“Mouth breather” and “long in the tooth” Origin?

These 2 expressions are fairly common and like many things that are passed down over the generations are based on a long history of casual observation.  This casual observation is often later “proved” to be true in some respect.  Mouth breather and long in the tooth are not exception to that, as both are based on some generally observed traits and have been proved to be true in modern studies.

“Long in the tooth”

The expression “long in the tooth”, meaning someone is old or has been around for awhile, comes from the simple fact that as we age many people lose bone around their teeth.  When bone is lost around teeth the gums follow the bone and this recession of the gums makes our teeth appear longer.  Although the teeth themselves are not growing or getting any longer than they ever were, it’s just that more of the tooth structure is exposed.

“Mouth breather”

While long in the tooth is often used in a somewhat respectful manner, mouth breather is a derogatory insult.  To call someone a mouth breather means that individual is viewed as someone that is stupid or slow.  Unfortunately, this phrase is also based on casual observation that has real world research and reasons to back it up.  You see mouth breathing is a sign of someone that is struggling to get air because their nasal and/or posterior airway is restricted.  Enlarged adenoids are the most common cause of nasal obstruction in children that results in mouth breathing.  For adults it is often multi-factorial and includes obesity.  No matter the reason the constriction in the airway typically results in trouble breathing at night, snoring, grinding, and sleep apnea.  Sleep apnea in children and adults causes fatigue and irritability.  Many children suffering from sleep apnea are misdiagnosed with at­tention deficit disorder and hyperactivity, when in reality they have a biological issue that can be fixed.    Have this problem for a lifetime and it will be difficult to stay focused on school, tasks, and your job.  The resulting low energy will result in someone that appears stupid or slow, and if the problem is not addressed the person will become that with time.  Fortunately, airway issues caught early can easily be fixed with a palatal expander or surgical removal of tonsils.

Besides enlarged adenoids, what else causes airway constriction and mouth breathing?

Enlarged adenoids are the most common cause of airway constriction, especially in children, but there are other causes.  Enlarged tonsils, an enlarged tongue, nasal polyps, allergic rhinitis, and being overweight can all contribute.

Mouth breathers do not get as much oxygen!

Blood gas studies have shown mouth breathers have 20% lower partial pressures of oxygen in the blood and 20% higher levels of carbon dioxide.  They have lower pulmonary compliance and reduced velocity.

Adenoid facies and mouth breather

For children it should be assumed mouth breathing is a result of enlarged adenoids.  This mouth breathing results in characteristic facial structural changes that occur and will become permanent if treatment is not initiated.  Just as a child that has allergies and has trouble breathing will have facial changes so will all other mouth breathers.  Chronic mouth breathers have often have a long/narrow face, drooping eyes, and a narrow nostril and mouth.  They also have thin upper lips with inverted lower lips, thus resulting in an inadequate lip seal and a gummy smile.  A mouth breathers lips will be dry and hypotonic.  Together the changes are known as adenoid facies.  To someone trained to look for these things the “look” is obvious.

Dentally speaking mouth breathing, or more precisely it’s underlying cause, result in gingivitis, crooked teeth, anterior open bite, and a high palatal vault.  Although not all research will agree or show all the things listed and mouth breathing are related, one thing always rings true – adenoid obstruction and malocclusion are related.  Another unfortunate and socially offensive side effect of mouth breathing is halitosis or bad breath.  Motta 2011 Clinic

Enlarged adenoids cause what else?

Besides mouth breathing and all the other things discussed so far, enlarged adnoids also cause congestion, eustachian tube dysfunction, otitis media, rhinosinusitis, swalling problmes, smell and taste issues, and speech problems.  A great artcile on enlarged adenoids and their impact can be found here.

Want to test if you or your child is a mouth breather?

Place water in the suspected mouth breathers mouth and do not swallow for three minutes.  If the individual is not capable of doing this without running out of air then they are a mouth breather.

Treatment of nasal obstruction

1. Adenoid removal with or without tonsil removal is often the first line of treatment for children.
2. Septal surgery may be recommended for adults.
3. Maxillary expansion with an orthodontic appliance, although this is only for children.