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March 16, 2023
Margit Hiebl
Performance and restful sleep are highly dependent on how we breathe. That's why you should breathe through your nose.
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"Actually, humans are naturally designed to breathe through the nose."
Nose or mouth? As strange as it may sound, this question about our preferred organ for breathing is not. Nasal breathing is more essential than one might think. In fact, humans are naturally designed to breathe through the nose. This is vital for survival because it allows us to breathe and eat simultaneously without choking. Even newborns can regulate the temperature of the air entering their lungs through their noses – as the lungs do not favor air that is too warm or too cold. Harmful particles and bacteria are also filtered out of the air by the cilia, preventing them from reaching the lungs. At the same time, the inhaled air is humidified.
Breathing more through the mouth often starts when, as a child, one cannot breathe well through the nose. This then sets off a chain of events that manifest impressively in many areas later in life. This affects not only the protection of the respiratory organs but also oral health: If you constantly breathe through your mouth, saliva production decreases, and teeth and gums become susceptible to bacteria. If the oral microbiome is destroyed, it leads to problems such as gingivitis, periodontitis, cavities, or bad breath.
Physical and cognitive performance also suffers: Numerous studies show that habitual mouth breathing during waking and sleeping hours leads to fatigue, concentration weakness, reduced performance, and mood swings. And also to obesity. Everything from minor limitations to massive health problems is possible. "The only occasion to temporarily forego natural nasal breathing and breathe through the mouth should be when you have to exert yourself and need to get more air into your lungs faster, or when the nasal passages are blocked due to congestion, allergies, or a cold," says Augsburg dentist Dr. Christian Leonhardt. That they might be in the right place on the topic of proper breathing with the dentist is probably new to most of us.
"Breathing through the nose is more essential than one might think"
Dentist Dr. Christian Leonhardt in the interview
How does a dentist recognize whether someone is breathing through the mouth or nose?
Those who were mouth breathers as children are more likely to have a high palate, very crowded teeth, a malformed jaw, a disturbed bite, an incorrect tongue position, or incorrect swallowing patterns in adulthood. This means: To reduce these manifestations, we need to screen patients as early as possible and support them on a myofunctional level. So address the causes and not just straighten the teeth.
What does myofunctional mean?
Everything that concerns the functionality of the muscles in and around the mouth. This starts with a proper lip closure and goes up to the correct tongue position and tone, so that the tongue does not fall backwards like a bag of cement, but ideally lies flat behind the front teeth with some under-pressure against the palate. Up to a proper swallowing pattern - many people press their tongue forward with every swallow and do not roll it off.
How does one train tongue tone?
The simplest exercise is targeted tongue clicking - not the classic top-down pop, but sucking up top and then applying enough under-pressure to keep the tongue stuck to the palate even with an open mouth. This incorrect tongue position also prevents athletes from breathing properly through their noses and reaching their full potential.
Is tongue tone also important during sleep?
When the entire skeletal musculature relaxes during the deep sleep phase, the tongue falls backwards - and one begins to snore. Then you wake up because the sleep pattern is interrupted by lack of oxygen. Immediately, the body sounds the alarm: "Stress!" and remains stuck in a higher sleep phase - it cannot recover there. Moreover, the released stress hormone cortisol also causes insulin to be secreted - actually an ancient reflex that helps us quickly provide energy for flight. But since the sugar is not needed by the muscles right now, it ends up in the fat cells. Many wonder why they don't lose weight. But it goes further: those affected have increased high blood pressure, are exhausted and tired, recover worse, and are often sick. The sooner you intervene here, also in dentistry, the better. Snoring is not a trifling matter at any stage of life.
How do you approach it?
On the dental level, we do scans, videos, photo analyses, we look at swallowing patterns, facial expressions. In the case of the snoring problem, we conduct a somnography via sleep trackers that patients can use at home under their usual conditions. The next morning, there is feedback on how many sleep interruptions they had, what the pulse is doing, in which sleep stage they were. Depending on the age of the patients, teeth can then be moved in position or the upper jaw can be expanded without surgery, or you can proceed in parallel with speech therapy and myofunctional training - which often means lifelong training.
How can you tell if you or your child mainly breathes through the mouth?
Symptoms include snoring, as mentioned, but also a slightly open mouth, dry mouth, hoarse voice, "loud" eating, or chronic fatigue. In children, it's particularly important for parents to watch for signs like irritability, concentration difficulties, night terrors, or chapped lips.
Who should I contact first?
Dentist and/or speech therapist, pediatrician, ENT – in that order.
"Nasal breathing should be an imperative for athletes."
KaCan you practice nasal breathing?
Provided there is no anatomically caused or acquired deformity of the nasal passages. It's simply about pattern interruption and training until nasal breathing becomes a habit. This works through conscious exercises. For unconscious breathing at night, a mouth tape is very helpful as it simply seals the mouth. Additionally, tubes can be placed in the nose to expand the nasal passages.
Tape the mouth shut?
Yes, it really works amazingly well and brings a lot of quality of life. You wake up refreshed. The first week to acclimate is exhausting, but from the second week onwards it goes well and the patients are grateful.
Is nasal breathing also an issue in sports?
Nasal breathing should be an imperative for athletes. In summary, nasal breathing offers significant advantages over mouth breathing, particularly for athletes who want to improve their performance and recover more efficiently. Among the many benefits are better sleep in preparation for a competition and the regulation of input and output through the exchange of oxygen and CO2. With mouth breathing, you often expel too much CO2, leading to hyperventilation. Nasal breathing releases nitric oxide, which regulates the homeostasis of many body functions such as heart rate, blood pressure, and respiration. This underrated molecule is naturally present in the body, but nasal breathing drastically increases its production rate. The disadvantages of mouth breathing also include poor body posture, as the tongue placed in the lower jaw causes a forward-leaning head position. Additionally, a larger amount of dry, unfiltered air than necessary is inhaled, which can also contribute to greater dehydration. Professionals who want to maximize their performance through breathing should include a breathing coach in their team.
1. Box breathingThis exercise helps relax through the practice of nasal breathing. Important: When inhaling, first expand the abdomen, then the diaphragm, and finally the chest; when exhaling, follow the reverse order. Initially, inhale for five seconds, then hold your breath for five seconds. Then exhale for five seconds, and subsequently hold your breath for five seconds. Repeat three to five times.
2. Alternate nostril breathingSit with a straight back, relax your shoulders, neck, and tongue. Then place your left hand on your left knee and press your right thumb on your right nostril. Inhale through the left nostril, hold your breath, and then move your ring finger and right little finger to close the left nostril. Exhale through the right nostril, inhale again, and close the nostril with your thumb. Then open the left nostril, exhale, and inhale again. Switch several times.
3. Thrust ExhalationSit upright, shoulders relaxed. Place both hands on the belly with palms facing upwards. Close your mouth and inhale deeply through the nose. Your belly should expand calmly. Then exhale quickly and forcefully through the nose, letting your belly pull back in. Repeat until you find a comfortable rhythm for yourself. Then you can increase the intensity.
