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From Trisha's Desk Trisha E. O’Hehir, RDH, BS Hygienetown Editorial Director

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Close Your Mouth
– by Trisha E. O’Hehir, RDH, BS, Hygienetown Editorial Director

As you read this, is your mouth open or closed? Are your lips together or apart? Are you breathing through your nose or your mouth? Normal mouth rest posture is lips together with the tongue resting in the palate and breathing done through the nose. In mouth breathers, the tongue is no longer resting against the palate, but is moved down and forward. Oxygen absorption levels are lowered, palate development is compromised and snoring often occurs during sleep. For these and other functional reasons, nasal breathing is preferred.
Every cell in the body needs oxygen to survive. Although mouth breathing might bring in more air, it also expels more carbon dioxide, leading to reduced oxygen absorption. Nose breathing brings in less air than the mouth, due to the smaller size of the nostrils and also less air is exhaled, creating a back pressure in the lungs that allows for more oxygen to be absorbed into the blood, creating a balanced oxygen / carbon dioxide exchange. This also ensures the desired blood pH remains between 7.35 and 7.45, making it slightly alkaline. Reduced carbon dioxide levels change the pH of blood.

Mouth breathing sends a message to the brain that carbon dioxide is being lost too quickly. In response, goblet cells are stimulated to produce mucous, slow the breathing and trigger constriction of the blood vessels. Nose breathing limits air intake, forcing one to slow down, thus reducing hypertension and stress. It’s like the cruise control on a car or like a governor on a car engine.

Protecting the lungs from dust, dirt and unwanted microorganisms is the function of the nose and sinuses. Nose breathing warms and filters the air through nasal hairs in the anterior nasal passage. Breathing through the mouth bypasses the warming and filtration, allowing potentially harmful particles to enter the lungs and respiratory system.

Snoring is due to obstructed air movement causing vibration of the uvula and soft palate during breathing. When breathing through the nose with the tongue against the palate creating a seal with the throat, no sound occurs. Mouth breathing, with the tongue down and forward can be a contributing factor for snoring.

Mouth breathing in children can lead to abnormal palatal growth, creating a narrow, high-vaulted palate resulting in what’s called the “Long Face Syndrome.” When breathing through the mouth, the tongue is no longer resting in the palate, providing passive pressure for proper growth and development. Without the tongue resting against the roof of the mouth, a narrow palate will develop leading to crowded teeth and malocclusion.

Those who breathe through their mouths might be perceived to lack intelligence or have poor social skills. The down and forward tongue position results in slumped posture, followed by a forward head position to open the airway and is considered less attractive than nose breathing. Oral malodor becomes a problem for mouth breathers as the oral tissues dry. Lips apart lack tone and can appear swollen or flaccid. Take a look at children considered to have learning disabilities and you’ll find a high incidence of mouth breathers.

Before asking your patients to open their mouths, notice if their lips are together and if they are nose breathing. Despite so often asking patients to “open wide” the valuable message really is “close your mouth.”

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