Why Should Sleeping With an Open Mouth in Children Be Taken Seriously?

Prof. Dr. Mehmet Oğuz Öztoprak’s functional jaw orthopaedics and airway approach.

Many parents notice that their children sleep with their mouth open at night. Often this is considered normal. However, constantly sleeping with an open mouth in childhood is not always an innocent habit. In some children, sleeping with an open mouth can be one of the early signs of:

• Airway problems
• Nasal obstruction
• Jaw development issues
• Deterioration in sleep quality

For this reason we have to ask: If your child sleeps with their mouth open, is this just a habit, or a condition that can affect the growth and development process?

Healthy Breathing Starts From the Nose

The human body is basically designed to breathe through the nose. The nose performs the following functions:

• Filters the air
• Humidifies it
• Warms it
• Increases breathing efficiency

For this reason, under normal conditions children are expected to breathe through the nose during sleep. Constantly sleeping with an open mouth, however, can be a finding that should be evaluated.

Why Do Children Sleep With Their Mouth Open?

There can be many causes of sleeping with an open mouth. These may include:

• Enlarged adenoids
• Enlarged tonsils
• Nasal obstruction
• Allergic problems
• A narrow upper jaw
• Airway narrowing

In some children, more than one factor may be present at the same time. For this reason, it is necessary to focus not only on the symptom but on the underlying cause.

Can Sleeping With an Open Mouth Affect Jaw Development?

During the growth and development period, the facial bones and jaws can be affected by environmental factors. In some children with long-term mouth breathing, the following may be seen more often:

• A narrow upper jaw
• A high palate
• Crossbite
• A retruded lower jaw
• Lip closure problems

This does not occur the same way in every child. However, it is accepted that the way of breathing is one of the factors that can affect jaw development.

Facial Development Can Also Be Affected

In childhood, the breathing habit can also affect facial development. In some children, the following findings may be seen:

• A long face appearance
• A narrow face structure
• Dark circles under the eyes
• Lips that constantly remain open

This appearance is sometimes described in the literature as the "long face pattern".

Can There Be Effects on Attention and Concentration?

Quality sleep is one of the fundamental parts of children’s learning and development processes. In some children, sleeping with an open mouth can be seen together with:

• Snoring
• Restless sleep
• Frequent waking
• Morning fatigue

Deterioration in sleep quality can, in some children, be related to:

• Reduced attention span
• Difficulty concentrating
• A decline in academic performance
• Behavioural problems

This is not valid for every child. However, the relationship between sleep quality and learning processes is well known.

Relationship With Posture and Body Balance

Some children who cannot breathe comfortably through the nose may change their head position to open the airway. In particular, the following can develop:

• Forward head posture
• Increased load on the neck muscles
• Rounded (forward) shoulders
• Postural adaptations

For this reason, mouth breathing should be evaluated as a functional process that can affect not only the mouth and nose region but the entire musculoskeletal system.

Why Is It Even More Important for Children Who Do Sports?

In children who do sports, the following play an important role:

• Breathing capacity
• Sleep quality
• Concentration
• Balance mechanisms

For this reason, in children with mouth breathing, not only tooth alignment but also the airway and overall functional development should be evaluated.

Prof. Dr. Mehmet Oğuz Öztoprak’s Approach

In our clinic, children who sleep with an open mouth are not evaluated only from an orthodontic perspective. At the same time, the following are examined as a whole:

• The way of breathing
• Airway structure
• Upper jaw development
• Jaw joint functions
• The facial growth pattern
• Posture
• Sleep symptoms

The aim is not only to correct the teeth, but to identify at an early stage the functional factors that can affect the growth and development process.

Conclusion

Sleeping with an open mouth in children should not be evaluated as a simple habit. In some children, this can be part of a broader functional picture related to the airway, sleep quality, jaw development and facial development.

For this reason, in children who sleep with an open mouth, it is necessary to look not only at the teeth but also at the way of breathing, sleep quality and the growth and development process together.

Because sometimes a mouth that remains open at night is an important developmental message that a growing child gives us.

If you are also curious about why jaw development should be monitored in children who snore, you can read our article "Why Should Jaw Development Be Closely Monitored in Children Who Snore?"

Frequently Asked Questions

Is constantly sleeping with an open mouth normal in a child?

Constantly sleeping with an open mouth in childhood is not always an innocent habit. In some children it can be one of the early signs of airway problems, nasal obstruction, jaw development issues and deterioration in sleep quality.

Why do children sleep with their mouth open?

There can be many causes, including enlarged adenoids, enlarged tonsils, nasal obstruction, allergic problems, a narrow upper jaw and airway narrowing. In some children, more than one factor may be present at the same time, so it is necessary to focus on the underlying cause.

Does sleeping with an open mouth affect jaw and facial development?

In some children with long-term mouth breathing, a narrow upper jaw, a high palate, crossbite, a retruded lower jaw, lip closure problems and a long face appearance ("long face pattern") may be seen more often. However, it does not occur the same way in every child.

Does sleeping with an open mouth affect attention and school performance?

Sleeping with an open mouth can be seen together with snoring, restless sleep, frequent waking and morning fatigue. Deterioration in sleep quality can be related, in some children, to reduced attention span, difficulty concentrating, a decline in academic performance and behavioural problems.

Does sleeping with an open mouth affect posture?

Some children who cannot breathe comfortably through the nose may change their head position to open the airway; forward head posture, increased load on the neck muscles, rounded shoulders and postural adaptations can develop.

My child sleeps with the mouth open — how is it evaluated?

Not only from an orthodontic perspective; the way of breathing, airway structure, upper jaw development, jaw joint functions, facial growth pattern, posture and sleep symptoms are examined as a whole. The aim is to identify early the functional factors that may affect the development process.