Management of mouth breathing habit

Department of Pedodontics and preventive dentistry

RESOURCE FACULTIES: PRESENTED BY :

PROF. DR. BANDANA KOIRALA SUSHANT PANDEY
DR. MAMTA DALI 653
DR. SNEHA SHRESTHA
OBJECTIVES :

1. To know the etiology, oral manifestations of mouth

breathing
2. To diagnose mouth breathing
3. To know about the different treatments for mouth
breathing
4. To know about oral screen
Introduction

Defined as habitual respiration through the mouth

instead of the nose. (SASSOUNI, 1971)
Adenoid facies
• Long narrow face with long
narrow nose & flaccid lips
• Nose tipped superiorly in front
so an observer can look directly
into the nares
• Expressionless face
Gingiva:
• Inflamed & irritated gingival tissue
in the anterior maxillary arch
• Gingiva exhibits classic rolled
margin with an enlarged interdental
papilla
• Patient asked to take deep breath
Nasal breather keep the lip tightly closed
Mouth breather take deep breath keeping mouth open.
Treatment considerations

• Age of the child

• ENT examination:
– Rule out or eliminate nasal obstruction
Management

Management includes:
1. Elimination of the cause

2. Symptomatic treatment for gingiva

Petroleum jelly
Physical exercise

A) Breathing exercise

- Done in morning and at night

- Deep inhalation through the nose with arms raised
- After some time arms are dropped sideways and air
is exhaled
 B) Lip exercise

- During day time : hold a sheet of paper between the lips

- During night time : tape the lips together with surgical tapes

- Patient with short hypotonic upper lip : stretch the upper lip
to maintain lip seal
Button pull exercise Tug of war exercise
C) Mechanical

- Oral screen

Introduced by Newell in 1912.

• It is a myofunctional appliance placed in the labial

vestibule.
• Most effective way to re-establish nasal breathing, by
preventing air from entering oral cavity.
• The appliance has to be worn for 2-3 hrs during the day
and during sleep at night.
Principle :

• Works on the principle of force application as well

as force elimination.

• Can be used either to apply the forces of the

circumoral musculature to certain teeth or to
relieve those forces from the teeth thereby allowing
them to move due to the forces exerted by the
tongue.
If the upper incisors are proclined and spaced and there is an
increase in overjet and the oral screen is made so that it touches
only the proclined incisors and is not in contact with the teeth in
the buccal segments, the pressure of the lips and cheeks which
lie in with the oral screen will all be concentrated on the labial
surfaces of the proclined incisors near the incisal edges.

Oral screen also keeps the perioral musculature away from

exerting its force during functional movements on the buccal
aspect of posteriors. The lingual force (tongue) acting on the
posterior teeth is no longer counteracted by forces of perioral
musculature resulting in buccal drifting of posteriors.
Uses :

Used for the correction of the following conditions :

• Mouth breathing
• Thumb sucking, lip biting and tongue thrust
• Mild distocclusions with protrusion of maxillary
anteriors
• Flaccid orofacial musculature.
 Modifications

During initial phase, multiple holes are placed on the oral screen so
as not to completely block the airway passage and are closed one by
one over a period of time.

Hotz Modification : A metallic ring placed in the midline of the

appliance -- help to carry out muscle exercise

Double Oral Screen : An additional lingual screen for tongue

thrusting habit.
Conclusion :
References :

1. Contemporary orthodontics, William R Proffit 4th edition

2. Textbook of pedodontics , Sobha Tandon, 2nd edition
3. Orthodontics the art and science, Bhalajhi, 6th edition
Thank you !!
Questions ??