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March 16, 2023
Margit Hiebl
Many people breathe through their mouths without realizing it—hurting sleep, energy, and overall health. Discover why nasal breathing matters and how to retrain it.
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Nose or mouth? As strange as it may sound, this question about our preferred organ for breathing is not trivial. Breathing through the nose is more essential than one might think. Humans are actually designed by nature to breathe through the nose. This is crucial for survival as 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 they prefer it neither too warm nor too cold. Harmful particles and bacteria are also trapped by the cilia and do not reach the lungs. At the same time, the inhaled air is humidified.
Breathing more through the mouth often begins when, as children, we cannot breathe well through the nose. This then sets off a chain of events that make themselves impressively noticeable in many areas throughout life.
This affects not only the protection of the respiratory organs but also oral health: Constant mouth breathing dries up saliva production, making teeth and gums more 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 suffer: 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. From minor limitations to massive health problems, anything is possible.
“The only occasion to temporarily forego natural nasal breathing and breathe through the mouth should be when exerting yourself and needing to get more air into the lungs faster, or when the nasal passages are blocked due to congestion, allergies, or a cold,” says Augsburg dentist Dr. Christian Leonhardt. Most of us are probably not aware that the topic of correct breathing could also be relevant at the dentist's office.
How can a dentist tell if someone breathes through their 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, incorrect tongue position, or incorrect swallowing patterns as adults. This means: to reduce these manifestations, we need to screen patients as early as possible and guide them on a myofunctional level. That is, address the causes and not just straighten the teeth.
What does myofunctional mean?
Everything that affects the functionality of the muscles in and around the mouth. This starts with proper lip closure up to the correct tongue position and tone, meaning the tongue doesn't fall back like a sack of cement, but ideally lies flat behind the front teeth with some underpressure on the palate. Up to the correct swallowing pattern – many push their tongue forward with each swallow and don't roll it.
How do you train the tongue tone?
The simplest exercise is targeted tongue clicking – not classically snapping from top to bottom, but sucking upwards and then applying the underpressure so that you maintain the pull on the tongue even with an open mouth and it stays stuck to the palate. This incorrect tongue position also prevents athletes from breathing properly through the nose and achieving their full performance.
Is tongue tone also important when sleeping?
When the entire skeletal musculature relaxes during the deep sleep phase, the tongue falls backward – and you start snoring. Then you wake up because the sleep pattern is interrupted by a lack of oxygen. Immediately, the body sounds the alarm: “Stress!” and remains stuck in a higher sleep phase – where it cannot recover.
Moreover, the released stress hormone cortisol also causes insulin to be secreted – actually an ancient reflex that helps us quickly provide energy for fleeing. But since the sugar is not needed in the muscles right now, it ends up in the fat cells. Many wonder why they don't lose weight. But it goes further: The affected individuals have increased high blood pressure, are exhausted and tired, recover poorly, and are more often ill.
The earlier you intervene here, even in dentistry, the better. Snoring is not a minor offense at any stage of life.
How do you approach this?
On a dental level, we conduct scans, videos, photo analyses, look at swallowing patterns, facial expressions. For the snoring problem, we do 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 does, and what sleep stage they were in.
Depending on the age of the patients, you can then change the position of teeth or perhaps expand the upper jaw without surgery, or you can simultaneously work with speech therapy and myofunctional training – but that often means lifelong training.
How can you tell if you or your child primarily breathes through the mouth?
Symptoms include snoring as mentioned, but also an always 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, nighttime screaming episodes, or cracked lips.
Who should I contact first?
Dentist and/or speech therapist, pediatrician, ENT – in that order.
KaCan you practice nasal breathing?
Provided there is no anatomical or acquired malformation of the nasal passages. It's simply about breaking the pattern and training until nasal breathing becomes a habit. This works through conscious exercises. For unconscious breathing at night, a mouth tape – a mouth plaster – is very helpful as it simply closes the mouth. Additionally, tubes can be inserted into the nose to expand the nasal passages.
Tape the mouth shut?
Yes, it really works astonishingly well and brings a lot of quality of life. You wake up refreshed. The first week of getting used to it is indeed exhausting, but from the second week on, it works well and patients are grateful.
Is nasal breathing also an issue in sports?
Nasal breathing should be imperative for athletes. In summary, nasal breathing offers significant advantages over mouth breathing, especially 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 control of input and output through the exchange of oxygen and CO2. Because with mouth breathing, you usually expel too much CO2, leading to over-breathing. Nasal breathing releases nitric oxide, which regulates the homeostasis of many bodily functions such as heart rate, blood pressure, and breathing.
This underrated molecule occurs naturally in the body, but nasal breathing drastically increases its production rate. Disadvantages of mouth breathing also include poor posture, as the tongue placed in the lower jaw causes a forward-leaning head position.
Additionally, a larger amount of dry, unfiltered air is inhaled than necessary – this 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 to relax by practicing nasal breathing. Important: When inhaling, first expand the abdomen, then the diaphragm, and finally the chest; exhale in reverse order. First, inhale for five seconds, then hold your breath for five seconds. Then exhale for five seconds, and hold your breath again 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 the right thumb against the right nostril. Inhale through the left nostril, hold your breath, then move the 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. Alternate several times.
3. Forceful exhalationSit up straight, shoulders relaxed. Place both hands on your abdomen, palms facing upwards. Close your mouth and inhale deeply through your nose. The abdomen should expand calmly. Then exhale quickly and forcefully through your nose, allowing the abdomen to contract. Repeat until you find a comfortable rhythm. Then you can increase the intensity.
