Malocclusion and mouth breathing: An often underestimated connection

May 7, 2025Dr. Julia Steinmaierapprox. 5 min read

There is an often underestimated connection between misaligned teeth and mouth breathing, which we explain here.

As your orthodontic practice for modern orthodontics in Cologne-Rodenkirchen, we at JUST KFOknow: many misalignments of the teeth and jaws are not caused by genetic factors alone. The way we breathe – and mouth breathing in particular – plays a decisive role in the development of the teeth, the jaws and the facial skeleton. In this article we show you why early detection is so important, what consequences chronic mouth breathing can have and how orthodontics can provide targeted support.

Why do we breathe through the mouth?

Mouth breathing can occur temporarily during colds or allergies – that is completely normal. It becomes a problem when mouth breathing turns into a habit. Possible causes include:

  • Enlarged adenoids or tonsils

  • A chronically blocked nose (e.g. due to allergies or nasal polyps)

  • A narrow nasal passage or a deviated nasal septum

  • Habits in childhood (e.g. thumb sucking)

What effects does mouth breathing have on the development of the teeth and jaws?

With regular mouth breathing, the natural pressure of the tongue against the palateis missing, which is crucial for the correct growth of the upper jaw. The result: the palate stays narrow, the jaw does not develop symmetrically – and misaligned teeth can develop, such as:

  • Crossbite

  • Crowding

  • Open bite

  • Protruding front teeth

  • A receding lower jaw

In addition, chronic mouth breathing can also affect posture, as well as lip function and speech . The development of the jaws and the teeth is negatively influenced by this habit.

How to recognize mouth breathing in your child

Mouth breathing rarely becomes apparent during an office visit—but at home, if you know what to look for. Observe your child over several days:

  • During sleep: open mouth, snoring or audible breathing, restless sleep, wet pillow, dry mouth or bad breath in the morning.
  • During the day: The mouth remains open at rest, lips are dry or chapped, the child swallows audibly while eating or breathes through the mouth while chewing.
  • In the face: a narrow, elongated face, dark circles under the eyes, a “tired” expression; the nostrils barely move when breathing.
  • In everyday life: frequent colds and ear infections, difficulty concentrating, daytime fatigue.

A simple test: Ask your child to close their lips and breathe calmly through the nose for one minute. If this is not possible without effort or if they open their mouth after a few breaths, nasal breathing is obstructed.

When you should take action: If there is snoring with pauses in breathing, pronounced daytime fatigue, or if the signs persist for weeks, the child should first be seen by an ENT specialist—enlarged adenoids or tonsils are the most common cause in children (Marcus et al. 2012, see Sources). The orthodontic examination then shows whether the upper jaw has already become narrow and whether early treatment makes sense—more on our page Pediatric Orthodontics in Cologne.

Early detection: the earlier, the easier

The earlier mouth breathing is recognized and treated orthodontically, the better secondary damage can be avoided. In children in particular , the jaw is still malleable. In our practice we work with coordinated early treatment concepts – tailored individually to the needs of your child.

More on this topicOrthodontics for Children and Teens in Cologne

When treatment during growth can make sense, how the first examination works and how we support children along the way.

Go to Orthodontics for Children

Orthodontics as part of an interdisciplinary treatment approach

In many cases, successful treatment is only possible in collaboration with other medical disciplines . Since mouth breathing can lead to health problems such as tooth decay and misaligned jaws, we at JUST KFO work closely with:

  • Ear, nose and throat (ENT) physicians

  • Speech therapists

  • Pediatricians

  • Myofunctional therapists

in order to identify the causes of mouth breathing and treat them comprehensively.

How we at JUST KFO can help

As a practice specializing in orthodontics for children and adolescents , we advise you comprehensively on functional disorders and their effects on dental development and on the gums. Our services include:

  • Early diagnosis using digital 3D analysis

  • Individual treatment planning with functional appliances

  • Support through interdisciplinary networks

  • Information and instruction for parents and children

Don’t underestimate mouth breathing

Mouth breathing is not a harmless phenomenon; it can have long-term consequences for the health of the teeth and jaws. An early orthodontic evaluation helps to avoid complex misalignments and to support natural development.

Book a consultation appointment at our practice in Cologne-Rodenkirchen – we take our time and advise you individually, with empathy and sound expertise.

Sources:

  • Grippaudo, C., Paolantonio, E. G., Antonini, G., et al. (2016). Association between oral habits, mouth breathing and malocclusion. Acta Otorhinolaryngologica Italica, 36(5), 386–394. https://doi.org/10.14639/0392-100X-770
  • Baratieri, C., Alves, M., de Souza, M. M. G., et al. (2011). Does rapid maxillary expansion have long-term effects on airway dimensions and breathing? American Journal of Orthodontics and Dentofacial Orthopedics, 140(2), 146–156. https://doi.org/10.1016/j.ajodo.2011.02.019
  • Marcus, C. L., Brooks, L. J., Draper, K. A., et al. (2012). Diagnosis and Management of Childhood Obstructive Sleep Apnea Syndrome. Pediatrics, 130(3), 576–584. https://doi.org/10.1542/peds.2012-1671

Frequently asked questions about misaligned teeth caused by mouth breathing

How can mouth breathing lead to misaligned teeth?

With persistent mouth breathing, the natural pressure of the tongue against the palate, which shapes the upper jaw, is missing. The palate can remain narrow, which favors crowding, a crossbite or an open bite – especially during the growth phase.

How do I recognize mouth breathing in my child?

Signs include a mouth that is often open, dry lips, snoring, restless sleep or frequent infections of the upper airways. A reliable assessment is possible by looking at orthodontic and ENT findings together.

Is mouth breathing only a cosmetic problem?

No. It can affect the development of the teeth and jaws, nasal breathing and sleep. That is why an early evaluation is important, in order to avoid long-term effects.

What role does orthodontics play in mouth breathing?

Orthodontics can create more space, for example with a palatal expansion, and support nasal breathing. It is part of an interdisciplinary approach – the cause of the mouth breathing must always be treated as well.

Who should I turn to about mouth breathing?

A combination of ENT physicians (to evaluate the nose and throat), speech therapy and orthodontics is advisable. We coordinate the treatment within an interdisciplinary network.

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About the Author

Dr. Julia Steinmaier

Specialist in orthodontics. Owner of JUST KFO in Cologne, sought-after speaker and author who regularly appears in professional publications and media.

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Dr. Julia Steinmaier
JUST KFO

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Reviewed by Dr. med. dent. Julia Steinmaier, specialist in orthodontics · Last reviewed on September 6, 2026

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