Guidelines proposal for clinical recognition of mouth breathing children.
BACKGROUND
Mouth breathing (MB) is an etiological factor for sleep-disordered breathing (SDB) during childhood. The habit of breathing through the mouth may be perpetuated even after airway clearance. Both habit and obstruction may cause facial muscle imbalance and craniofacial changes.


OBJECTIVE
The aim of this paper is to propose and test guidelines for clinical recognition of MB and some predisposing factors for SDB in children.


METHODS
Semi-structured interviews were conducted with 110 orthodontists regarding their procedures for clinical evaluation of MB and their knowledge about SDB during childhood. Thereafter, based on their answers, guidelines were developed and tested in 687 children aged between 6 and 12 years old and attending elementary schools.


RESULTS
There was no standardization for clinical recognition of MB among orthodontists. The most common procedures performed were inefficient to recognize differences between MB by habit or obstruction.


CONCLUSIONS
The guidelines proposed herein facilitate clinical recognition of MB, help clinicians to differentiate between habit and obstruction, suggest the most appropriate treatment for each case, and avoid maintenance of mouth breathing patterns during adulthood.
Department of Clinical Dentistry, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, BR.
Maria Christina Thomé
MC
Pacheco
Brazil, BR.
Camila Ferreira
CF
Casagrande
Universidade Federal do Espírito Santo, Vitória, Espírito Santo, BR.
Lícia Pacheco
LP
Teixeira
Universidade Federal do Espírito Santo, Vitória, Espírito Santo, BR.
Nathalia Silveira
NS
Finck
Department of Physiological Sciences, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, BR.
Maria Teresa Martins
MT
de Araújo
D057189:Checklist; D002648:Child; D003430:Cross-Sectional Studies; D005123:Eye / Q000473:pathology; D005145:Face / Q000473:pathology; D005221:Fatigue / Q000175:diagnosis; D005260:Female; D005891:Gingivitis / Q000175:diagnosis; D006184:Habits; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis; D008046:Lip / Q000033:anatomy & histology; D008297:Male; D008310:Malocclusion / Q000175:diagnosis; D009058:Mouth Breathing / Q000175:diagnosis*; D015508:Nasal Obstruction / Q000175:diagnosis; D024343:Open Bite / Q000175:diagnosis; D000066792:Orthodontists / Q000193:education; D017410:Practice Guidelines as Topic; D019239:Practice Patterns, Dentists'; D011446:Prospective Studies; D012307:Risk Factors; D012798:Sialorrhea / Q000175:diagnosis; D012894:Sleep Stages / Q000502:physiology; D012913:Snoring / Q000175:diagnosis