title: Assessment of the body posture of mouth-breathing children and adolescents.
abstract: OBJECTIVE
  To investigate associations between mouth breathing (MBr), nose breathing (NBr) and body posture classification and clinical variables in children and adolescents, by comparing patients with mouth breathing syndrome with a control group of similar age.
  
  
  METHODS
  This was an observational, analytical, controlled, cross-sectional study conducted at a university hospital. Children aged 5 years or more were recruited to one of two groups: healthy controls (NBr) or an MBr group. The MBr group comprised patients with a diagnosis of mouth breathing syndrome confirmed by clinical examination by a physician plus nasal endoscopy. The control group comprised healthy volunteers of the same age, with NBr confirmed by medical examination. All participants underwent postural assessment. Data were analyzed using the Mann-Whitney nonparametric test, the chi-square test and Fisher's exact test, to a significance level of 0.05%.
  
  
  RESULTS
  A total of 306 MBr and 124 NBr were enrolled. Mouth breathers were more likely to be male (p = 0.0002), have more frequent and more severe nasal obstruction and larger tonsils (p = 0.0001) than NBr. Mouth breathers also exhibited higher incidence rates of allergic rhinitis (p = 0.0001), of thoracic respiratory pattern (p = 0.0001), high-arched palate (p = 0.0001) and unfavorable postural classifications (p = 0.0001) with relation to the control group. Postural classification scores were directly proportional to nasal obstruction (p = 0.0001) and male sex (p = 0.0008).
  
  
  CONCLUSIONS
  Postural problems were significantly more common among children in the group with mouth breathing syndrome, highlighting the need for early interdisciplinary treatment of this syndrome.
authors.affiliation: Cursos de Especialização e Aprimoramento em Fisioterapia Pediátrica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil. patriciablau@gmail.com
authors.forename: Patrícia Blau Margosian
authors.initials: PB
authors.lastname: Conti
authors.forename: Eulália
authors.initials: E
authors.lastname: Sakano
authors.forename: Maria Angela Gonçalves de Oliveira
authors.initials: MA
authors.lastname: Ribeiro
authors.forename: Camila Isabel Santos
authors.initials: CI
authors.lastname: Schivinski
authors.forename: José Dirceu
authors.initials: JD
authors.lastname: Ribeiro
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D009058:Mouth Breathing / Q000150:complications*; D015508:Nasal Obstruction / Q000150:complications* / Q000453:epidemiology; D011187:Posture / Q000502:physiology*; D012737:Sex Factors