changes to the skull occur, the delicate balance of muscles around the mouth and face, which stabilizes structure, is disrupted, and breathing through the mouth becomes a cycle that changes the face, mouth, and the structures of the body around them in a predictable way.
Defining “Mouth Breather Face”: Visual Cues of Altered Facial Development
An example of mouth breather face is evident when a long, narrow face is observed, which is also referred to as “long face syndrome”. Additional noticeable examples of the syndrome include a recessed jaw, flattened cheeks, a narrow jaw, crooked/crowded teeth, and a recessed chin. A person is most likely to notice mouth breather face as a condition characterized by having the mouth open at all times, producing lips that are high or have a narrow shape, and a bridge of the nose that is also high, with the person having dark circles that are referred to as “allergic shiners” around the eyes. These shiners are actually caused by a collection of blood in the nasal cavity.
The Critical Role of Tongue Posture and Its Impact on Craniofacial Development
The tongue naturally rests at the floor of the mouth with mouth breathing, but with nasal breathing, the tongue rests at the roof of the mouth. This resting position is important for the development of the jaw, as the tongue should exert a gentle downward pressure to aid in widening the jaw during its development. This downward pressure when breathing and properly resting the tongue is necessary to avoid a narrow vertical development of the jaw when pressure is absorbed by the tongue placed at the floor of the mouth, and the jaw is developed in a narrow form instead of a bed jaw. This minimal support actually drives the facial changes observed in children.
How Mouth Breathing Influences Maxilla Growth and Airway Size
Poor tongue posture and an underdeveloped maxilla lead to serious problems. A narrow and high palate is the roof of the mouth, which causes a crowding of teeth along with other orthodontic problems. More importantly, the floor of the nose is the roof of the mouth. As the roof of the mouth gets higher and narrower, the space available for the nasal passages gets smaller, which makes the nasal airway smaller. This creates a cycle where the nose becomes blocked. This leads to mouth breathing, which then causes changes to the structure of the face in a way that makes the airway even more restricted. This makes nasal breathing more difficult.
Long Face Syndrome as a Particular Expression of the Condition
“Long Face Syndrome” (facial hyperdivergence) is the clinical description of the vertical growth pattern seen with many chronic mouth breathers. As the mouth remains open, the lower jaw (mandible) drops and rotates backward. This results in the face growing longer and becoming narrower rather than more forward developing in a balanced way. This isn’t just an aesthetic issue, as the altered growth pattern leads to problems with the bite, the jaw joint, and even the stability of the face.
Spotting the Signs: Visual Cues, Oral Health Indicators, and Sleep Disruptions
When figuring out chronic mouth breathing, it is important to go beyond the standard open mouth position. There are a variety of signs to look for when it comes to the face, oral health, and sleep of the person that demonstrate a dysfunctional breathing habit.
Distinctive Facial Features of a Chronic Mouth Breather
The main visual indicators are having a longer and narrower face. They may also have a weak chin, a flattened midface, and an inability to close the mouth all the way at rest. The person may also have tired-looking and droopy tired looking eyes, as well as some dark circles below the eyes. The person may have small and underdeveloped nostrils that look as though they have been unused. Overall, they may have a sloped facial profile that is convex.
These indicators are most telling when the person is a child and in a primary growth phase.
Oral and Dental Health Indicators Beyond Malocclusion
Your mouth can tell you a lot about yourself. For instance, a person’s mouth can become dry (xerostomia) if they breathe through their mouth. Saliva (xerostomia) can evaporate if a person’s mouth is continually open, and if left untouched, a mouth can become dry and slimy. If a person’s mouth is open for long periods of time, they are more likely to have dry, bad breath (halitosis), more cavities, and gum disease (gingivitis).
Red, irritated, and swollen gums are visible signs of mouth breathing. If a person’s mouth is open for an extended time, they are also more likely to have a narrow mouth (narrow palate) with more teeth (dental crowding), which are signs of needing braces. There is a lot of scientific evidence that mouth breathing children need braces to fix their mouths.
Sleep and Respiratory Symptoms That Point to Mouth Breathing
Sleep (and sleep quality) is highly affected. Mouth breathing can also cause excessively loud breathing and snoring (as tissues in the throat vibrate). Some more signs of mouth breathing that are audible during sleep are restless sleep, waking up/sitting up quickly, and sleep apnea. Waking up with a dry mouth and a super sore throat are also signs. Breathable air is very important, and if air is hard to breathe in (nasal obstructions), sleep can be very interrupted, and mouth breathing will be necessary to breathe. 75% of mouth breathers are waking up during the night due to nasal congestion, which proves that airflow breathing is important during sleep.
Other General Health Signs (e.g., chronic fatigue, dark circles)
The effects of poor sleep and inadequate breathing show up in every system of the body. Sleep problems like fatigue and sleepiness that carry over into the day become common problems due to poor sleep and low oxygen levels. Poor sleep can lead to cognitive strain and problems like low concentration, irritability, and behavioral issues in children. Dark circles under the eyes are a sign of blood pooling due to a blockage of the veins under the eye, which can be the result of chronic nasal congestion.
Understanding This Problem: Mouth Breathing
Mouth breathing can be a habit, but most of the time it’s a necessity due to a blocked nasal airway. Determining what the blockage is and the specific location is the most important part of the solution. This is very common in children and can range in prevalence from research on it showing levels as low as 11% to as high as 56% due to having developmental issues.
Nasal Obstruction: The Primary Culprit Blocking Nasal Passages
If there is any physical blockage in the nose, it will be necessary to switch to mouth breathing. The most common problems that lead to mouth breathing are:
Enlarged adenoids and tonsils. These are lymphatic tissues in the back of the throat. Particularly in children, these can become swollen due to infections, inflammation, or blockage of the airway.
Deviated Septum
Some people might have a condition called a deviated septum, which occurs when the thin wall of cartilage and bone that separates the nostrils is misaligned. This condition can block the flow of air in one or both nostrils.
Nasal Polyps or Tumors
Although it’s less likely, blockages and obstructions can result from growths or benign tumors on the inside of the nasal passages.
Chronic Nasal Congestion
Allergies, sinusitis, or recurrent upper respiratory infections can inflame the nasal tissue and result in temporary or long-lasting nasal obstructions.
Mouth Breather Face
Because of the aforementioned habits, a condition called ‘mouth breather face’ can develop. This condition stems from an alteration of the forces that guide facial growth and development.
Habits and Development: How Tongue Posture and Muscle Memory Contribute
In selected cases, a learned habit of mouth breathing can even persist after the initial obstruction is no longer present. This is due to the facial and tongue muscles developing a memory for maintaining an open mouth. When the tongue is used to resting low in the mouth, it’s likely to stay there and not go back to its ideal position resting on the palate. These factors, along with low muscle tone and an incorrect pattern of breathing, can contribute to the feeling of nasal breathing being difficult, especially without direct intervention.
Additional Influencing Factors: From Allergies to Physical Differences
Stale allergens lead to chronic inflammation on the nasal surface (allergic rhinitis). Physical differences with a person having a smaller nasal opening or large turbinates (structures that warm air), might have a greater risk of nasal obstruction. In some situations, asthma is also a factor that can lead to a certain type of chronic mouth breathing, as the person becomes distant from the air and the body tries to conserve energy with the least resistant form of air distress.
The Deeper Health Impacts: Beyond Aesthetics and Oral Health
Chronic mouth breathing consequences are not limited to just facial changes. Systemic consequences and disorders bypassing the nose and its fine architectural filter, and the complex changes associated with gas exchange during mouth breathing. The consequences are long-lasting, and the medical community suggests that they might even be critical and infringe on life expectancy through essential function interruptions. Some mouth breathing dental practitioners are even noted claiming that a person could lose 10 or more years of life through chronic mouth breathing.
What Is Reduced Oxygen Intake and Its Systemic Effects (Hypoxaemia)?
When it comes to getting blood oxygenated, nasal breathing is the more effective method. The body produces a gas called nitric oxide that is used to dilate blood vessels within the lungs to improve oxygen uptake. Since nitric oxide is produced through the nose and not the mouth, mouth breathing will result in a bypass of this important process, ultimately leading to lower oxygen saturation. The chronic, albeit mild, state of hypoxemia can lead to a multitude of issues, including high blood pressure, heart conditions, and a general decrease in energy and even will to live.
Airway Issues and the Connection to Obstructive Sleep Apnea
The anatomical changes that happen when a child presents with “mouth breather face” can result in a recessed jaw, narrowed airway, and then sleep apnea. Mouth breathing is a major health concern that needs to be resolved, especially with the risk of sleep apnea and the multitude of health consequences that can happen. In Obstructive Sleep Apnea, the airway will collapse, and breathing will stop, resulting in the sleep cycle getting extremely fragmented due to the cardiovascular system having to overexert itself.
Cognitive Function, Nervous System, and Chronic Fatigue
Low oxygen levels and poor sleep quality can come from prolonged periods of sleep. Poor quality sleep can impair cognitive abilities and lead to issues with focus, learning, and memory. This can even lead to symptoms resembling ADHD in children. The impact of your nervous system also plays a role by making breathing hard. This can contribute to a rise in anxiety and even mood shifts.
The Impact of Saliva Flow and Bacteria on Oral Deterioration
A dry mouth is a perfect environment for bad bacteria to thrive. The washing and neutralizing power of saliva is nonexistent, which increases the chances of gum inflammation, tooth decay, and the demineralization of enamel through the roof. Without resolving the dry mouth, which is the root of the problem, it becomes more and more difficult to manage these ongoing issues.
Effective Corrections and Treatment Pathways
A coordinated effort is needed to address the issues that chronic mouth breathing causes. The end goal is to retrain a person’s breathing pattern while also clearing their airway.
Addressing Nasal Obstruction
Your ears, nose, and throat (ENT) physician is your first and most important point of contact with the healthcare system and the first point of contact with healthcare to begin understanding and addressing the nasal obstruction’s position in your case. Depending on the patient’s case, the ENT may begin with an initial assessment with suggestions for allergy testing and management, other medications to reduce nasal cavity inflammation, and/or follow surgical interventions with other surgical adenoidectomies, tonsillectomies, and septoplasties to improve nasal cavity drainage and potentially create an airway for nasal breathing.
Nasal Breathing: Breathing Retraining and Myofunctional Therapy
Having an open airway is a wonderful first step, but in order to breathe with your nose, the habit of mouth breathing has to be unlearned. This is possible with orofacial myofunctional therapy. This therapy is a specialized physical rehabilitation of the oral and paraoral (oral and surrounding) structures. The therapist is trained to guide your breathing with mouth closure to guide the neuromuscular system to prioritize nasal breathing.
Orthodontic and Dental Interventions: Correcting Structure and Guiding Development
With regard to the structural changes, the orthodontist is most responsible. During the growth phase, children can use palate expanders to widen the upper jaw and create additional room for teeth, while also enlarging the nasal cavity. In both adults and children, orthodontics has the ability to fix dental crowding and malocclusion. In some complex cases related to sleep apnea, combined treatments can be very effective. As an example, one study indicated the significant improvement of sleep apnea severity by using the combination of a mouthpiece and mandibular advancement device (MAD) as opposed to using a MAD alone.
Lifestyle Adjustments and Supportive Measures for Optimal Breathing
The best assistive measures for aiding the change to nasal breathing are simple to adopt. The most effective is to practice conscious nasal breathing during the day. To help keep nasal passages clear, consider using saline rinses. To assist with overnight mouth breathing, consider specialized hypoallergenic tape, which calmly encourages lip closure while sleeping. This promotes nasal breathing, but make sure to clear any breathing obstructions medically.
Reversibility, Prevention, and Long-Term Management
One of the most asked questions is concerning the facial changes that can occur with mouth breathing and whether it can be reversed. As with many related questions, the outcome is determined by age and how severe the changes are.
Can Age Impact Changes Related to Mouth Breather Face?
When kids and teens change their breathing patterns and clear the airway to fix their mouth breathing, they can change and redirect how their face grows, and start to reverse the effects of mouth breathing. In adults, however, facial growth is fixed in place and can only be changed through surgery, and without addressing the myofunctional pattern, some effects of mouth breathing can be changed or improved to some extent.
Positive changes can be seen, however, from the therapies administered and the changes made to oral function, the alignment of the teeth, and even facial aesthetics. Best outcomes are obtained through early detection, intervention, and myofunctional treatment.
Conclusion
While it may seem like mouth breather face is just an aesthetic issue, it’s much more than that. It’s also a result of dysfunctional breathing and can lead to issues with constant changes in facial bones, mouth, teeth, and can even affect overall bodily systems. Understanding this condition and the compromised airway are both critical to improving our health. Most importantly, while mouth breathing is common, it’s not how our body is meant to function and can lead to underdeveloped facial systems and poor growth. Nasal breathing is what the body is made to do, and it is much more effective and better for the immune system as well as facial growth.
Continuously opening your mouth, snoring, chronic fatigue, and dental overcrowding are just a few signs of chronic mouth breathing. If you or your child exhibits these signs, it is a matter of taking a multi-disciplinary approach. Evaluate your ENT for a clear nasal airway. After that, find a myofunctional therapist to help retrain the oral and facial muscle patterns, and find a skilled orthodontist or dentist to resolve where there are structural problems. These actions can help you address the cause, reduce potential problems associated with it, and regain the ability to breathe in and out of your mouth like you are supposed to.
Frequently Asked Questions (FAQs)
What are the common signs of mouth breathing?
Common signs include open-mouth posture, dry lips, snoring, narrow jaw, crooked teeth, dark circles, and a tired facial appearance.
What causes mouth breather face?
Mouth breathing is often caused by nasal blockage, allergies, enlarged tonsils or adenoids, deviated septum, chronic sinus issues, or long-term habits formed in childhood.
Can mouth breather face be corrected?
Yes, improvement is possible depending on age and severity. Treatments may include breathing therapy, orthodontics, myofunctional therapy, treating nasal obstruction, or cosmetic and surgical options in adults.
Is mouth breathing harmful in the long term?
Yes. Long-term mouth breathing can affect facial growth, dental alignment, sleep quality, posture, and overall health if not treated early.
