11 October 2013

How often does an average human being take a breath each day?

How often does an average human being take a breath each day? The answer is roughly 25,000 times per day. For an activity that consumes so much of our everyday lives, and is so fundamental to life, breathing, or how we breathe, is one of the most misunderstood influences of facial growth and development. Humans breathe to survive, and when the normal nasal mode of breathing is diminished, then we breathe through our mouths.

The tongue, which is normally placed in the roof of the mouth, drops to the floor of the mouth to allow air to pass into the back of the throat. When the mouth opens, all the muscles that control head, neck, jaw, and tongue posture must adapt and change their posture. As a result, all areas affected will grow abnormally. The earlier in life this adaptation occurs, the greater the alternation in the facial growth of the child.The medical and the dental professions have long championed disease prevention. Children are inoculated against whooping cough, tentanus, measles, etc. Fluoride and plaque-controlling techniques have done much to control dental disease.

However, most of these preventative measures were not readily accepted. It took years for fluoride to be recognized as a safe and effective method for controlling dental decay, just as it took years for immunization to become routine medical practice. Likewise, the recognition of the ill effects of chronic mouth breathing in the medical and dental professions has lagged behind the acquisition of knowledge on the subject provided through research. At the moment, most referrals to pediatric ENTs for evaluation of tonsil and adenoid removal is for an increased incidence of strep throat, not for chronic mouth breathing.

When a child is unable to maintain a consistently healthy nasal airway with proper tongue posture, a number of unhealthy things happen to that child. From a whole, systemic aspect, this includes but is not limited to an increased incidence of middle ear infections, upper airway infections, headaches, incontinence, and sleep disturbances. Snoring is a clear indication of mouth breathing problems and is often associated with a decrease in oxygen intake into the lungs. Research has shown that people who snore are more likely to suffer from high blood pressure and coronary artery disease.

Childhood snoring is believed by many in medical literature to be a cardinal sign for development of sleep apnea later in life.More particularly, breathing through the mouth affects facial development. If you detect that your child constantly breathes through his or her mouth during the day or night, think about the adaptation that happens to allow this breathing pattern to take place. The tongue falls to the floor of the mouth (versus the roof), the cheeks apply more inward pressure on the upper jaw towards the tongue, the tongue is not at the roof of the mouth to cancel the inward cheek force resulting in collapse and narrowing of the upper jaw, sometimes forcing it into a crossbite. If the patient is in crossbite and it is unilateral (expressed on one side), the child must then shift their jaw to close, exposing on joint to more pressure than the other, possibly leading to asymmetric growth and future TMJ problems. The lowered tongue posture aids the lower jaw growing clockwise in more vertical growth, facilitating diminishment of the chin. The deleterious consequences do not end here.  The teeth become crowded as arches narrow and have less room, the patient’s bite may open up anteriorly from the jaw growing down and back, from pressure from the lowered tongue, and the ensuing tongue-thrust.Some parents will deny that their child is a mouth breather, thinking that they are protecting the child from untoward criticism or treatment. In addition, once the problem has been identified, they may seek the opinion of other professionals who may not understand or appreciate the significance of the problem, and a state of confusion sets in. This dilemma can only be resolved by a careful evaluation of the facts:

  1. Mouth breathing is abnormal.
  2. Mouth breathing causes facial deformities that are often too severe for orthodontics alone to correct. These require jaw surgery to correct.
  3. Mouth breathing causes sleep disturbances in many children and adults.
  4. Mouth breathing is related to head, neck, face, and jaw pain problems in children and adults.
  5. Mouth breathing is associated with high blood pressure and coronary heart disease in adults.

Care of the developing face begins at birth. Parents should be just as concerned about how their children breathe as they are about how well they walk, talk, and learn.

There has been a rather dramatic change in the last 20 years in the treatment of the middle ear, and adenotonsillar infections. Middle ear infections are now commonly treated with ventilation tubes, and adenotonsillar infections with antibiotics. The net result of this conservative treatment has been a dramatic increase in nasal obstruction due to prevalence of enlarged tonsils and adenoids in young children. The enlargement of these structures coupled with allergic enlargement of the turbinates results in blockage of the air passages within the nose.

One can clearly see that if a young, rapidly growing child has chronic, untreated nasal obstruction and must breathe through his mouth all day and all night, then the normal muscular activity of the face and jaw muscles will be altered. These events are life sustaining, and the body accommodates to allow these to occur at the expense of the systems that must adapt. In mouth breathing, the adaptation may occur in the muscles of the face, jaw, tongue, lips, neck, back, shoulder, ribs, and diaphragm. The abnormal pull of these muscles on the growing bones of the face and jaws slowly deforms these bones, causing mismatched jaws and malocclusions.


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