The Surprising Link Between Mouth Breathing and Behavior Problems in Kids

Dr. Dina Chehab
6 days ago
7 min read

Updated: 8 minutes ago

When 7-year-old Marcus came to Urbana Pediatric Dentistry, his parents weren't primarily concerned about his teeth. They were exhausted from constant phone calls from his teacher about his inability to sit still, frequent outbursts, and difficulty following directions. His mom mentioned almost as an afterthought that he snored loudly and always seemed to have his mouth open.

What they discovered changed everything.

Marcus's story isn't unique. In fact, it's becoming increasingly common as we recognize the profound connection between mouth breathing and behavioral challenges in children. What many parents don't realize is that the child struggling with focus, hyperactivity, or emotional regulation might actually be dealing with a breathing problem—not a behavioral one.

mouth breathing and behavior problems in children

The Hidden Connection: How Breathing Affects Behavior

When children habitually breathe through their mouth instead of their nose, it creates a cascade of effects that extend far beyond dental health. Chronic mouth breathing disrupts sleep quality, reduces oxygen intake, and triggers a stress response in the body—all factors that directly impact a child's ability to regulate emotions, focus attention, and control impulses.

Here's what happens inside your child's body when mouth breathing becomes the default:

Sleep Disruption and Fragmented Rest: Mouth breathing often leads to restless, fragmented sleep. Children may appear to sleep through the night but never reach the deep, restorative sleep stages crucial for brain development and emotional regulation. Remember Lucas from our previous article? His transformation began when his sleep improved through myofunctional therapy.

Reduced Oxygen Efficiency: Nasal breathing naturally filters, warms, and humidifies air while producing nitrous oxide—a compound that enhances oxygen delivery to tissues. Mouth breathing bypasses these benefits, potentially leading to chronic low-level oxygen deficiency that affects brain function.

Chronic Stress Response: Poor sleep and inefficient breathing can keep a child's nervous system in a heightened state of alert, making it difficult to remain calm, focused, and emotionally regulated throughout the day.

Recognizing the Signs: When Breathing Problems Look Like Behavior Problems

Parents often spend months or years addressing behavioral symptoms without realizing the root cause might be related to breathing patterns. Here are key indicators that your child's behavior challenges might be connected to mouth breathing:

Academic and Attention Challenges:

Difficulty concentrating or completing tasks
Frequent daydreaming or appearing "spacey"
Declining grades despite normal intelligence
Trouble following multi-step instructions
Hyperactivity or inability to sit still

Emotional and Social Difficulties:

Increased irritability, especially in the morning
Emotional outbursts or meltdowns over minor issues
Difficulty with transitions or changes in routine
Social challenges due to fatigue or mood swings
Anxiety or fearfulness that seems disproportionate

Physical Signs Often Overlooked:

Chronic mouth breathing, even at rest
Snoring or restless sleep
Frequent complaints of tiredness
Dark circles under the eyes
Forward head posture or slouching

As we discussed in our article on myofunctional therapy for crowded teeth, Emma's parents initially noticed her daytime fatigue and difficulty focusing in kindergarten—symptoms that resolved once her breathing patterns improved.

Can Mouth Breathing Cause Behavior Problems?

Yes, mouth breathing can absolutely contribute to behavior problems in children. The relationship is both direct and indirect:

Direct Effects: Poor sleep quality from mouth breathing leads to symptoms that mirror ADHD, including inattention, hyperactivity, and impulsivity. Children who don't get quality sleep struggle with executive function—the brain's ability to plan, focus, and control behavior.

Indirect Effects: Chronic fatigue and irritability from disrupted sleep can create a cycle where children become increasingly difficult to manage, leading to more stress for both child and family.

Is Mouth Breathing Associated with ADHD?

While mouth breathing doesn't cause ADHD, there's a significant overlap between sleep-disordered breathing and ADHD-like symptoms. Research suggests that up to 25% of children diagnosed with ADHD may actually have sleep-disordered breathing as a primary or contributing factor.

The symptoms can be strikingly similar:

Difficulty sustaining attention
Hyperactivity and fidgeting
Impulsive behavior
Problems with organization and time management
Emotional dysregulation

The key difference: Children with breathing-related behavioral issues often show improvement when their sleep and breathing patterns are addressed through interventions like myofunctional therapy, while those with primary ADHD typically require different therapeutic approaches.

What Are the Side Effects of Mouth Breathing in Children?

The effects of chronic mouth breathing extend throughout a child's development:

Immediate Effects:

Dry mouth and increased risk of cavities
Bad breath and gum inflammation
Frequent respiratory infections
Daytime fatigue and irritability
Difficulty concentrating

Long-term Developmental Impact:

Facial growth changes: Chronic mouth breathing can contribute to a long, narrow face shape, high-arched palate, and crowded teeth
Postural problems: Forward head posture and rounded shoulders
Speech difficulties: Problems with certain sounds due to tongue positioning
Social and academic challenges: Due to persistent fatigue and behavioral issues

Is Mouth Breathing a Symptom of Autism?

Mouth breathing isn't a direct symptom of autism, but children with autism spectrum disorders may be more prone to mouth breathing for several reasons:

Sensory processing differences may make nasal breathing feel uncomfortable
Anxiety and stress can lead to altered breathing patterns
Structural differences in the oral cavity may make nasal breathing more challenging
Difficulty with oral motor coordination can affect breathing patterns

For children on the autism spectrum, addressing mouth breathing through myofunctional therapy can be particularly beneficial, as improved sleep and breathing often leads to better sensory regulation and communication skills.

Is It True That Mouth Breathing Impacts Face Development in Kids?

Absolutely. This is one of the most significant long-term consequences of chronic mouth breathing. The position of the tongue, lips, and jaw during breathing directly influences facial growth and development.

How Mouth Breathing Changes Facial Development:

Tongue Position: When breathing through the mouth, the tongue typically rests low in the mouth instead of against the roof of the mouth (palate). The tongue's upward pressure is crucial for proper palate width and upper jaw development.

Jaw Growth: Without the tongue's support, the upper jaw may develop more narrowly, while the lower jaw may grow more vertically, creating a longer facial appearance.

Dental Alignment: Poor jaw development often leads to crowded teeth and bite problems, as we discussed in our comprehensive guide to myofunctional therapy for crowded teeth.

The good news: Early intervention can help guide proper facial development. This is why we recommend evaluation by age 4-6, when growth patterns are still malleable.

A Success Story: Marcus's Transformation

Remember Marcus from the beginning of our story? After a comprehensive evaluation revealed signs of sleep-disordered breathing, we referred him for a sleep study and began myofunctional therapy to address his mouth breathing patterns.

Within two months of starting therapy:

His teacher reported significant improvements in attention and behavior
His parents noticed he was waking up more refreshed
His snoring decreased dramatically
Most importantly, he began sleeping through the night

By six months, Marcus was a different child—calmer, more focused, and significantly happier. His parents were amazed that addressing his breathing had such a profound impact on his behavior and overall well-being.

Taking Action: What Parents Can Do

If you recognize these signs in your child, here are important steps to take:

Start with Observation:

Monitor your child's breathing patterns during sleep and rest
Note any behavioral patterns related to tiredness or sleep quality
Document concerns to share with healthcare providers

Seek Professional Evaluation:

Schedule a comprehensive dental evaluation that includes airway assessment
Consider consultation with an ENT specialist if structural issues are suspected
Work with qualified myofunctional therapists for breathing retraining

Address Environmental Factors:

Manage allergies that might contribute to nasal congestion
Ensure optimal sleep environment (cool, dark, quiet)
Consider how diet and exercise might impact sleep quality

The Bigger Picture: Whole-Child Wellness

At Urbana Pediatric Dentistry, we believe in looking beyond teeth to understand how oral health impacts your child's entire well-being. Addressing mouth breathing isn't just about preventing dental problems—it's about unlocking your child's potential for better sleep, improved behavior, and enhanced quality of life.

The connection between breathing and behavior represents a paradigm shift in how we think about childhood challenges. Instead of simply managing symptoms, we can address root causes and create lasting change.

Ready to Explore Solutions?

If your child struggles with behavioral challenges alongside signs of mouth breathing, don't wait. Early intervention can make a profound difference in their development and well-being.

Schedule a comprehensive evaluation with our team at Urbana Pediatric Dentistry. We'll assess not just your child's teeth, but their breathing patterns, sleep quality, and overall orofacial development. Together, we can determine if myofunctional therapy or other interventions might help your child thrive.

Remember, behind every behavioral challenge might be a breathing problem waiting to be solved. Let's work together to help your child sleep better, breathe easier, and reach their full potential.

Dr. Dina Chehab is a board-certified pediatric dentist with advanced training in airway-focused care and myofunctional therapy. She leads Urbana Pediatric Dentistry with a commitment to treating the whole child, not just their teeth.