Breathing- Not Everyone is Doing it Right.

Barbara Tritz
· July 13, 2014 ·

3 minutes

Are you breathing correctly? Do you know how?  And WHY is it important?
Please take a few minutes first to watch this attached video and then read on!
Done? Okay, here we go:
I’ve been a dental hygienist for over 34 years now and I’m still learning new things all the time.  Ever heard of “Long Face Syndrome?” (Yes, it definitely needs a new PR person. Another name for it is “skeletal open bite” but nobody really uses that.)  I hadn’t heard about it until recently but once I learned about it, I’ve been on a crusade to tell everyone I can.  This is vital information to parents, teachers, and, well, everyone!

Click to view larger
from a article on this subject.

Signs of Long Face Syndrome:

  • Mouth breathing
  • Snoring/sleep apnea
  • Difficulty keeping lips together
  • Open bite
  • Cross Bite
  • Crowded teeth
  • Elongation of the lower face
  • Retrognathia
  • Narrow arch
  • High palate
  • Gummy smile
  • Eyes look tired
  • Lack of definition of cheekbones
  • Head forward posture
  • Rounded shoulders

In short, they have a similar appearance to Napoleon Dynamite:

(from the movie Napoleon Dynamite)
Looking over this list, bet you know someone with many of these signs.  And I bet you did not know this was all the result of breathing through one’s mouth!
 Mouth breathing, especially in children, can be caused by allergies, enlarged tonsils, chronic sinusitis, thumb-sucking, or other habits and it literally changes the shape of the face, not in a good way.  Breathing constantly through the mouth causes the face to grow long and narrow, which results in  signs seen in the list above, as well as improper swallowing, speech problems such as lisping, tongue thrusting, and a restricted airway.
 In addition to all that, it causes children’s jaws to develop improperly, further restricting the airflow to the lungs.  Reducing the size of the airway causes snoring and sleep apnea- yes, even in young children.
Orthodontics is one option for correcting a narrow palate.
photo found here— I’m not the only dental professional
that’s concerned about this!
When proper nasal breathing is occurring, the tongue rests behind the upper front teeth causing the jaw to form and grow in a nice curved arch, resulting in straight teeth (mostly).  When mouth breathing occurs, the tongue instead is resting either on the floor of the mouth or somewhere in between.  Without the tongue to act as a dental appliance, the palate, jaw and face grow narrow.
 Here’s the real clincher! Children (and adults too) who are mouth breathers can suffer from poor health, low energy, high blood pressure, dry cracked lips, bad breath, gingivitis, day time fatigue, and reduced concentration (from the sleep apnea!)  Sleep apnea can then affect growth and contribute to poor academic performance, as well as to behavioral problems.  Often these children are misdiagnosed with “attention deficient disorder” or “hyperactivity” (you did watch the video, right?) They are then given drugs which do not solve the problem.  The real problem is lack of oxygen!   See the YouTube video at the top!
In addition to improving academic performance, nasal breathing will also improve athletic performance.  Our body needs oxygen, but it also needs nitric oxide, which is only produced in the parasinuses.  Nitric oxide is a vasodilator (it widens the blood vessels) and enhances the uptake of oxygen by the blood, so when we only breath through our mouth, the body just does not get enough oxygen into the blood stream, and we just do not perform as well athletically.
If you suspect you or your child is a mouth breather, it really is important to change that!   I always look in my patient’s throat and evaluate the airway.  Depending on the cause of the problem, your dentist can help guide you to the correct health professional.  Myofunctional therapists can help teach correct breathing.  Learning to breathe through the nose is vital to good health!
Please help spread the word-  breathing through the nose is the proper way to breathe. Doing so will help you and your child to live a healthier life.  Any questions or comments are appreciated.
Barbara’s Dental Pearl of Wisdom for today: Close your mouth!  and Keep smiling!
Until next time,

Hello, I'm Barbara Tritz

Unveiling the Stories Behind Dental Hygiene

Loving science, especially biology, from an early age, Barbara is a registered dental hygienist, certified biological hygienist, and orofacial myofunctional therapist. In 2019, she received the Hu-Friedy/ADHA Master Clinician Award from the American Dental Hygienist Association.

Share your thoughts below!


  1. K J Gillenwater

    Ok, here I am reading up on mouth breathing!

    1) This is the weird thing, Barbara….BOTH of my children had under developed jaws and required a jaw appliance and braces to correct the problem. My daughter had a worse jaw problem that they could not 100% correct, but most of the problem was fixed with the appliance and braces…oh and palate spreaders.

    2) My son, who has the gum problems, has had a lisp his whole life that speech pathologists never really got rid of 100% (he's a teenager now).

    3) My son had a narrow arch and high palate, which is what the speech pathologist told me probably caused the lisp.

    4) Since birth my son has been 'phlegmy.' He still wakes up every morning to blow his nose repeatedly. Not sure what that is all about.

    Overall, I am not sure what to do with this information. I mentioned to my son that, since his father has sleep apnea, we might want to talk to a doctor about his snoring. I got the Look of Doom from teenage son. May still go this route.

    Never thought to equate these issues with his gingivitis problems!

  2. Barbara Tritz

    Hi KJ!
    Have a look under his tongue for a tongue tied frenum. I have not yet posted pix of tongue ties but you can look online for those. I'd be suspicious that might be the "root" of his problems. Snoring is a sign of possible sleep apnea. It's much more prevalent in children than previously thought. And tongue tied frenums anchor the tongue down to prevent "proper tongue posture". One of the docs at the Cleveland Clinic says there is no such thing as ADHD, it's all sleep apnea! It is definitely under-diagnosed in children. Tongue ties and sleep apnea go together. I have one more sleep apnea post on children titled- "Sleep like a (Cranky, Fussy, Irritable, Restless) Baby". Then look at my Buteyko breathing article- "Raising Healthy, Good Looking Children". I just got back from another course about breathing/muscles/airway so after you read those one, let me know. I have even more information! A sleep study would be where I would go if he's a snorer. Does he wake up tired? Dr. Brian Palmer's website is a wealth of information on frenums. (Probably more than you need to know. 😉 ) Find out now if that's the problem. It's vital to his entire body health!

  3. Deya


    How about adults? Is there anything we can do? I'm 25 and Iwore braces at the age of 13 but my chin is underdevelopped and I still breath through the mouth when I'm sleeping.
    I know breathing through the nose won't correct my face shape, but would it improve it somewhat? Or there's nothing you can do at that age?
    I also feel that the distance between nose and mouth is too long and my lower lip too thick and round.

  4. Barbara Tritz

    Hi Deya,
    So glad you asked! There's lots you can do! Myofunctional therapy will help you to learn to keep your tongue on the roof of your mouth, and through those exercises will tone and strengthen your facial muscles, as well as your lips. It may even start changing the shape of your face! A functional orthodontist may be helpful as well. There are appliances that may be able to widen your palate. I've just learned of one called an ALF. And, Buteyko breathing exercises will help. There's a book entitled: Close Your Mouth by Patrick McKeown. I took Patrick's course and have started paper taping my mouth closed at night. I sleep all night long and feel so much better when I wake. Most importantly, it's all about the airway, getting good oxygen in, especially while sleeping. You are young, follow up and take care of this now! Good for you for being aware enough to educate yourself. Here's another website- you can see some before and after pix of folks who've done myo therapy and you can see their faces have changed shape.
    Find a myofunctional therapist in your area and see what they think! If you need help finding one, let me know.
    Keep me posted.

  5. Anonymous

    I suggest finding a functional orthodontist for an evaluation, who specifically uses the ALF appliance, and works with a myofunctional therapist, who should also evaluate for tongue and lip ties.

  6. Anonymous

    Here is what I am doing, after many years of research and putting a plan together. I had retractive extraction (bicuspid and wisdom extractions) braces as a teen and have multiple structural and functional problems. I am a 38 year old woman who is glad to be learning all of this to help alleviate and avoid these issues in my children.
    1. ALF appliance palatal expansion
    2. Concurrent Osteopathic treatment
    3. Concurrent Myofunctional Therapy including home exercise program (adding daily Patakara device exercises for additional cranial oxygenation and circulation)
    4. Concurrent breath training – eg, Buteyko Method, Frolov Device, Optimal Breathing (McKeown's site) website protocol, etc. My myofunctional therapist incorporates Buteyko techniques in my therapy protocol.
    4. Laser surgery to release my previously undiagnosed lip and tongue ties
    5. Chew gently and firmly, daily, on "jawcersiser" or other similar soft silicone chewing item to promote true bone growth expansion versus only teeth tipping. (Option: hard chewing gum made for jaw exercise). If done, This must be done carefully, especially if existing damage to joints.
    6. Postural Corrective exercise program – eg. Postural Restoration Institute prescriptive exercises, Egoscue, or simply Gokhale Method book. Basically retraining postural muscles out of forward head posture and other postural compensations that have occurred as a result of airway insufficiency.
    7. Optional – Rolfing. If I can afford I will do a full rolfing series during my ALF treatment to further allow, integrate and support structural changes and unwinding of structural compensations.
    8. Optional – NCR. I have done several series of endonasal balloon treatments to facilitate release of cranial restrictions prior to my ALF appliance. No way of knowing for sure if this will help ease correction of my cranial strain patterns, or whether it is worth high cost, but I felt convinced enough of the principal theory of releasing cranial strains as much as possible prior to palate expansion, that I have done several NCR treatments. I have also done much craniosacral treatments, but think if you have solid / tough crainial restrictions the force of the NCR type balloon treatments may be required, potentially. Will never really know if this actually helps me or not, but many people researching the adult palatal expansion are ending up running into this concept any how.
    8. Optional – Acuppuncture, Acupressure. I cant afford clinical treatments at this point, so I'm doing acupressure at home on myself, to help ease muscle tension, supporting overall body in any way I can during my ALF treatment.

    Look at Dr. Mike Mew youtube videos, he deals with adult palate expansion / airway expansion.

    I travel to Michale Fetzik myofunctional therapist and her husband Dr. Stephen Fetzik for ALF treatment, just started a couple weeks ago. This is the best path I have been able to develop for myself. And I'm just now really getting started with the expansion.

    As far as other expansion devices, many orthos can expand with standard expanders to some extent, but noneact on the cranial base in all 3 dimensions in the same way as the ALF appliance, which is why I chose it. The DNA Appliance is another one I think has potential to do quite a lot with the crainial strains, however, I was convinced the ALF has more potential in the Yaw of the Roll Pitch Yaw dimensions, though I will never fully understand enoughto know if that is in fact true, the DNA may be just as well. The other benefit of ALF is its small unobtrusive form, which allows for complete access of tongue to mouth roof, required for tongue posture retraining, that was a big deciding factor for me. I personally was not as convinced of the potential of theHomeoblock as I was of the DNA, and ultimately decided on the ALF. These are the main devices I've seen used for the type of palatal expansion in adults, though I'm sure there are others.

  7. Barbara Tritz

    Excellent job finding the answer to your problems! Good for you doing your research. You have spelled it out very well. This is all so new to me, as a hygienist for 35 years- I had no idea this type of therapy even existed until this year. Most dental people are still not aware of and educated about these options. Hope your TMJ is relaxing and your airway is opening! Sounds like you are your way to feeling better and being healthy. Please keep me posted on your progress!

  8. Unknown

    I have been wearing braces for 1 year now. I didn't know the consequences of it. I had a really wide arch before but now it's so narrow. I cannot place my tongue on the roof of my mouth.
    Therefore I asked my dentist in my last visit to widen the arch but my dentist said that it will ruin my face if I do it and I will not be able to eat as my upper set of teeth will not meet my lower set of teeth and I will have my gap back again in my front teeth. But I was able to eat properly even when I had a wide arch. So should I tell my dentist to widen it? I don't know. Please help. Will i really be nor able to eat because of it? Please answer.

  9. Barbara Tritz

    Good Morning,
    Sorry to have missed your reply! If you'd still like to chat about this, please email me at While I'm not a dentist, we can discuss this and look at options.



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