Classification And Management Of Mouth Breathing In Children
Write a short note on mouth breathing habits.
Or
Define and classify habits. Describe in detail the etiology, clinical features, and management of mouth breathing habit.
Answer.
Mouth breathing is defined as “habitual respiration through the mouth instead of the nose.”
Classification of Mouth Breathing by ‘Finn’
- Obstructive: Increased resistance to or complete obstruction of normal airflow through nasal passage.
- Habitual: As a matter of habit or persistence of the habit even after the elimination of the obstructive cause.
- Anatomical: Short upper lip leads to incompetence of lips and hence mouth breathing.
Etiology
- Anatomic causes: Short upper lip and underdeveloped nasal cavity.
- Obstructions: Nasal polyp, enlarged adenoid, deviated nasal septum, upper respiratory tract infection.
- Obstructive sleep apnea.
- In association with other habits such as thumb sucking.
Clinical Features
- Protrusion of maxillary and mandibular incisors
- Narrow maxillary arch.
- Posterior dental crossbiteThe palatal vault is high.
- Posterior teeth get supra erupted.
- Anterior open bite.
- Increased incidence of caries.
- Steep mandibular plane.
- Anterior facial height is excessive.
- Lip posture incompetent with lip trap.
- External nares are widelyflareddThe cervical cap column gets inclined forward.
- Head posture is extended.
- In the anterior region, marginal gingivitis is present.
Diagnosis
- Observe the patient:
- Mouth breathers—lips will be apart.
- Nasal breathers—lips will be touching
- Mirror test (jog test): Two surfaced mirrors are placed on the patient’s upper lip. If air condenses on the upper side of the mirror, the patient is a nasal breather, and if it does so on the opposite side, then he is a mouth breather.
- Massier’s water holding test: The patient is asked to hold the mouth full of water. Mouth breathers cannot retain the water for a long time.
- Butterfly test: Take a few fibers of cotton and place them just below the nasal opening on exhalation if the fiber of the cotton flutters downwards, the patient is a nasal breather, and if the fiber flutters upward, he is a mouth breather.
- Cephalometrics: This helps to assess the amount of nasopharyngeal space, size of adenoids, and diagnosing long face.
- Rhinomanometry: Study of nasal airflow characteristics using airflow devices such as flow meters and pressure gauges. Estimation of airflow via nasal passage and the amount of nasal resistance.
Treatment
- Removal of nasal or pharyngeal obstruction.
- Interception of the habit—By use ofanna oral screen. Mainly, a passive oral screen is used, and breathing holes should be placed and removed gradually.
- Alternatively, adhesive tapes can be used to establish an IP seal.
- Rapid maxillary expansion—Patients with narrow, constricted maxillary arches benefit from rapid palatal expansion. The rapid maxillary expansion has been found to increase the nasal airflow and decrease nasal air resistance.
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