Effects of Mouth Breathing on Craniofacial Growth and Oral Health in Children

Abstract

Mouth breathing in children is a health problem that can cause serious problems in terms of general health, craniofacial development, and oral health. Developmental failures, sleep quality disorders, atypical swallowing, speech disorders, dental caries, gingivitis, adenoid facial shape, and skeletal malocclusions can be seen in mouth breathing children. In these cases, malocclusions such as narrowed maxilla, a deeper palatal vault, posterior cross bite, increased overjet, and anterior open bite can be observed. Early diagnosis of aetiological factors and multidisciplinary treatment approaches are of great importance for children with mouth breathing. This review aimed to emphasize the relationships between mouth breathing and craniofacial/occlusal development and oral health, and to report on the clinical studies and the treatment approaches on this subject.

Keywords

• Mouth breathing
• craniofacial growth
• oral health
• children
• oral habits

Çocuklarda Ağız Solunumunun Kraniyofasiyal Gelişime ve Ağız Sağlığına Etkileri

Abstract

Ağız solunumu, çocuklarda genel sağlık, kraniyofasiyal gelişim ve ağız diş sağlığı açısından önemli sorunlara neden olabilen bir sağlık sorunudur. Ağız solunumu yapan çocuklarda gelişimsel yetersizlik, uyku kalitesi bozuklukları, atipik yutkunma, konuşma bozuklukları, diş çürükleri, diş eti iltihabı, adenoid yüz şekli ve iskeletsel maloklüzyonlar görülebilmektedir. Olgularda, üst çene darlığı, derin damak kubbesi, posterior kapanış, artmış overjet ve ön açık kapanış gibi maloklüzyonlar oluşabilmektedir. Ağız solunumu görülen çocuklarda etyolojik faktörlerin erken tanısı ve multidisipliner tedavi yaklaşımları ise büyük önem taşımaktadır. Bu derlemede, çocuklarda ağız solunumu ile kraniyofasiyal ve oklüzal gelişim, ağız sağlığı arasındaki ilişkilerin vurgulanması; bu konuda yapılmış klinik çalışmaların ve tedavi yaklaşımlarının bildirilmesi amaçlanmıştır.

Keywords

• Ağız solunumu
• kraniyofasiyal gelişim
• ağız sağlığı
• çocuklar
• ağız alışkanlıkları

References

1. 1. Phulari BS. Orthodontics: principles and practice. New Delhi: Jaypee Brothers Medical Publishers LTD; 2011. google scholar
2. 2. Abreu RR, Rocha RL, Lamounier JA, Guerra AF. Etiology, clinical manifestations and concurrent findings in mouth-breathing children. J Pediatr 2008;84(6):529-35. google scholar
3. 3. Godinho R, Britto AT, Carvalho DG, Mocellin M. The role of adenotonsillar hipertrophy in mouth-breathing syndrome. IV IAPO, Manual of Pediatric Otorhinolaryngologhy 2006;15:83-8. google scholar
4. 4. Yıldırım M, Aktören O. Çocuklarda ağızdan solunumun ağız diş sağlığına ve çevre dokulara etkisinin değerlendirilmesi. J Istanb Univ Fac Dent 2012;41(3):65-74. google scholar
5. 5. Valera FC, Travitzki LV, Mattar SE, Matsumoto MA, Elias AM, Anselmo-Lima WT. Muscular, functional and orthodontic changes in pre school children with enlarged adenoids and tonsils. Int. J. Pediatr. Otorhinolaryngol 2003;67(7):761-70. google scholar
6. 6. Öztürk Ş, Ballıkaya E. Çocuklarda oral fonksiyon bozuklukları ve maloklüzyon. Türkiye Sağlık Bilimleri ve Araştırmaları Derg 2020;3(2):75-86. google scholar
7. 7. Maspero C, Giannini L, Galbiati G, Rosso G, Farronato G. Obstructive sleep apnea syndrome: a literature review. Minerva Stomatol 2015;64(2):97-109. google scholar
8. 8. Erverdi N. Çağdaş Ortodonti. İstanbul: Quintessence Yayıncılık; 2017. google scholar

9. 9. Erdur Ö, Erdur EA, Erol M. Çocuklarda ağız solunumunun kraniyofasiyal gelişim üzerine etkisi. Kulak Burun Boğaz Uygulamaları 2018;6(1):6-10. google scholar
10. 10. Warren DW. Effect of airway obstruction upon facial growth. Otolaryngol Clin North Am 1990;23(4):699-712. google scholar
11. 11. Harvold EP, Tomer BS, Vargervik K, Chierici G. Primate experiments on oral respiration. Am J Orthod 1981;79(4):359-72. google scholar
12. 12. Linder-Aronson S. Adenoids. Their effect on mode of breathing and nasal airflow and their relationship to characteristics of the facial skeleton and the denition. A biometric, rhino-manometric and cephalometro-radiographic study on children with and without adenoids. Acta Otolaryngol Suppl 1970; 265:1-132. google scholar
13. 13. Proffit WR, Fields H, Sarver D. Contemporary Orthodontics. Elsevier Health Sciences; 2006. google scholar
14. 14. Grippaudo C, Paolantonio EG, Antonini G, Saulle R, La Torre G, Deli R. Association between oral habits, mouth breathing and malocclusion. Associazione fra abitudini viziate, respirazione orale e malocclusione. Acta Otorhinolaryngol Ital 2016;36(5):386-94. google scholar
15. 15. Shintani T, Asakura K, Kataura A. Adenotonsillar hypertrophy and skeletal morphology of children with obstructive sleep apnea syndrome. Acta Otolaryngol Suppl 1996;523:222-24. google scholar
16. 16. Trotman CA, McNamara JA Jr, Dibbets JM, van der Weele LT. Association of lip posture and the dimensions of the tonsils and sagittal airway with facial morphology. Angle Orthod 1997;67(6):425-32. google scholar
17. 17. Pacheco MC, Casagrande CF, Teixeira LP, Finck NS, de Araûjo MT. Guidelines proposal for clinical recognition of mouth breathing children. Dental Press J Orthod 2015;20(4):39-44. google scholar
18. 18. Jefferson Y. Mouth breathing: adverse effects on facial growth, health, academics, and behavior. Gen Dent 2010;58(1):18-80. google scholar
19. 19. de Freitas FCN, Bastos EP, Primo LS, de Freitas VL. Evaluation of the palate dimensions of patients with perennial allergic rhinitis. Int J Paediatr Dent 2001;11(5):365-71. google scholar
20. 20. Chambi-Rocha A, Cabrera-Domınguez ME, Domınguez-Reyes A. Breathing mode influence on craniofacial development and head posture. J Pediatr (Rio J) 2018;94(2):123-30. google scholar
21. 21. Tourne LP. The long face syndrome and impairment of the nasopharyngeal airway. Angle Orthod 1990;60(3):167-76. google scholar
22. 22. Fields HW, Warren DW, Black K, Phillips CL. Relationship between vertical dentofacial morphology and respiration in adolescents. Am J Orthod Dentofacial Orthop 1991;99(2):147-54. google scholar
23. 23. El Aouame A, Daoui A, El Quars F. Nasal breathing and the vertical dimension: A cephalometric study. Int Orthod 2016;14(4):491-502. google scholar
24. 24. Ucar FI, Uysal T. Comparision of orofacial airway dimensions in subject with different breathing pattern. Prog Orthod 2012;13(3):210-7. google scholar
25. 25. Basheer B, Hegde KS, Bhat SS, Umar D, Baroudi K. Influence of mouth breathing on the dentofacial growth of children: a cephalometric study. J Int Oral Health 2014;6(6):50-5. google scholar
26. 26. Souki BQ, Lopes PB, Pereira TB, Franco LP, Becker HM, Oliveira DD. Mouth breathing children and cephalometric pattern: does the stage of dental development matter?. Int J Pediatr Otorhinolaryngol 2012;76(6):837-41. google scholar
27. 27. Ardehali MM, Zarch VV, Joibari ME, Kouhi A. Cephalometric assessment of upper airway effects on craniofacial morphology. J Craniofac Surg 2016;27(2):361-4. google scholar
28. 28. Ahlqvist-Rastad J, Hultcrantz E, Svanholm H. Children with tonsillar obstruction: indications for and efficacy of tonsillectomy. Acta Paediatr Scand 1988;77(6):831-5. google scholar
29. 29. Chung Leng Munoz I, Beltri Orta P. Comparison of cephalometric patterns in mouth breathing and nose breathing children. Int J Pediatr Otorhinolaryngol 2014;78(7):1167-72. google scholar
30. 30. Kawashima S, Peltomaki T, Sakata H, Mori K, Happonen RP, Rönning O. Craniofacial morphology in preschool children with sleep-related breathing disorder and hypertrophy of tonsils. Acta Paediatr 2002;91(1):71-7. google scholar
31. 31. Paolantonio EG, Ludovici N, Saccomanno S, La Torre G, Grippaudo C. Association between oral habits, mouth breathing and malocclusion in Italian preschoolers. Eur J Paediatr Dent 2019;20(3):204-8. google scholar
32. 32. Zheng W, Zhang X, Dong J, He J. Facial morphological characteristics of mouth breathers vs. nasal breathers: A systematic review and meta-analysis of lateral cephalometric data. Exp Ther Med 2020;19(6):3738-50. google scholar
33. 33. Farronato M, Lanteri V, Fama A, Maspero C. Correlation between malocclusion and Allergic rhinitis in pediatric patients: A systematic review. Children (Basel) 2020;7(12):260. google scholar
34. 34. Kerr WJ, McWilliam JS, Linder-Aronson S. Mandibular form and position related to changed mode of breathing--a five-year longitudinal study. Angle Orthod 1989;59(2):91-6. google scholar
35. 35. El-Dawlatly M, Aboulfotouh M. Analyzing the contribution of the dental components and abnormal habits in the development of dental open bite in growing children: A cross sectional study. Egypt Dent J 2021;67(1):55-60. google scholar
36. 36. Baeshen HA. Malocclusion trait and the parafunctional effect among young female school students. Saudi J Biol Sci 2021;28(1):1088-92. google scholar
37. 37. Vig KW. Nasal obstruction and facial growth: the strength of evidence for clinical assumptions. Am J Orthod Dentofacial Orthop 1998;113(6):603-11. google scholar
38. 38. Feres MF, Muniz TS, de Andrade SH, Lemos Mde M, Pignatari SS. Craniofacial skeletal pattern: is it really correlated with the degree of adenoid obstruction?. Dental Press J Orthod 2015;20(4):68-75. google scholar
39. 39. Rossi RC, Rossi NJ, Rossi NJ, Yamashita HK, Pignatari SS. Dentofacial characteristics of oral breathers in different ages: a retrospective case-control study. Prog Orthod 2015;16:23. google scholar
40. 40. Klein JC. Nasal respiratory function and craniofacial growth. Arch Otolaryngol Head Neck Surg 1986;112(8):843-9. google scholar
41. 41. Shanker S, Vig KW, Beck FM, Allgair E Jr, Vig PS. Dentofacial morphology and upper respiratory function in 8-10-year-old children. Clin Orthod Res 1999;2(1):19-26. google scholar
42. 42. Motta LJ, Bachiega JC, Guedes CC, Laranja LT, Bussadori SK. Association between halitosis and mouth breathing in children. Clinics (Sao Paulo) 2011;66(6):939-42. google scholar
43. 43. Alqutami J, Elger W, Grafe N, Hiemisch A, Kiess W, Hirsch C. Dental health, halitosis and mouth breathing in 10-to-15 year old children: A potential connection. Eur J Paediatr Dent 2019;20(4):274-9. google scholar
44. 44. Ballikaya E, Guciz Dogan B, Onay O, Uzamis Tekcicek M. Oral health status of children with mouth breathing due to adenotonsillar hypertrophy. Int J Pediatr Otorhinolaryngol 2018;113:11-5. google scholar
45. 45. Jacobson L. Mouthbreathing and gingivitis. 1. Gingival conditions in children with epipharyngeal adenoids. J Periodontal Res 1973;8(5):269-77. google scholar
46. 46. Atila E, Sabah E, Ersin N. Miyofonksiyonel düzenleyici apareyler: Trainer Sistemi. EÜ Dişhek Fak Derg 2012;33(2):64-9. google scholar
47. 47. Bingöl S, Kaya B. Sınıf II maloklüzyonların tedavisinde fonksiyonel apareylerin yeri. ADO J of Clinical Sci 2018;9(1):1581-92. google scholar