Proper Breathing and Jaw Development in Children

Breathing is simply defined as the body taking in oxygen from the air to obtain energy and exhaling carbon dioxide, which is harmful to the body. In many languages, the words breathing, inhaling and exhaling are associated with concepts beyond the inhaled air, such as life energy and creativity. Breathing is a reflex and does not require attention to continue, whereas breathing is behavioral and requires some focus and attention. Healthy and natural breathing is a vital need, both physically and spiritually. While correct breathing increases the quality of life, incorrect or inadequate breathing can cause some problems. Especially the energy that children need for their development is met with correct breathing, and correct breathing strengthens the immune system. When the required energy is provided with correct breathing, the autonomic nervous system, like all systems, works perfectly and hormonal balance is achieved.

So what is proper breathing?

The World Health Organization (WHO) defines proper breathing as; inhaling and exhaling through the nose, lungs should be filled to full capacity, diaphragm muscle should be used while inhaling and exhaling, there should be no wheezing from the lungs or nose and the number of breaths we take per minute should be minimum. The number of breaths a person takes per minute indicates the respiratory frequency and this frequency is 12-20 per minute for an average healthy adult, 16-22 for a healthy child and 18-24 for a healthy baby. Increasing this frequency does not mean taking more oxygen into our body, in order to send the oxygen taken into the body to all our cells through the blood, we need to fill the lungs with deep and slow breaths and slowly release them back. Therefore, not fast, but on the contrary, slow and deep breaths are ideal.

The first condition for proper breathing is to breathe through the nose. This is important for the air that will go to the lungs to be humidified, warmed, filtered and healthy. The air taken through the mouth is not of good quality because it will go to the lungs as is.

Learning proper breathing in childhood is important to continue in adulthood. In adults who breathe through their mouths without any other reason, it can be seen that this is usually a habit from childhood. Therefore, it is important to evaluate breathing at a young age and solve any problems.

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

In children who breathe through their mouths and cannot breathe in good quality, fatigue/falling asleep during the day, growth and developmental delay compared to their peers, hyperactivity, aggressive behavior, restlessness, failure in school, headaches in the morning, especially in children over the age of 4, and sweating especially around the head/neck during sleep may be observed.

In untreated cases, the body cannot receive sufficient and high-quality oxygen through mouth breathing alone, which can lead to growth and development disorders, behavioral problems, sleep disorders, cardiovascular problems, and, in cases with obesity, endocrine disorders.

Apart from general health, nasal breathing is directly related to jaw and facial development and body posture. Nasal breathing is necessary for the proper development of the upper jaw, skull bones and sinus cavities. A child who cannot breathe through the nose bends his head forward, extends it or tilts it back in order to breathe more comfortably through the mouth, which causes the neck to be positioned incorrectly, puts pressure on the cervical vertebrae, overwork of the neck muscles, elevation of the ribs and collarbones, and thus a hunchbacked posture. As a result of mouth breathing that continues for a long time, the child pushes his lower jaw and tongue down in order to breathe, the palate deepens, the lower jaw cannot grow, the cheek muscles compress the upper jaw and do not allow it to expand to the sides, the back teeth grow since the mouth is constantly open and the mouth cannot close completely, and joint problems may be observed. In this type of breathing, the face is longer and narrower and there is a typical appearance called "adenoid face". Apart from jaw, facial development and body posture, since the mouth is constantly open, the gums and teeth cannot be wetted and washed with saliva, the gums are dry, swollen, red and bleeding, especially in the upper front area, and the risk of decay is increased.

As can be seen, just taking the wrong breath 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 entire system as a whole. A child who breathes correctly can have all the energy needed to use his/her own potential through breathing. That is why it is very important to detect and treat wrong breathing in childhood.

It is very important for pediatric dentists, orthodontists, ear, nose and throat doctors, pediatricians and even physiotherapists to work together as a team and provide guidance in case of doubt. Pediatricians and pediatric dentists can detect developmental differences in the early stages. While ear, nose and throat doctors offer medical or surgical treatment options for airway obstructions, orthodontists can evaluate growth and development, expand the jaws with early period appliances and teach the child the proper position of the tongue with some easy exercises.

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

Pediatric Dentist Cansu Uzun Önalan