The Trouble with Mouth Breathing and Treatment Options

There are many different types of noses: some are narrow and hawk-like, some are thin and straight as an arrow, some are bumpy like an old road and some are turned up at the tip like a ski-slope.  Whichever style of sniffer you were blessed with, every nose has one thing in common: it protects and serves the respiratory system by filtering, warming and humidifying the air you breathe.

In addition to acting as the respiratory system’s first line of defense, nasal respiration – or breathing through the nose – also plays a critical role in protecting your health. First, it’s essential to the production of nitric oxide, a gas naturally produced by the body. Nitric oxide via nasal respiration increases oxygen exchange efficiency, increases blood oxygen by as much as 18% and improves oxygen absorption by the lungs.1 Furthermore, breathing through the nose places less stress on the heart, decreases mucous production, increases oxygenation and reduces snoring.2 But what happens when nasal passages go awry, forcing a person to breathe through their mouth? Is mouth breathing at all beneficial or can it be hazardous to our health?

Mouth Breathing: Are you in the Dark?

Most people, including healthcare professionals, are unaware of the negative health effects brought on by mouth breathing. In adults, mouth breathing is associated with poor sleep quality,1 early facial aging3 and a lower concentration of oxygen in the blood; a condition that often leads to high blood pressure and heart failure.1 Untreated mouth breathing in children can lead to abnormal facial and dental development and sleep disturbances that can dramatically impact their growth and performance in school.1

In an interview conducted by registered dental hygienist, Trisha O’Hehir, Dr. Steven Sue, DDS, MS, explains the following:

“Because the breathing mechanism is situated in the nose and not in the mouth, the brain of a mouth breather thinks carbon dioxide is being lost too quickly from the nose and stimulates the goblet cells to produce mucous to slow the breathing. Thus the viscous circle of mouth breathing triggers mucous formation, blocking nasal passages and nose breathing, leading to more mouth breathing.1”

 

Mouth Breathing and Supplemental Oxygen

Oxygen therapy has many benefits, including increasing survival when used more than fifteen hours a day. But, compared to nasal breathers, do mouth breathers obtain the same health benefits from supplemental oxygen?

There are two well-known research studies that examined oxygen saturation in mouth breathers; each produced results that contradicted the other. The first5 measured oxygen saturation in 323 subjects who were mouth breathers. Of these, 34.6% had normal (95% or greater) oxygen saturation levels, 22.6% had an oxygen saturation of 95% and 42.8% were considered hypoxic, having an oxygen saturation of less 95%. The study concluded that, while mouth breathing doesn’t always lead to hypoxia, it can contribute to it.

In the second study involving 10 healthy subjects, researchers analyzed gas samples taken from the tip of a nasal cannula positioned in the nasopharnyx, an area in the back of the throat. The study concluded that subjects who breathed through their mouths while using supplemental oxygen had a significantly higher FIO2 (fraction of inspired oxygen) than those who didn’t. However, an editorial published in Respiratory Care disputed the validity of this study, stating that the results were likely to be inaccurate. Under normal circumstances, when a patient breathes supplemental oxygen through a nasal cannula, they breathe a combination of oxygen mixed with room air. During mouth breathing, oxygen delivered through a nasal cannula doesn’t mix with room air; it’s pushed through the nose and into the nasopharnyx where it remains highly concentrated. Gas samples taken from an oxygen-enriched area may yield a higher concentration of oxygen, but they won’t represent a patient’s true oxygen concentration because the gas is undiluted by room air.6

Mouth Breathing Treatment

The solution for many folks who use oxygen and are mouth breathers is to place the nasal cannula in their mouths. This is not only unsanitary, but as mentioned previously, it doesn’t make the delivery of oxygen to the lungs very effective.

The best approach to mouth breathing is a multidisciplinary one, involving your doctor, dentist and oftentimes, an Ear, Nose and Throat specialist.1 Depending upon the cause, mouth breathing treatment varies from using functional devices to correct facial and dental abnormalities to surgery.2 If you identify as a mouth breather, talk to your health care provider today to get properly diagnosed and determine which type of mouth breathing treatment is best for you.

 

Author: Deborah Leader RN, BSN, PHN

 

1 Yosh Jefferson, DMD, MAGD. Mouth breathing: Adverse effects on facial growth, health, academics, and behavior. General Dentistry. January/February 2010.
2 Trisha E. O’Hehir, RDH, MS. An Interview with Steven Sue, DDS, MS, on Mouth Breathing vs. Nose. October 2010.
3 Oliveira AC, et. al. Indicative factors of early facial aging in mouth breathing adults. 2007 Jul-Sep;19(3):305-12.
4 Stoller, James K. MD, MS, FCCP et. al. Oxygen Therapy for Patients With COPD: Current Evidence and the Long-Term Oxygen Treatment Trial. Chest. 2010 July; 138(1): 179–187. doi: 10.1378/chest.09-2555. PMCID: PMC2897694.
6 Poulton, Thomas J., MD. Assessing the Dose of Supplemental Oxygen: Let Us Compare Methodologies. Respiratory Care. Vol 50 No 5. May, 2005.

One thought on “The Trouble with Mouth Breathing and Treatment Options”

  1. Frank A. Leto says:

    I have been a mouth breather my whole life. I am 70 years old, I have COPD, Fibrousis, & Emphazema. I use my Inogen 24-7, I have to force myself to breath thru my nose . Is it still helping? ???????

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