Correct Breathing and Jaw Development in Children

Respiration is simply defined as the body breathing in oxygen from the air to obtain energy and breathing out carbon dioxide, which is harmful to the body. In many languages, the words breathing, inhaling and exhaling have become synonymous with concepts beyond inhaled air, such as life energy and creativity. Breathing is a reflex and does not require attention to continue, while breathing is behavioral and requires some focus and attention. Healthy and natural breathing is a vital requirement both physically and mentally. While correct breathing improves the quality of life, incorrect or inadequate breathing can cause some problems. Especially for children, the energy they need for their development is met by correct breathing, at the same time, correct breathing strengthens the immune system, when the energy needed is provided by correct breathing, the autonomic nervous system works perfectly like all systems and hormonal balance is also provided.

So what is correct breathing?

The World Health Organization (WHO) defines proper breathing as; inhaling and exhaling through the nose, filling the lungs to full capacity, using the diaphragm muscle while breathing in and out, no rustling from the lungs or nose, and a minimum number of breaths per minute. The number of breaths per minute indicates the frequency of breathing and this frequency is 12-20 breaths per minute in an average healthy adult, 16-22 breaths per minute in a healthy child and 18-24 breaths per minute in a healthy baby. Increasing this frequency does not mean getting more oxygen into our body, we need to fill the lungs with deep and slow breaths and slowly give it back to the body in order to send it to all our cells through the blood. This is why slow and deep breaths are ideal, not fast ones.

The first condition for correct breathing is to breathe in and out through the nose. This is important for moisturizing, warming and filtering the air that goes into the lungs and making it healthy. Air taken through the mouth is not of good quality as it goes to the lungs as it is.

It is important to learn correct breathing in childhood so that it can be maintained in adulthood. In adults with mouth breathing without any other cause, it can often be seen that this is a habit from childhood. Therefore, it is important to evaluate breathing at a young age and solve any problems.

Some obstructions in the nasal passage can make nasal breathing difficult; abnormally large adenoids and tonsils, nasal deviation, presence of polyps, allergic rhinitis, sinusitis are some of these. In addition to nasal congestion, children may not be able to breathe through the nose due to genetic or behavioral/psychological reasons and may start breathing through the mouth. Especially in cases where the airway is narrow or the respiratory muscles cannot contract sufficiently or both together, snoring and sleep apnea and mouth breathing at night can be seen in children. It is known that 1-5% of children aged 2-7 years have obstructive sleep apnea.

In children who mouth breathe and cannot breathe well, fatigue/sleepiness during the day, growth and development retardation compared to their peers, hyperactivity, aggressive behavior, restlessness, failure in lessons, headache in the morning especially in children over 4 years of age, sweating during sleep, especially around the head/neck.

In untreated cases, growth and development disorders, behavioral problems, sleep disorders, cardiovascular problems and endocrine disorders can be seen in cases with obesity, as the body cannot receive sufficient and quality oxygen only with mouth breathing.

Apart from general health, nasal breathing is directly related to jaw and facial development and body posture. Nasal breathing is necessary for proper development of the upper jaw, skull bones and sinus cavities. A child who cannot breathe through the nose tilts, stretches or tilts his/her head backwards in order to breathe more easily through the mouth, which leads to incorrect positioning of the neck, stress on the cervical vertebrae, overwork of the neck muscles, elevation of the ribs and collarbones and hence a hunched posture. As a result of prolonged mouth breathing, the child pushes the lower jaw and tongue downwards to breathe, the palate deepens, the lower jaw cannot grow, the cheek muscles compress the upper jaw and do not allow it to expand sideways, the back teeth grow and the mouth cannot close completely because the mouth is constantly open, joint problems may occur. In this type of breathing, the face is longer and narrower and has a typical appearance called “adenoid face”. Apart from the jaw, facial development and body posture, because the mouth is constantly open, the gums and teeth cannot be wet and washed with saliva, the gums are dry, swollen, red and bleeding, especially in the upper anterior region, and the risk of caries is increased.

As can be seen, just breathing incorrectly can have consequences that affect almost the entire system. Children growing up breathing correctly is the most important factor for the perfect functioning and development of the whole system as a whole. A child who breathes correctly can have all the energy necessary to use his/her potential with the breath.  This is why it is so important to detect and treat improper breathing in childhood.

It is very important that pediatric dentists, orthodontists, otolaryngologists, pediatricians and even physiotherapists work together as a team and provide guidance in case of suspicion. Pediatricians and pediatric dentists can detect developmental differences at an early stage. While otolaryngologists can offer medication or surgical treatment options for airway obstructions, orthodontists can evaluate growth and development, widen the jaws with early appliances and teach the child the proper position of the tongue with some easy exercises.

Learning how to breathe correctly in childhood and getting the necessary treatments to make it permanent is a small, simple and effective step that affects the whole life.