Better use your nose

Chronic mouth breathing is when some people exclusively breathe through their mouth. What are the medical conditions that cause mouth breathing?

When a person breathes normally through the nose, the air goes through a filtration process. When there is unwanted air debris, the nasal hair and mucus cause a sneeze reflex to release it, while the nasal lining naturally humidifies incoming clean air. But someone with nasal problems or blockages often experiences stuffy nose, so they will automatically breathe through the mouth.

Other causes of nasal obstruction include a deviated septum, adenoid hypertrophy or enlarged adenoids (a kind of tonsil located behind the nasal cavity) and/or allergies that are not controlled. To determine the cause, we must look at the nasal cavity with the help of special tools, a nasal endoscopy examination that has a high level of diagnostic accuracy, and ordinary radiology examinations, such as sinus paranasal CT-Scans.

Chronic mouth breathing can change one’s facial structure. How is this possible? What are other health complications associated with this condition?

Persistent or chronic mouth breathing does cause a distinct change in the facial structure. For example, the face becomes slightly elongated, the mouth remains open, the arch of the ceiling in the mouth is high, the upper lip becomes low, and the person’s overall expression looks dazed.

Occasionally, a person is also unable to effectively breathe through the mouth, which causes loud snoring during sleep or other issues with night breathing, including a swollen nose. Such conditions can cause a person to suffer from a lung disease called pulmonary hypertension or a heart condition also caused by pulmonary hypertension and coronary heart disease. Adenoid enlargement in children can lead to infection of the ear, which can result in loss of conductive hearing, while constant nasal secretion due to inflamed adenoids can cause sinus infections.

Patients tend to hesitate seeking treatment for mouth breathing. Why is this the case and when is a patient recommended to seek professional help?

Do not ignore a child or family member who constantly breathes through the mouth. Immediately seek an ENT specialist to evaluate the condition, including the nasopharynx, throat and enlarged tonsils. Allowing a person to continue mouth breathing will only prolong their suffering, such as from a dry or sore throat (due to the incoming air not undergoing filtration and humidification), a runny nose and eventually facial structural changes.

How is mouth breathing treated?

The main principle in treating mouth breathing is to facilitate airflow through the nose. If breathing through the mouth is caused by a deviated septum, then a surgical procedure is performed to correct it. If the cause is a large nasal concha, the bones forming the upper chambers of the nasal cavity, then a conjuncture reduction using bipolar cautery or laser can be performed. If the cause is a large adenoid especially with large tonsils, which does not improve with drugs, then a surgical procedure to remove the adenoid and tonsils may be considered. The ENT specialists will decide the appropriate treatment case by case according to the particular diagnosis.

Zainal Adhim, MD, is a Head and Neck Specialist and Laryngopharyngology consultant at Pondok Indah Hospital in Jakarta.

This story was originally published in the Global Health and Travel issue of January 2018.