The Trouble with Mouth Breathing and Treatment Options

Wondering why mouth breathing matters, how it affects you and how to stop mouth breathing? If you are a mouth breather, you probably have all of these questions and more. Read on to learn why being a mouth breather can have a surprising impact on your health.

Nose Breathing vs. Mouth Breathing

You might not realize how big of a difference the way you breathe can make on your well-being, but believe it not, there are so many ways that breathing can be more (or less) efficient. From your breathing technique to your body position when you breathe to whether you breathe through your nose or mouth, all of these factors make a difference in whether or not you get the oxygen you need. When it comes to nose breathing vs. mouth breathing, the difference is surprisingly significant. 

Your nose serves an essential purpose when it comes to breathing: 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 is essential to the production of nitric oxide, a gas naturally produced by the body. The nitric oxide created during nasal respiration increases oxygen exchange efficiency, blood oxygen and arterial oxygen tension, and also improves oxygen absorption by the lungs.[1,2] Furthermore, breathing through the nose activates the calming part of your nervous system, rather than keeping you in a stress state.[3] This results in lower blood pressure, better immune defenses and improved neurotransmission.[1] 

Overall, with nasal breathing, your body is better able to maintain balance in regards to the chemical conditions inside the body.[1] In addition, the nitrous oxide produced through nasal breathing relaxes vascular smooth muscle and allows blood vessels to dilate, which increases oxygenation and reduces snoring, mucus production and fatigue.[4,5,6] 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?

What Causes Mouth Breathing?

Mouth breathing can be caused by any number of factors. In some cases, the shape of the nose or jaw, nasal congestion due to allergies or illness, nasal polyps, a deviated septum, enlarged tonsils, adenoids, turbinates or, in rare cases, tumors, can block your nasal airways.[5] In other cases, people develop a bad habit of breathing through their mouths because of stress, anxiety, sleep apnea or a general feeling of breathlessness.[1,5] Once mouth breathing becomes a habit, many people do not realize they are breathing this way, and it can be a difficult habit to break.  

The Impact of Mouth Breathing: Are You in the Dark?

If you are a mouth breather, you probably want to know, “What is the problem with mouth breathing?” Most people, including many 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 aging[7] 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.[4]

In an interview conducted by registered dental hygienist, Trisha O’Hehir, Dr. Steven Sue, DDS, MS, explains the following:[6]

“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.”

This means that once you get in the habit of mouth breathing, your body could become confused into continued mouth breathing. At this point, intervention of some kind may be required.

Mouth Breathing and Supplemental Oxygen

Oxygen therapy has many benefits, including increasing survival when used more than fifteen hours a day.[15] But, when comparing nose breathing vs. mouth breathing, 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 first[8] 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 than 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 nasopharynx, 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 is pushed through the nose and into the nasopharynx where it remains highly concentrated. Gas samples taken from an oxygen-enriched area may yield a higher concentration of oxygen, but they are unlikely to represent a patient’s true oxygen concentration because the gas is undiluted by room air.[9,10]

How to Stop Mouth Breathing

If you are a mouth breather and want to know how to stop mouth breathing, it is important to try to discover the cause. Once you know the cause, you can treat it, which will help resolve the symptom of mouth breathing. If you cannot find the cause on your own, seek help from a specialist. 

• Address nasal congestion: If you know you have allergies or frequent nasal congestion, see if you can find a way to resolve your nasal congestion to help you better breathe through your nose. Get in the habit of blowing your nose before bed, and look into allergy medication or allergy shots, or try nasal irrigation (via saline or neti pot) to clear nasal congestion.[11,12]
• Stop eating before bed: Stomach juices can make their way up into your nose, sinuses, ears and mouth when you eat before bed, causing congestion and inflammation that can cause mouth breathing.[11]
• Practice nose breathing vs. mouth breathing: If you are a mouth breather, it has likely become a habit, so practicing your nasal breathing technique can actually be a surprisingly effective way to change your breathing. Try to pay attention to the way you breathe throughout the day. Then, once you have noticed a pattern in the times that you typically breathe through your mouth, work on intentionally changing the way you breathe at those times.[13]
• Exercise: Getting more exercise is a great way to improve your oxygenation as a whole, but practicing nasal breathing while exercising has multiple benefits. First, it allows more oxygen to reach your active tissues. In addition, it makes your breathing more efficient and effective, so you do not have to breathe as fast. This allows more time for oxygen to reach your bloodstream, minimizing the likelihood that you will feel the need to breathe through your mouth. It can take a little while to adjust to nose breathing vs. mouth breathing during exercise, but nasal breathing is significantly better for you.[3]
• Work on stress relief: Nasal breathing activates a state of rest and recovery, while mouth breathing can activate a stress state.[3,12] The more stressed you feel, the more likely you are to breathe through your mouth, taking shallow breaths and breathing too quickly, which can begin a nasty cycle. Working on stress relief will allow you to focus on nasal breathing, but also remember that nasal breathing will help you reach that relaxed state. Practice nasal breathing when you feel stressed, and work on stress relief strategies to help you maintain your nasal breathing habit.
• Change the way you sleep: Sleep habits could be the cause of your mouth breathing, or they can exacerbate the problem for someone who is already a mouth breather. If you want to know how to stop mouth breathing, take a look at how you sleep. Make sure you have a pillow that props your head up enough, or try sleeping on your left side, rather than on your back.[12] Additionally, it may be worth finding out if you have sleep apnea. If you have a partner, they might have clues about your sleep. 

If none of these methods resolves your mouth breathing, you may need to see a myofunctional therapist or an ear, nose and throat doctor to discuss medical or therapeutic interventions. They will be able to help you address any medical or physical causes of mouth breathing, and help you find the correct treatment.

Mouth Breathing Treatment

Some folks who use oxygen and are mouth breathers have tried placing the nasal cannula in their mouths, rather than their noses, to attempt to solve the problem. This is not only unsanitary, but as mentioned previously, it makes the delivery of oxygen to the lungs significantly less effective.

The best approach to treating mouth breathing is a multidisciplinary one, involving your doctor, dentist and often times an ear, nose and throat specialist.[1] Your doctor may also recommend that you see a myofunctional therapist, who can help you learn how to chew, swallow and breathe correctly to help retrain yourself to breathe through your nose. Depending upon the cause, mouth breathing treatment varies from treating the cause, to using functional devices to correct facial and dental abnormalities to, in rare cases, surgery.[6] If you identify as a mouth breather, talk to your health care provider today to get properly diagnosed so you can determine the cause of your mouth breathing and determine which type of mouth breathing treatment is best for you.

Frequently Asked Questions About Mouth Breathing

Is it bad to be a mouth breather?

While mouth breathing in and of itself is not bad when it occurs occasionally, ongoing mouth breathing can have negative effects on the way you feel and on your overall health over time. 

How do I stop mouth breathing?

If you are a mouth breather, there are ways to stop and retrain yourself to breathe through your nose instead. Start by practicing nasal breathing whenever you notice you are breathing through your mouth. From there, you should try to treat the cause of your mouth breathing, including nasal congestion. If you are unable to stop mouth breathing on your own, see your doctor to explore the cause of your mouth breathing. Learning to practice nose breathing vs. mouth breathing can significantly improve the way you feel and your long-term health.

Can mouth breathing cause shortness of breath?

Mouth breathing can worsen symptoms like shortness of breath, and it can also increase the need to breathe faster, which can make you feel breathless. This can create an unfortunate cycle wherein you breathe through your mouth in an attempt to address shortness of breath, which then causes you to feel more short of breath. Learning to breathe through your nose can help you stop this cycle and can help you treat your shortness of breath by slowing your breathing down and allowing your blood to become more oxygenated.[14] 

Sources:

1. Macaluso, Martha, and Patrick McKeown. “Mouth Breathing: Physical, Mental and Emotional Consequences.” Oral Health , Oral Health Group, 9 Mar. 2017, www.oralhealthgroup.com/features/mouth-breathing-physical-mental-emotional-consequences/.
2. Lundberg , J O. “Inhalation of Nasally Derived Nitric Oxide Modulates Pulmonary Function in Humans.” Acta Physiologica Scandinavica, U.S. National Library of Medicine, Dec. 1996, Inhalation of nasally derived nitric oxide modulates pulmonary function in humans – PubMed (nih.gov)
3. Berman, Jae. “Perspective | Could Nasal Breathing Improve Athletic Performance?” The Washington Post, WP Company, 30 Jan. 2019, www.washingtonpost.com/lifestyle/wellness/when-it-comes-to-breathing-during-exercise-youre-probably-doing-it-wrong/2019/01/23/b4d3c338-1e59-11e9-8b59-0a28f2191131_story.html.
4. Jefferson, Yosh. “Mouth Breathing: Adverse Effects on Facial Growth, Health, Academics, and Behavior.” General Dentistry, U.S. National Library of Medicine, Jan. – Feb. 2010, Mouth breathing: adverse effects on facial growth, health, academics, and behavior – PubMed (nih.gov)
5. Cafasso, Jacquelyn. “Mouth Breathing: Symptoms, Complications, and Treatments.” Healthline, Healthline Media, 15 July 2019, www.healthline.com/health/mouth-breathing.
6. O’Hehir, Trisha E. “An Interview with Steven Sue, DDS, MS, on Mouth Breathing vs. Nose.” Hygienetown.com, Hygienetown, Oct. 2010, www.dentaltown.com/Images/dentaltown/magimages/1010/DTOct10pg112.pdf
7. Oliveira, A.C. et. al. “Indicative Factors of Early Facial Aging in Mouth Breathing Adults” Pró-Fono Revista De Atualização Científica, Jul. – Sept. 2007, www.scielo.br/pdf/pfono/v19n3/a09v19n3.
8. Stoller, James K, et al. “Oxygen Therapy for Patients with COPD: Current Evidence and the Long-Term Oxygen Treatment Trial.” Chest, U.S. National Library of Medicine, July 2010, Oxygen therapy for patients with COPD: current evidence and the long-term oxygen treatment trial – PubMed (nih.gov)
9. Wettstein, Richard B, et al. “Delivered Oxygen Concentrations Using Low-Flow and High-Flow Nasal Cannulas.” Respiratory Care, U.S. National Library of Medicine, May 2005, Delivered oxygen concentrations using low-flow and high-flow nasal cannulas – PubMed (nih.gov)
10. Casaburi, Richard. “Assessing the Dose of Supplemental Oxygen: Let Us Compare Methodologies.” Respiratory Care, U.S. National Library of Medicine, May 2005, Assessing the dose of supplemental oxygen: let us compare methodologies – PubMed (nih.gov)
11. Smith, Jen Rose. “How to Stop Mouth Breathing for Better Sleep.” CNN, Cable News Network, 20 Aug. 2020, www.cnn.com/2020/08/20/health/how-to-stop-mouth-breathing-sleep-wellness/index.html.
12. “5 Ways to Stop Mouth Breathing.” Sinus and Nasal Specialists of Lousiana, 21 May 2020, www.sinusandnasalspecialists.com/5-ways-to-stop-mouth-breathing/.
13. “Stop Mouth Breathing.” Colorado ENT and Allergy, 11 Mar. 2020, www.coloradoent.com/7-ways-to-stop-mouth-breathing/.
14. “Home.” Whole Health Dental Center, Accessed 20 Nov. 2020, Habitual Mouth Breathing: Damages and Solutions – Whole Health Dental Center
15. Long-Term Oxygen Therapy 24 vs 15 h/day and Mortality in Chronic Obstructive Pulmonary Disease – PMC (nih.gov)