Is My Child a Mouth Breather?

Although mouth breathing is common and sometimes overlooked, it is a primary cause of facial and dental deformities and irregularities. Mouth breathing is caused by chronic nasal obstruction (CNO). No one breathes through the mouth as a habit!

Children rarely complain of mouth breathing because they quickly accept it as their “normal.” Dental and facial deformities / irregularities can be prevented or minimized by timely and appropriate treatment.

Is My Child a Mouthbreather

Signs and symptoms of mouth breathing may include:

  • Open mouth posture, especially while sleeping
  • Dry lips
  • Narrow palate, crowded teeth
  • Increasingly long and narrow face (long face syndrome)
  • Thick fibrotic gum tissue
  • Gum tissue shows when smiling
  • Bad breath (halitosis)
  • Dark circles under the eyes “allergic shiners”
  • Snoring
  • Sleep apnea (OSA)
  • Requires much sleep / poorly rested
  • High incidence of airway infections (sinus, ear, colds, etc.)

Why is it important for mouth breathers to see an orthodontist by age seven? Because an orthodontist can help direct growth ... but only in a GROWING patient! By the teen years, bone is mature enough that the orthodontics (specifically, dentofacial orthopedics to direct skeletal growth) becomes much less effective. A simple analogy is a gardener using a stake to straighten a sapling versus trying to straighten a mature tree.

For teens and adults it is too late for simple orthodontic treatment. A combination of surgery and orthodontics may be required to shorten the length of the face. Aesthetic improvements after surgery are usually dramatic.

Below is an example of palate expansion in a CNO patient. The roof of the mouth is the floor of the nasal cavity. From this you may infer similar improvements in nasal volume. This much-researched subject confirms measured increases in nasal volume for 100% of patients.

Sixty percent of patients report noticeable improvements in breathing. The other 40% may be further restricted by adenoids or other anatomy. Palate expansion is performed to correct jaw deformities that are common with CNO. Airway improvement may be a tremendous side benefit.

palate deformity before and after expansion

Note that the roof of the mouth is the nasal floor. Palate expansion means nasal floor expansion.

nasal floor expansion

It is important for a patient to be evaluated for CNO before the facial and dental effects become more severe. Facial deformities generally increase with growth. Mouth breathers present with different problems in different forms so you may need to see more than one doctor.

Some CNO patients need to have their allergies treated, some may need adenoids removed, and some may need palate expansion. ENTs, orthodontists, and allergists can work together to diagnose and correct these problems.


Q: Wouldn’t my child complain if there is a problem with his breathing?

A: No! Having never experienced “normal breathing,” children do not recognize their own problem. Usually the parent or doctor must recognize the problem first.

Q: What health improvements might I expect from “normal breathing”?

A: Improvement or prevention of most/all the symptoms listed above. It is hard to overstate the potential improvement in overall health. Health improvements should be life-long.


"Dr. Grady,

I cannot thank you, Dr. Kastner, and your staff enough for how much you have helped my son Logan. As a parent, you feel helpless when your child is suffering from an ailment that you do not know how to remedy. Since birth, Logan was a mouth-breather and always had a croup-like cough when he was sick. I just assumed this was normal for him. However at about age 6, this croup-like cough became more persistent, especially at night. It started disrupting Logan’s ability to sleep. At the recommendation of our pediatrician, we started with albuteral treatments which later failed. Their solution was to take Singulair as a maintenance drug to suppress the cough. Logan remained on this drug for nearly two years. During this time, I had many failed attempts at trying to find the cause of Logan’s problem. We consulted many specialists resulting in extensive allergy testing, nasal medication, X-rays, etc. The end result was still the same, that Logan should remain on the maintenance drug Singulair.

I truly believe, as a parent, I found a miracle at your office. After an initial evaluation, you and Dr. Kastner told me that Logan needed expansion immediately due to his deep, narrow palate; that without expansion, Logan’s face would start to grow very long and narrow. You also informed me that in many cases this is also what causes a child to be a mouth-breather. This is the first time a doctor had ever told me that.

The expansion of Logan’s upper palate allowed him to start breathing through his nose instead of his mouth. This in turn allowed Logan’s body to filter many of the allergens that caused his disruptive cough. He no longer needed the Singulair. With only six weeks of an upper expander, a problem that plagued my son for eight years of his life was finally identified and corrected. It was the solution to Logan’s problem. I am forever thankful to you, Dr. Grady, as well as Dr. Kastner for what you both have done for my son, Logan."

"My daughter was able to discontinue using C-pap due to her treatment of dental expansion. This was such a wonderful experience. At age 8, Sara was able to overcome all the issues that come along with C-pap, and due to Dr. Grady and Dr. Kastner’s treatment plan with the expansion, we obtained the necessary room for Sara’s tongue and discontinued C-pap after a year of treatment. Thanks!"

-Michelle Knox

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