Mouth breathing

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Mouth breathing
SymptomsSnoring, dry mouth, hoarse voice, bad breath, fatigue
CausesChronic nasal congestion
TreatmentTreatment of the underlying cause of nasal congestion if present, building a habit to breathe through the nose

Mouth breathing is breathing through the mouth. It often is caused by an obstruction to breathing through the nose, the innate breathing organ in the human body.[1][2] Chronic mouth breathing may be associated with illness.[3] The term "mouth-breather" has developed a pejorative slang meaning.

Etymology[edit]

1911 photograph of mouth breathing child
Image 23 from the 1903 book by William F. Barry, M.D., The Hygiene of the Schoolroom. Barry describes this child as having "the typical face of a mouth-breather."

In the early 20th century, "mouth-breather" was a technical term used by doctors to describe children who were breathing through their mouths due to an underlying medical condition. English lexicographer Jonathon Green notes that by 1915, the phrase "mouth-breather" had developed a pejorative connotation within English slang, defined as a "stupid person."[4] Currently, the Macmillan Dictionary defines the term "mouth breather" as a pejorative noun that is used to mean "a stupid person."[5][3]

Overview[edit]

Jason Turowski, MD of the Cleveland Clinic states that "we are designed to breathe through our noses from birth — it's the way humans have evolved."[1][2] Thus, the impact of chronic mouth breathing on health is a research area within orthodontics (and the related field of myofunctional therapy)[6] and anthropology.[7] It is classified into three types: obstructive, habitual, and anatomic.[8]: 281 

Nasal breathing produces nitric oxide within the body, while mouth breathing does not.[2][9][10][11] In addition, the Boston Medical Center notes that the nose filters out particles that enter the body, humidifies the air we breathe and warms it to body temperature.[12] In contrast, however, mouth breathing "pulls all pollution and germs directly into the lungs; dry cold air in the lungs makes the secretions thick, slows the cleaning cilia, and slows down the passage of oxygen into the bloodstream."[12] As a result, chronic mouth breathing may lead to illness.[10][13][14][15][16] In about 85% of cases, it is an adaptation to nasal congestion,[8]: 281 [14] and frequently occurs during sleep.[13] More specialized causes include: antrochoanal polyps;[17]: 350  a short upper lip which prevents the lips from meeting at rest (lip incompetence);[8]: 281  and pregnancy rhinitis which tends to occur in the third trimester of pregnancy.[18]: 435 

Potential effects[edit]

Conditions associated with mouth breathing include cheilitis glandularis,[17]: 490  Down syndrome,[19]: 365  anterior open bite,[18]: 225  tongue thrusting habit,[18]: 225  cerebral palsy,[20]: 422  ADHD,[21][22] sleep apnea,[23] and snoring.[23] In addition, gingivitis,[18]: 85  gingival enlargement,[18]: 85  and increased levels of dental plaque[18]: 108  are common in persons who chronically breathe through their mouths. The usual effect on the gums is sharply confined to the anterior maxillary region, especially the incisors (the upper teeth at the front). The appearance is erythematous (red), edematous (swollen) and shiny. This region receives the greatest exposure to airflow during mouth breathing, and it is thought that the inflammation and irritation is related to surface dehydration, but in animal experimentation, repeated air drying of the gums did not create such an appearance.[18]: 85 

Chronic mouth breathing in children may affect dental and facial growth.[16] It may also lead to the development of a long, narrow face, sometimes termed long face syndrome.[24] Conversely, it has been suggested that a long thin face type, with corresponding thin nasopharyngeal airway, predisposes to nasal obstruction and mouth breathing.[14]

COVID-19 studies[edit]

As of April 2020, studies and trials are underway that examine the possible benefits of nitric oxide in the treatment of COVID-19.[9][25][26][27] This research is based on the fact that nitric oxide was investigated as an experimental therapy for SARS.[28] Brian Strickland, MD, a fellow in Wilderness Medicine at Massachusetts General Hospital who studies "acute respiratory distress" in high altitudes, is applying this research towards COVID-19.[29][30] He is currently involved in clinical trials which apply the use of inhaled nitric oxide as a treatment for COVID-19.[31] This approach was inspired by the work of Associate Professor of Emergency Medicine at the Harvard Medical School N. Stuart Harris, who has been studying the effects of altitude sickness on mountain climbers, such as those who climb Mount Everest. Harris noticed that the consequences of high level altitude sickness on the human body mirrored COVID-19's dysfunctional impact on the lungs. His focus on nitric oxide comes from its role in being able to breathe in high altitudes.[29][32] According to WCVB-TV, similar trials are being conducted at Tufts Medical Center.[33] Other studies speculate that replacing mouth breathing (which decimates NO) with nasal breathing (which increases NO)[2][10][11] is a "lifestyle change" that "may also help to reduce SARS-CoV-2 viral load and symptoms of COVID-19 pneumonia by promoting more efficient antiviral defense mechanisms in the respiratory tract."[13]

Exercise[edit]

A 2018 study suggests that nasal breathing offers a greater advantage over mouth breathing during exercise. Breathing heavily through the mouth instead of through the nose while doing high intensity training will cause an excessive loss of CO2, which is necessary to keep our cells oxygenated.[11]

Additional approaches to mouth breathing[edit]

George Catlin[edit]

George Catlin was a 19th-century American painter, author, and traveler, who specialized in portraits of Native Americans in the Old West. Travelling to the American West five times during the 1830s, he wrote about, and painted portraits that depicted, the life of the Plains Indians.[34] He was also the author of several books, including The Breath of Life[35] (later retitled as Shut Your Mouth and Save Your Life) in 1862.[36][37] It was based on his experiences traveling through the West, where he observed a consistent lifestyle habit among the Native American communities he encountered: a preference for nose breathing over mouth breathing. He also observed that they had perfectly straight teeth.[38] He repeatedly heard that this was because they believed that mouth breathing made an individual weak and caused disease, while nasal breathing made the body strong and prevented disease.[38] He also observed that mothers repeatedly closed the mouth of their infants while they were sleeping, to instill nasal breathing as a habit.[39]

Yoga[edit]

Yogis such as B. K. S. Iyengar advocate both inhaling and exhaling through the nose in the practice of yoga, rather than inhaling through the nose and exhaling through the mouth,[40][41][42] using the phrase, "the nose is for breathing, the mouth is for eating."[40][41][43][44]

References[edit]

  1. ^ a b Turowski, Jason (29 April 2016). "Should You Breathe Through Your Mouth or Your Nose?". Cleveland Clinic. Retrieved 28 June 2020.
  2. ^ a b c d Glazier, M.D., Eve (4 November 2019). "'Nose breathing has more benefits than mouth breathing". The Times and Democrat. Retrieved 9 July 2020.
  3. ^ a b Wollan, Malia (23 April 2019). "How to Be a Nose Breather". New York Times. Retrieved 31 May 2020.
  4. ^ Kelly, John (23 August 2016). "How '80s Is the Slang in Stranger Things?". Slate. Retrieved 2 July 2020.
  5. ^ "Macmillan Dictionary: Mouthbreather". The Macmillan Dictionary. Retrieved 31 May 2020.
  6. ^ Frey, Lorraine (November 2014). "The Essential Role of the Com in the Management of Sleep-Disordered Breathing: A Literature Review and Discussion". The International Journal of Orofacial Myology. Int J Orofacial Myology. 40: 42–55. doi:10.52010/ijom.2014.40.1.4. PMID 27295847.
  7. ^ Gross, Terry (27 May 2020). "How The 'Lost Art' Of Breathing Can Impact Sleep And Resilience". National Public Radio (NPR)/Fresh Air. Retrieved 23 June 2020.
  8. ^ a b c Phulari BS, ed. (2011). Orthodontics : principles and practice. New Delhi: Jaypee Bros. Medical Publishers. ISBN 9789350252420.
  9. ^ a b Cohan, Alexi (26 July 2020). "Nitric oxide, a 'miracle molecule,' could treat or even prevent coronavirus, top doctors say". Boston Herald. Retrieved 27 July 2020.
  10. ^ a b c Dahl, Melissa (11 January 2011). "'Mouth-breathing' gross, harmful to your health". NBC News. Retrieved 28 June 2020.
  11. ^ a b c Berman, Joe (29 January 2019). "Could nasal breathing improve athletic performance?". Washington Post. Retrieved 31 May 2020.
  12. ^ a b "Your Nose, the Guardian of Your Lungs". Boston Medical Center. 7 August 2017. Retrieved 29 June 2020.
  13. ^ a b c Martel, Jan; Ko, Yun-Fei; Young, John D.; Ojcius, David (6 May 2020). "Could nasal nitric oxide help to mitigate the severity of COVID-19?". Microbes and Infection. 22 (4–5): 168–171. doi:10.1016/j.micinf.2020.05.002. PMC 7200356. PMID 32387333.
  14. ^ a b c Rao A, ed. (2012). Principles and Practice of Pedodontics (3rd ed.). New Delhi: Jaypee Brothers Medical Pub. pp. 169, 170. ISBN 9789350258910.
  15. ^ Nall, Rachel (22 September 2017). "What's wrong with breathing through the mouth?". Medical News Today. Retrieved 31 May 2020.
  16. ^ a b Valcheva, Zornitsa (January 2018). "THE ROLE OF MOUTH BREATHING ON DENTITION DEVELOPMENT AND FORMATION" (PDF). Journal of IMAB. Retrieved 31 May 2020.
  17. ^ a b Barnes L, ed. (2009). Surgical pathology of the head and neck (3rd ed.). New York: Informa healthcare. ISBN 978-1-4200-9163-2.
  18. ^ a b c d e f g Newman MG, Takei HH, Klokkevold PR, Carranza FA, eds. (2012). Carranza's clinical periodontology (11th ed.). St. Louis, Mo.: Elsevier/Saunders. ISBN 978-1-4377-0416-7.
  19. ^ Regezi JA, Sciubba JJ, Jordan RK (2011). Oral pathology : clinical pathologic correlations (6th ed.). St. Louis, Mo.: Elsevier/Saunders. ISBN 978-1-4557-0262-6.
  20. ^ Cawson RA, Odell EW (2008). Cawson's essentials of oral pathology and oral medicine (8th ed.). Edinburgh: Churchill Livingstone. ISBN 978-0-7020-4001-6.
  21. ^ Won, Dana (February 2017). "It Is Just Attention-Deficit Hyperactivity Disorder…or Is It?". Journal of Developmental and Behavioral Pediatrics. J Dev Behav Pediatr. 38 (2): 169–172. doi:10.1097/DBP.0000000000000386. PMC 5401711. PMID 28079611.
  22. ^ Sano, Masahiro (October 2013). "Increased oxygen load in the prefrontal cortex from mouth breathing: a vector-based near-infrared spectroscopy study". NeuroReport. 24 (17): 935–940. doi:10.1097/WNR.0000000000000008. PMC 4047298. PMID 24169579.
  23. ^ a b Pacheco, Maria Christina Thome (July–August 2015). "Guidelines proposal for clinical recognition of mouth breathing children". Dental Press Journal of Orthodontics. 20 (4): 39–44. doi:10.1590/2176-9451.20.4.039-044.oar. PMC 4593528. PMID 26352843.
  24. ^ Basheer, Bahija (November 2014). "Influence of Mouth Breathing on the Dentofacial Growth of Children: A Cephalometric Study". Journal of International Oral Health. 6 (6): 50–55. PMC 4295456. PMID 25628484.
  25. ^ Katsnelson, Alla (20 May 2020). "Multiple clinical trials test whether NO gas can treat and prevent COVID-19". Chemical & Engineering News. Retrieved 14 July 2020.
  26. ^ Gander, Kashmira (7 April 2020). "What Is Nitric Oxide? How the Gas That Gave Us Viagra Could Help Treat Coronavirus Patients". Newsweek. Retrieved 25 June 2020.
  27. ^ "Nitric Oxide Investigated as COVID-19 Treatment". WebMD. Retrieved 10 April 2020.
  28. ^ Åkerström, Sara; Mousavi-Jazi, Mehrdad; Klingström, Jonas; Leijon, Mikael; Lundkvist, Åke; Mirazimi, Ali (1 February 2005). "Nitric Oxide Inhibits the Replication Cycle of Severe Acute Respiratory Syndrome Coronavirus". Journal of Virology. 79 (3): 1966–1969. doi:10.1128/JVI.79.3.1966-1969.2005. PMC 544093. PMID 15650225.
  29. ^ a b Powell, Alvin (6 May 2020). "Applying wisdom from the Himalayas to the ER's COVID battle". The Harvard Gazette. Retrieved 25 June 2020.
  30. ^ "Lessons from the Backcountry in Finding a Potential COVID-19 Treatment". Massachusetts General Hospital. 24 June 2020. Retrieved 25 June 2020.
  31. ^ "Inhaled Nitric Oxide Therapy for Emergency Room COVID-19 Patients". Massachusetts General Hospital. 24 June 2020. Retrieved 25 June 2020.
  32. ^ Meredith, Sam (1 May 2020). "How the gas that gave the world Viagra could help treat coronavirus patients". CNBC. Retrieved 5 July 2020.
  33. ^ Riemer, Emily (23 June 2020). "Tufts researchers test inhaled nitric oxide as COVID-19 treatment". WCVB-TV. Retrieved 5 July 2020.
  34. ^ "Catlin Virtual Exhibition". Smithsonian American Art Museum. Archived from the original on 25 September 2014. Retrieved 28 October 2014.
  35. ^ The breath of life, or mal-respiration, and its effects upon the enjoyments & life of man. HathiTrust. 1862. Retrieved 28 June 2020.
  36. ^ Nestor, James (2020). Breath: The New Science of a Lost Art. Riverhead Books. p. 48. ISBN 978-0735213616.
  37. ^ "George Catlin on Mouth Breathing". PubMed. Retrieved 2 July 2020.
  38. ^ a b Nestor, James (2020). Breath: The New Science of a Lost Art. Riverhead Books. p. 49. ISBN 978-0735213616.
  39. ^ Nestor, James (2020). Breath: The New Science of a Lost Art. Riverhead Books. p. 50. ISBN 978-0735213616.
  40. ^ a b Yoga Journal Editors (12 April 2017). "Q&A: Is Mouth Breathing OK in Yoga?". Yoga Journal. Retrieved 26 June 2020.
  41. ^ a b Payne, Larry. "Yogic Breathing: Tips for Breathing through Your Nose (Most of the Time)". Yoga For Dummies, 3rd Edition. Retrieved 26 June 2020.
  42. ^ Himalayan Institute Core Faculty, Himalayan Institute Core Faculty (13 July 2017). "Yogic Breathing: A Study Guide". Himalayan Institute of Yoga Science and Philosophy. Retrieved 26 June 2020.
  43. ^ Krucoff, Carol (2013). Yoga Sparks. New Harbinger Publications. ISBN 9781608827022. Retrieved 31 May 2020.
  44. ^ Jurek, Scott (2012). Eat and Run. Houghton Mifflin. ISBN 978-0547569659. Retrieved 31 May 2020.

Further reading[edit]

External links[edit]

Classification