When I see a child for the first time seeking orthodontic treatment the first thing I assess is the breathing pattern. Children who are chronic mouth breathers will all hyperventilate. In normal nasal breathing the child will inhale/exhale about every six seconds. Children who are chronic mouth-breathers will inhale/exhale about every three seconds. It is often possible to note this by looking at the rise and fall of the shoulders in time with the breathing.
When I see the shoulders and chest moving during relaxed breathing I see it as a clear indication that all is not well. Breathing should always be controlled from the diaphragm with no visible outward signs of the breathing.
In addition, breathing should be silent. So when I can hear the child breathe it is a strong indication the breathing is dysfunctional.
Children who are chronic mouth breathers as a result of an allergic rhinitis will only manage to breathe through the nose if it is possible identify and eliminate the allergens. Allergens may be airborne and inhaled or food allergies that are consumed.
For the children who do not display allergic rhinitis then establishing nasal breathing is often a matter of breaking the mouth-breathing pattern. Sometimes is is necessary to reduce the hyperventilation in these children before the pattern can be changed.
Generally the younger the patient the easier it is to change the breathing pattern. The techniques I use to help children to establish nasal breathing include:
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The Pre-Orthodontic TRAINER worn for a minimum of one year.
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Arch expansion followed by the TRAINER or Biobloc therapy or fixed appliance.
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The Breathing Well Programme.
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A Home Audit.
