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Prevalence of Malocclusion Patterns in Mouth Breathing Children Compared to Nasal Breathing Children – A Systematic Review

Received: 4 May 2021    Accepted: 4 August 2021    Published: 11 August 2021
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Abstract

The prevalence of malocclusion in mouth breathing children compared to nasal breathing children is unclear, therefore the aim of this study is to identify this prevalence in a systematic review. Seven studies were included. Six studies investigated the prevalence of malocclusion in mouth breathers and compared them with the prevalence data in nose breathers. One study evaluated the prevalence of mouth- and nose breathing in children with malocclusion. The prevalence rates for class I to class III malocclusions vary significantly between studies. For class I malocclusions, a prevalence between 9% and 74% was identified in the included studies. For class II malocclusions a prevalence between 21% and 73% was shown, which equalled roughly the prevalence of class I malocclusions. Class III malocclusions were the least prevalent, between 5% and 24%. There is insufficient evidence for a difference in prevalence patterns of class I – III malocclusions between mouth and nasal breathers in order to draw a definite conclusion. The quality of the included studies was rated moderate to poor. Research on the prevalence of malocclusions in mouth breathing compared to nasal breathing children is scarce. Identified prevalence rates differ significantly, which is likely due to different assessment and reporting methods used in the included studies. The evidence of a difference in prevalence patterns for class I – III malocclusions and other occlusion traits between mouth and nasal breathers is insufficient to draw a definite conclusion.

Published in International Journal of Clinical Oral and Maxillofacial Surgery (Volume 7, Issue 2)
DOI 10.11648/j.ijcoms.20210702.12
Page(s) 17-27
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Occlusion, Mouthbreathing, Nosebreathing, Prevalence, Malocclusion

References
[1] Hassan, R. and Rahimah, AK (2007). Occlusion, malocclusion and method of measurements-an overview. Archives of orofacial sciences, 2, 3-9.
[2] Pocket Dentistry (2017). Classification of malocclusions. Available from URL: https://pocketdentistry.com/classification-of-malocclusions/ accessed 20.08.2020.
[3] WHO (2020). What is the burden of oral disease? Available from URL: https://www.who.int/oral_health/disease_burden/global/en/ Accessed 12.08.2020.
[4] Góis, E. G. O., Ribeiro-Júnior, H. C., Vale, M. P. P., Paiva, S. M., Serra-Negra, J. M. C., Ramos-Jorge, M. L., & Pordeus, I. A. (2008). Influence of nonnutritive sucking habits, breathing pattern and adenoid size on the development of malocclusion. The Angle Orthodontist, 78 (4), 647-654.
[5] Bonuck, K. A., Chervin, R. D., Cole, T. J., Emond, A., Henderson, J., Xu, L. and Freeman, K., 2011. Prevalence and persistence of sleep disordered breathing symptoms in young children: a 6-year population-based cohort study. Sleep, 34 (7), pp. 875-884.
[6] Abreu, R. R., Rocha, R. L., Lamounier, J. A., & Guerra, Â. F. M. (2008). Etiology, clinical manifestations and concurrent findings in mouth-breathing children. Jornal de pediatria, 84 (6), 529-535.
[7] Felcar, J. M., Bueno, I. R., Massan, A. C. S., Torezan, R. P., & Cardoso, J. R. (2010). Prevalence of mouth breathing in children from an elementary school. Ciencia & saude coletiva, 15 (2), 427-435.
[8] Triana, B. E. G., Ali, A. H., & León, I. G. (2016). Mouth breathing and its relationship to some oral and medical conditions: physiopathological mechanisms involved. Revista Habanera de Ciencias Médicas, 15 (2), 200-212.
[9] Farid MM, Metwalli N. Computed tomographic evaluation of mouth breathers among paediatric patients. Dentomaxillofac Radiol. 2010; 39 (1): 1-10.
[10] Al-Awadi RN, Al-Casey M. Oral health status, salivary physical properties and salivary Mutans Streptococci among a group of mouth breathing patients in comparison to nose breathing. J Bagh College Dentistry. 2013 Jun; 25 (Special Issue 1): 152-9.
[11] Motta LJ, Bachiega JC, Guedes CC, Laranja LT, Bussadori SK. (2011). Association between halitosis and mouth breathing in children. Clinics (Sao Paulo). Jun 2011; 66 (6): 939–42.
[12] Hallani, M., Wheatley, J. R., & Amis, T. C. (2008). Enforced mouth breathing decreases lung function in mild asthmatics. Respirology, 13 (4), 553-558.
[13] Rossi, R. C., Rossi, N. J., Rossi, N. J. C., Yamashita, H. K., & Pignatari, S. S. N. (2015). Dentofacial characteristics of oral breathers in different ages: a retrospective case–control study. Progress in orthodontics, 16 (1), 23.
[14] Pacheco, M. C. T., Fiorott, B. S., Finck, N. S., & Araújo, M. T. M. D. (2015). Craniofacial changes and symptoms of sleep-disordered breathing in healthy children. Dental press journal of orthodontics, 20 (3), 80-87.
[15] De Menezes, V. A., Leal, R. B., Pessoa, R. S., & Pontes, R. M. E. S. (2006). Prevalence and factors related to mouth breathing in school children at the Santo Amaro project-Recife, 2005. Brazilian journal of otorhinolaryngology, 72 (3), 394-398.
[16] Zhao, Z., Zheng, L., Huang, X., Li, C., Liu, J. and Hu, Y., 2020. Effects of mouth breathing on facial skeletal development and malocclusion in children: A systematic review and meta-analysis.
[17] Lione, R., Buongiorno, M., Franchi, L., & Cozza, P. (2014). Evaluation of maxillary arch dimensions and palatal morphology in mouth-breathing children by using digital dental casts. International journal of pediatric otorhinolaryngology, 78 (1), 91-95.
[18] Souki, B. Q., Lopes, P. B., Veloso, N. C., Avelino, R. A., Pereira, T. B., Souza, P. E.,. & Becker, H. M. (2014). Facial soft tissues of mouth-breathing children: Do expectations meet reality?. International journal of pediatric otorhinolaryngology, 78 (7), 1074-1079.
[19] Mattar SE, Valera FC, Faria G, Matsumoto MA, Anselmo-Lima WT: Changes in facial morphology after adenotonsillectomy in mouth-breathing children. International journal of paediatric dentistry 2011, 21 (5): 389-396.
[20] Hsu HY, Yamaguchi K. Decreased chewing activity during mouth breathing. J Oral Rehabil. 2012 Aug; 39 (8): 559-67.
[21] Ikenaga N, Yamaguchi K, Daimon S. Effect of mouth breathing on masticatory muscle activity during chewing food. J Oral Rehabil. 2013 Jun; 40 (6): 429-35.
[22] Chung Leng Muñoz I, Beltri Orta P. Comparison of cephalometric patterns in mouth breathing and nose breathing children. Int J Pediatr Otorhinolaryngol. 2014 Jul; 78 (7): 1167-72.
[23] Bolzan Gde P, Souza JA, BotonLde M, Silva AM, Corrêa EC. Facial type and head posture of nasal and mouth-breathing children. J Soc Bras Fonoaudiol. 2011 Dec; 23 (4): 315-20.
[24] Leech, H. L. (1958). A clinical analysis of orofacial morphology and behaviour of 500 patients attending an upper respiratory research clinic. Dent Practit, 4, 57-68.
[25] Gwynne-Evans, E. (1958). Discussion on the mouth-breather. Proceedings of the Royal Society of Medicine, 51 (4), 279-282.
[26] Fraga, W. S., Seixas, V. M., Santos, J. C., Paranhos, L. R., & Cesar, C. P. (2018). Mouth breathing in children and its impact in dental malocclusion: a systematic review of observational studies. Minerva stomatologica, 67 (3), 129-138.
[27] JBI (2020). About JBI – Who are we? Available from URL: https://joannabriggs.org/about-jbi accessed 01.08.2020.
[28] Ma, L. L., Wang, Y. Y., Yang, Z. H., Huang, D., Weng, H., & Zeng, X. T. (2020). Methodological quality (risk of bias) assessment tools for primary and secondary medical studies: what are they and which is better?. Military Medical Research, 7 (1), 1-11.
[29] EQUATOR Network (2020). PRISMA transparent reporting of systematic reviews and meta-analysis. Available from URL: http://www.prisma-statement.org/ (accessed 08th June 2020).
[30] Zicari, A. M., Albani, F., Ntrekou, P., Rugiano, A., Duse, M., Mattei, A., & Marzo, G. (2009). Oral breathing and dental malocclusions. Eur J Paediatr Dent, 10 (2), 59-64.
[31] Harari, D., Redlich, M., Miri, S., Hamud, T., & Gross, M. (2010). The effect of mouth breathing versus nasal breathing on dentofacial and craniofacial development in orthodontic patients. The Laryngoscope, 120 (10), 2089-2093.
[32] D’Ascanio, L., Lancione, C., Pompa, G., Rebuffini, E., Mansi, N., & Manzini, M. (2010). Craniofacial growth in children with nasal septum deviation: a cephalometric comparative study. International journal of pediatric otorhinolaryngology, 74 (10), 1180-1183.
[33] Shanker, S., Fields, H. W., Beck, F. M., Vig, P. S., & Vig, K. W. L. (2004). A longitudinal assessment of upper respiratory function and dentofacial morphology in 8-to 12-year-old children. In Seminars in Orthodontics (Vol. 10, No. 1, pp. 45-53). WB Saunders.
[34] Becking BE, Verweij JP, Kalf-Scholte SM, Valkenburg C, Bakker EWP, van Merkesteyn JPR: Impact of adenotonsillectomy on the dentofacial development of obstructed children: a systematic review and meta-analysis. European journal of orthodontics 2017, 39 (5): 509-518.
[35] o Nascimento RR, Masterson D, Trindade Mattos C, de Vasconcellos Vilella O: Facial growth direction after surgical intervention to relieve mouth breathing: a systematic review and meta-analysis. J Orofac Orthop 2018.
[36] Gryczynska, D., Powajbo, K., & Zakrzewska, A. (1995). The influence of tonsillectomy on obstructive sleep apnea children with malocclusion. International journal of pediatric otorhinolaryngology, 32, S225-S228.
[37] Bresolin D, Shapiro GG, Shapiro PA, Dassel SW, Furukawa CT, Pierson WE, Chapko M, Bierman CW. Facial characteristics of children who breathe through the mouth. Pediatrics. 1984; 73: 622–625.
[38] Hartgerink DV, Vig PS. Lower anterior face height and lip incompetence do not predict nasal airway obstruction. Angle Orthod. 1989; 59: 17–23.
[39] Foster TD, Hamilton MC. Occlusion in the primary dentition. Study of children at 2 ½ to 3 years of age. Br Dent J. 1969; 126: 76–79.
[40] Moyers RE. Handbook of Orthodontics. 3rd ed. Chicago, IL: Year Book Medical Publishers; 1973: 442.
[41] Warren JJ, Bishara SE. Duration of nutritive and nonnutritive sucking behaviors and their effects on the dental arches in the primary dentition. Am J Orthod Dentofacial Orthop. 2002; 121: 347–356.
[42] Wieler WJ, Barros AM, Barros LA, Camargo ES, Ignácio SA, Maruo H. A combined protocol to aid diagnosis of breathing mode. Rev Clin Pesq Odontol. 2007; 3 (2): 101–14.
[43] Warren DW, Hairfield WM, Dalston ET. Effect of age on nasal cross-sectional area and respiratory mode in children. Laryngoscope 1990; 100: 89-93.
[44] Pacheco, M. C. T., Casagrande, C. F., Teixeira, L. P., Finck, N. S., & Araújo, M. T. M. D. (2015). Guidelines proposal for clinical recognition of mouth breathing children. Dental press journal of orthodontics, 20 (4), 39-44.
[45] Jena, A. K., Duggal, R., Mathur, V. P., & Parkash, H. (2005). Class-III malocclusion: genetics or environment? A twins study. Journal of Indian Society of Pedodontics and Preventive Dentistry, 23 (1), 27.
[46] Ruf, S., & Pancherz, H. (1999). Class II Division 2 malocclusion: genetics or environment? A case report of monozygotic twins. The Angle Orthodontist, 69 (4), 321-324.
[47] Ovsenik, M. (2007). Assessment of malocclusion in the permanent dentition: reliability of intraoral measurements. The European Journal of Orthodontics, 29 (6), 654-659.
Cite This Article
  • APA Style

    Markus Greven. (2021). Prevalence of Malocclusion Patterns in Mouth Breathing Children Compared to Nasal Breathing Children – A Systematic Review. International Journal of Clinical Oral and Maxillofacial Surgery, 7(2), 17-27. https://doi.org/10.11648/j.ijcoms.20210702.12

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    ACS Style

    Markus Greven. Prevalence of Malocclusion Patterns in Mouth Breathing Children Compared to Nasal Breathing Children – A Systematic Review. Int. J. Clin. Oral Maxillofac. Surg. 2021, 7(2), 17-27. doi: 10.11648/j.ijcoms.20210702.12

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    AMA Style

    Markus Greven. Prevalence of Malocclusion Patterns in Mouth Breathing Children Compared to Nasal Breathing Children – A Systematic Review. Int J Clin Oral Maxillofac Surg. 2021;7(2):17-27. doi: 10.11648/j.ijcoms.20210702.12

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  • @article{10.11648/j.ijcoms.20210702.12,
      author = {Markus Greven},
      title = {Prevalence of Malocclusion Patterns in Mouth Breathing Children Compared to Nasal Breathing Children – A Systematic Review},
      journal = {International Journal of Clinical Oral and Maxillofacial Surgery},
      volume = {7},
      number = {2},
      pages = {17-27},
      doi = {10.11648/j.ijcoms.20210702.12},
      url = {https://doi.org/10.11648/j.ijcoms.20210702.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcoms.20210702.12},
      abstract = {The prevalence of malocclusion in mouth breathing children compared to nasal breathing children is unclear, therefore the aim of this study is to identify this prevalence in a systematic review. Seven studies were included. Six studies investigated the prevalence of malocclusion in mouth breathers and compared them with the prevalence data in nose breathers. One study evaluated the prevalence of mouth- and nose breathing in children with malocclusion. The prevalence rates for class I to class III malocclusions vary significantly between studies. For class I malocclusions, a prevalence between 9% and 74% was identified in the included studies. For class II malocclusions a prevalence between 21% and 73% was shown, which equalled roughly the prevalence of class I malocclusions. Class III malocclusions were the least prevalent, between 5% and 24%. There is insufficient evidence for a difference in prevalence patterns of class I – III malocclusions between mouth and nasal breathers in order to draw a definite conclusion. The quality of the included studies was rated moderate to poor. Research on the prevalence of malocclusions in mouth breathing compared to nasal breathing children is scarce. Identified prevalence rates differ significantly, which is likely due to different assessment and reporting methods used in the included studies. The evidence of a difference in prevalence patterns for class I – III malocclusions and other occlusion traits between mouth and nasal breathers is insufficient to draw a definite conclusion.},
     year = {2021}
    }
    

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    AU  - Markus Greven
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    T2  - International Journal of Clinical Oral and Maxillofacial Surgery
    JF  - International Journal of Clinical Oral and Maxillofacial Surgery
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    AB  - The prevalence of malocclusion in mouth breathing children compared to nasal breathing children is unclear, therefore the aim of this study is to identify this prevalence in a systematic review. Seven studies were included. Six studies investigated the prevalence of malocclusion in mouth breathers and compared them with the prevalence data in nose breathers. One study evaluated the prevalence of mouth- and nose breathing in children with malocclusion. The prevalence rates for class I to class III malocclusions vary significantly between studies. For class I malocclusions, a prevalence between 9% and 74% was identified in the included studies. For class II malocclusions a prevalence between 21% and 73% was shown, which equalled roughly the prevalence of class I malocclusions. Class III malocclusions were the least prevalent, between 5% and 24%. There is insufficient evidence for a difference in prevalence patterns of class I – III malocclusions between mouth and nasal breathers in order to draw a definite conclusion. The quality of the included studies was rated moderate to poor. Research on the prevalence of malocclusions in mouth breathing compared to nasal breathing children is scarce. Identified prevalence rates differ significantly, which is likely due to different assessment and reporting methods used in the included studies. The evidence of a difference in prevalence patterns for class I – III malocclusions and other occlusion traits between mouth and nasal breathers is insufficient to draw a definite conclusion.
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Author Information
  • Department of Prosthodontics, University Dental School MedUni Vienna, Vienna, Austria

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