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Time to remove the Dummie’s and Thumb’s: The central and surprising role of NOSE BREATHING in childhood development and adult longevity.

By Osteopath, Melissa McDougall

From the moment we are born, we breathe. For most of us, breathing provides oxygen for brain and body function… and that’s about it.

However research now suggests that the way we breathe can influence our teeth alignment, facial development, posture, behaviour, concentration, learning, tendencies to allergy, blood pressure and heart health (1,2,3).

Breathing as a child:

Childhood is a excellent time to establish healthy breathing patterns.
What’s healthy?

Firstly, it is important that children can breathe through their nose effortlessly.

Chronic nasal obstruction causes chronic mouth open posture at rest (4). It is now well accepted that the muscles of the tongue, lips and cheeks play a major role in tooth position, jaw and facial development (3).  Fingers and thumbs and dummies in the mouth may predispose to open mouth posture and a lower position of the tongue.

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Facial profiles of two sisters. Kelly (left) 9yrs corrected her mouth breathing a few years prior. Samantha (right) 10 and a half yrs was less compliant and continued to mouth breathe. Case reproduced from www.buteykochildren.com.

'Use it or loose it' applies to nose's... A nose which is not used to breath through, will easily block, and stay blocked. Chronic mouth open posture at rest causes children to breathe cold, non filtered, non humidified air. It alters the position of the lips and the tongue which in turn alters muscle tension which leads to an altered pattern of facial growth and morphology with dental abnormalities (4).

The healthy resting position of the tongue is at the roof of the mouth, the teeth are touching or slightly apart, and the lips are together without strain. When a child grows up with proper oral posture the face develops in appropriate balance according to its genetic plan. Also, there is proper balance between the forces of the tongue and the cheeks, and the teeth tend to come in to relatively good positions (5).

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This is a view of the tongue in the mouth, looking from the back of the throat.
A) Correct tounge position at the roof of the mouth. The sides of the tongue exert pressure on the upper teeth and help to form an wide 'U' shaped upper dental arch. B) Lowered tongue position as in mouth breathing, associated with a more narrow upper dental arch.

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The upper dental arch. Left) U shaped upper dental arch can develop naturally by the pressure on the teeth by the tongue in the roof of the mouth. Right) V shaped arch, associated with a lowered tongue position and mouth breathing. Photo for demonstrative purposes only.

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tongue thrust during swallowing.

In mouth breathing, and when dummies, fingers and thumbs are in the mouth, the tongue is low and the teeth and lips are apart at rest, and if tongue position is incorrect, swallowing pattern also tends to become abnormal.

Commonly, when a predominately mouth breathing child swallows, the tongue tends to thrust forward and the lower jaw moves backwards (2). This creates forces that distort the position of the teeth that along with the absence of healthy muscle patterns of the tongue, lips and cheeks result in crowded teeth, gummy smiles, recessive chins, and long faces (6).

The cause of mouth breathing and alternations in swallowing may be different for every child and include multiple factors.  Osteopathically, birth strains and position of the head, neck and jaw can influence the way a baby feeds, and breathes. Other possibilities include allergy, tongue tie, then later,  prolonged thumb, finger and dummies habits.

Most people are surprised to learn that the tongue has a great role in facial growth and tooth position, that is healthy tongue position at rest, and balanced healthy movements of the tongue and face lead to good looking faces, straight teeth and a wide smile.

2D274905761868-super-tired.blocks_desktop_mediumHowever, breathing problems include more that just mouth breathing. Another surprise to most people is discovering that carbon dioxide is not just a waste gas, but is important for the ability of haemoglobin in our red blood cells to let go of oxygen so that it can be used by our body cells. Breathing too frequently is relatively common and often unconscious- It reduces our carbon dioxide levels and strengthens the bond between haemoglobin in our blood and oxygen, which means oxygen isn't given as freely to our body cells. In science, this is called the Bohr effect (3).

 

Adenoids_Gross_1.sized

How does your child breathe? Signs of disordered breathing:

mouth breathing
snoring
raised shoulders and noticeable breathing into the upper chest
forward head posture
sighing
bed wetting
irritability
anxiety
teeth grinding
dark circles under the eyes

 

Helping children and adults breathe through their noses:
There are many benefits breathing through our nose brings for adults and children:

  • less colds
  • improved asthma control
  • better oral health
  • less snoring and sleep apnea
  • better facial growth and less orthodontic problems
  • beautiful posture and less pain

Posture, especially of the head and neck is also very much influenced by the way we breathe. It has long been recognised that blocked or obstructed airways, at the nose or throat or bronchi (most common in children), will make a person tilt their head back to increase the size of the airway.

How-Tor-Improve-Posture-Toronto-Chiropractor
If this response becomes habitual the person develops fixed postural abnormalities, such as forward head posture. This is known to be associated with neck pain, back pain, headaches and temporal-mandibular joint (TMJ) syndrome. A child who is not getting enough air, or a child or adult who has become habituated to over-breathing or straining for air will frequently show a forward head posture and tight neck and shoulder muscles. Their diaphragm function tends to change and this affects the development of the rib cage and postural patterns in general (2).

Kyphosis-Normal-vs-Hyper-3

Sometimes mouth breathing can be cured by simple breathing techniques practiced with determination and persistence.
The Buteyko Breathing Method includes some of the best breathing techniques for clearing the nose and teaching people to breathe nasally.

--------------Clear your nose for step by step with Osteopath Rosalba Courtney here------------

The entire Buteyko Breathing course is offered for children and adults at growing bones (more info).

Multiple factors can contribute to obstructed airways. The most common forms of nasal obstruction include:

  • Allergic Rhinitis (inflammation and swelling of the nasal passages)image1-470x376
  • Adenoid hypertrophy (engaged lymphatic glands at the back of the nasal passages)
  • Nasal sepal deviation (bending of the usually straight bone and/or cartilage that separates the two nostrils)
  • Narrow, highly arched palate (narrow and high roof of the mouth, which decreases the height of the nasal passages)

But what’s most important is the cause of nasal obstruction be identified, and if possible all together avoided.  As mentioned before, osteopathically we consider birth position of the head neck and jaw, allergy, tongue tie, thumb, finger and dummies habits amongst others. There is rarely a single solution to any heath problem. This also applies to healthy nasal breathing.

Some things we can change to promote healthy breathing:

  • closing our mouths and breathing through our nose
  • taking thumbs, fingers and dummies out of the mouth: difficult? Not so. Check out details of our healthy smiles healthy bodies program at the end of this article.
  • breathing exercises: Buteyko Breathing exercises continue to be successful in changing the way individuals breathe and feel over the long term. The entire course is offered for children and adults at growing bones (more info).
  • looking at our diet to see if there are any foods that we feel my be causing inflammation and congestion in our bodies (most commonly, dairy tends to lead to congestion in the respiratory tract, but other foods and additives may affect others in other ways).
  • body work: osteopaths can work on areas of the body that may help promote drainage of the head and sinuses, balanced posture, relaxation and full balanced movement of the diaphragm (our primary breathing muscle) and exercises for the tongue and face that promote healthy tongue position, function and facial muscles at rest.
  • visit a salt room: check out Salt City in Yarraville!
  • geider_marian_01_trx_-2mos.174133958_stdfunctional orthodontics: In the briefest of description, traditionally orthodontics is about
    making the teeth fit the mouth, that is removing teeth in an over crowed mouth and using braces to straighten the teeth. There is a new approach to treating children (at a younger age) called functional orthodontics, this is where treatment is applied to help correct breathing, tongue position and orthodontic plates to help expand the upper and lower jaws, and assist healthy facial and postural balance. The Myobrace system, which is used by Melbourne dentist Meetal Shah and Queensland dentist Dan Hanson, and  slightly different approaches used by Melbourne dentists Nischal Singh and Simon Wong work on this model.
  • know our feelings, and live to feel better: emotions can change the way we hold our bodies, face and also affect the way we breathe. Full relaxed breathing and a balanced vibrant body come about when we feel secure and happy. Yoga, Pilates, Meditation, Buteyko and Biodanza all work with the body, mind and breath to bring about health. (Pilates, Biodanza + Buteyko Breathing are all available at growingbones).
  • sometimes surgery is needed: In some cases, in children with very large adenoids, surgery can solve the problem overnight.

It is important to know that in terms of facial growth the lower jaw or the mandible, is 80% of adult size by the age of six. Similarly the growth of the upper jaw, or the maxilla is 80% complete by the age of six. Both upper and lower jaws are 90% of adult size by the age of twelve so if any intervention to clear nasal obstruction (for example, osteopathy, orthodontics, breath retraining, surgery) is to take place, ideally it should occur before the age of six and definitely the earlier the better thereafter (5).  Most importantly, parents are best to identify any irritants in the child’s environment, including diet that may be contributing to an immune response, often associated with enlargement of these glands.

We now have our Healthy Smiles, Healthy Bodies program up and running, which helps children give up their dummy, thumb or finger, close their month and breathe through their nose and become more balanced & co-ordinated.

smile

The Healthy Smiles, Healthy Bodies program involves a 5 week program, where we introduce:

  • sticky spots into the roof of the mouth to support a closed moth posture and encourage the tongue to the roof of the mouth.
  • wearing of bandaid on the finger most often sucked
  • wearing of a glove in quiet times, such as reading a book, going to sleep
  • removal of any trigger, toy, blanket that is usually always help while sucking
  • some play based exercises, where compliant
  • osteopathic support
  • we give the child a sticker chart, as a reward for not sucking and doing the play exercises every morning and every afternoon.
  • a toy reward at the end of the program is also a good idea for parents to organise.

Fees are just as osteopathic visits, however there may be a few dollars extra here and there to cover materials.

Please email melissa@growingbones.com.au/growingbones for more information. 

 

Many thanks to Osteopath Rosalba Courtney for her extensive work on breathing in the osteopathic field.

References:

Gozal, D, Kheirandish-Gozal, L . (2008). Cardiovascular Morbidity in Obstructive Sleep Apnea
Oxidative Stress, Inflammation, and Much More Am J Respir Crit Care Med.177(4): 369–375. doi:  10.1164/rccm.200608-1190PP

Courtney, R. (2013). Correct Breathing and healthy airways are fundamental to children health. Retrieved 29th January, 2015 from http://www.breathandbody.com.au/storage/Correct%20Breathing_May2013.pdf

Hanson, D. (2015). Breathing, Crooked Teeth and Health. Retrieved 29th January, 2015 from
http://www.linkedin.com/pulse/breathing-crooked-teeth-health-dan-hanson?trk=prof-post

Havas, TE. (n.d.) Nasal Obstruction and Secondary Dento-facial deformaties in Children [Flyer]. Bondi Junction, NSW, Havas ENT Clinic.

Face Focused. (n.d.). Proper Oral Posture. Retrieved 29th January, 2015 from http://facefocused.com/proporpos.html

 

About the Author

Melissa McDougall