Bursa Orthodontic Specialist Dr. Begüm Ulaşan Explains

Does your child or do you sleep with your mouth open? Do you often breathe through your mouth during the day? When you look in the mirror, do you see noticeable crowding, protruding teeth, or a recessed jaw?

If the answer to these questions is yes, it is highly likely that the following concepts are interconnected:

1. Mouth breathing
2. Jaw structure disorders
3. Orthodontic crowding (teeth being tight and crooked)

In this comprehensive article, especially for children, adolescents, and adults considering orthodontic treatment in Bursa, we will address all of these questions one by one, based on the clinical perspective of orthodontic specialist Dr. Begüm Ulaşan:

1. What is mouth breathing, and why does it occur?
2. How does breathing through the mouth affect jaw structure and facial development?
3. What is the relationship between mouth breathing and orthodontic crowding?
4. What signs signal that "I must see an orthodontist and an ENT specialist"?
5. How does Dr. Begüm Ulaşan in Bursa approach these cases, and what are the treatment options?

1. What is Mouth Breathing?

Normally, the human body is designed to use the nose for breathing. The nose:

1. Warms the air.
2. Humidifies it.
3. Filters out dust, microbes, and allergens.
4. Also contributes to facial and jaw development.

Mouth breathing is the condition where a person predominantly breathes with their mouth open, day or night, inhaling air through the mouth instead of the nose.

This condition:

1. Can be temporary (e.g., a short-term flu-like infection, nasal congestion).
2. But when it becomes chronic, it can have serious effects on general health, craniofacial development, and tooth alignment.

2. What Are the Causes of Mouth Breathing?

Mouth breathing is not a disease in itself but is often a symptom of another underlying problem.

Common Causes:

1. Chronic Nasal Obstruction: Allergic rhinitis, enlarged adenoids (geniz eti), enlarged turbinates (konka), deviated septum.
2. Long-Term Bad Habits: Constantly keeping the mouth open, imbalances in the perioral muscles due to thumb-sucking or prolonged pacifier/bottle use.
3. Sleep-Related Issues: Snoring, sleep apnea, frequent dry mouth during the night.

The crucial point here is this: If a child or adult constantly breathes through their mouth, the question "Why can't they breathe through their nose?" must be investigated jointly by an ENT specialist and an orthodontic specialist.

Dr. Begüm Ulaşan, who specializes in orthodontics in Bursa, prefers to address this condition as a team effort (with an ENT, pediatrician, and, if necessary, an allergy or sleep specialist) rather than just straightening the teeth alone in patients with mouth breathing.

3. How Does Mouth Breathing Affect Jaw Structure?

Mouth breathing can significantly alter jaw and facial development, especially in growing children. This is because the position of the tongue, lips, and cheek muscles is "re-adjusted" according to the breathing pattern.

Normally:

1. The tongue rests near the upper palate.
2. It supports the upper jaw from within and contributes to its width.
3. The lips are closed, and the facial muscles work in balance.

In Mouth Breathing:

1. The mouth is constantly open.
2. The tongue adopts a lower and more posterior position.
3. It cannot provide sufficient support to the upper palate.

This can lead to the following long-term consequences:

3.1. Narrowing of the Upper Jaw

Because the upper jaw loses the support of the tongue, it can become narrow and have a high vault (high-arched palate). A narrow upper jaw does not leave enough space for the teeth, leading to orthodontic crowding and tightness.

3.2. Long, Narrow Facial Type

In children with mouth breathing, the facial shape may gradually become longer and narrower. Imbalances can occur in the nose-lip-chin line, leading to aesthetic disruptions in the profile view.

3.3. Posterior Positioning of the Lower Jaw

Mouth breathing and the change in tongue position can cause the lower jaw to position itself functionally further back. This can set the stage for Class II malocclusion problems later on, where the upper teeth appear too far forward and the lower jaw looks recessed.

3.4. Difficulty Closing the Lips

The upper and lower lips may struggle to close completely, and the child may often walk around with an "open mouth." This appearance can negatively affect both aesthetics and social self-confidence.

For this reason, mouth breathing should be viewed not just as a way of breathing but as a chronic condition that changes the "architecture" of a child's face. Dr. Begüm Ulaşan in Bursa always pays careful attention to:

1. Facial form,
2. Jaw width,
3. Lip closure,
4. Tongue position when evaluating children with mouth breathing.

4. The Link Between Mouth Breathing and Orthodontic Crowding

Orthodontic crowding is the misalignment of teeth due to a lack of sufficient space in the bone and imbalanced force dynamics.

Mouth breathing contributes to this process in three ways:

4.1. Upper Jaw Narrowing → No Space for Teeth

When the tongue moves away from the palate, the upper jaw loses the "push-out" support from the inside. The cheek muscles exert pressure on the upper jaw from the outside. The result is a narrow, high-arched upper jaw.

In this narrow jaw, the teeth:

1. Cannot find enough room.
2. Start to overlap, rotate, and position themselves inward or outward.
3. Orthodontic crowding becomes inevitable.

4.2. Relative Lower Jaw Recession → Anterior Teeth Disruption

In children with mouth breathing, the lower jaw can be functionally positioned slightly behind. The upper incisor teeth angle forward and protrude, while the lower incisors remain more recessed.

In this situation:

1. The teeth appear "protruding" when viewed from the front.
2. The risk of trauma increases (the incisors are more vulnerable in case of a fall or impact).

4.3. Imbalance of Lip, Cheek, and Tongue Muscles

Factors such as difficulty in lip closure, incorrect tongue position, and the tongue pushing against the teeth during swallowing and speaking (tongue thrust) can both increase orthodontic crowding and raise the risk of relapse (the teeth moving back) after treatment.

Therefore: Simply putting braces on the teeth, as long as mouth breathing continues, only means correcting the aesthetic part of the problem temporarily.

The main goal should be: to correct the tooth alignment and to find and manage the underlying causes of mouth breathing.

5. What Symptoms are Warning Signs for Mouth Breathing and Orthodontics?

Especially families living in Bursa should consider consulting an orthodontic specialist (such as Dr. Begüm Ulaşan) and an ENT specialist if they notice the following signs in their children:

1. The child mostly walks around with their mouth open.
2. Open mouth while sleeping, snoring, or irregular breathing.
3. Complaints of dry mouth and bad breath in the morning.
4. History of frequent upper respiratory tract infections, nasal congestion, or allergies.
5. Front teeth are noticeably protruding, and the lower jaw is recessed.
6. Upper jaw is narrow, teeth are overlapping and crowded.
7. The lower jaw shifts to one side when the teeth close completely.
8. Sensation of the tongue pressing between the teeth during swallowing (tongue thrust).
9. Difficulty pronouncing certain sounds (s, z, sh) in speech, lisping.

These symptoms are often indicators of the mouth breathing – jaw structure – orthodontic problem triangle.

6. How Does Dr. Begüm Ulaşan in Bursa Approach the Mouth Breathing – Jaw – Orthodontics Relationship?

Orthodontic specialist Dr. Begüm Ulaşan in Bursa prefers to follow these steps in patients suspected of having mouth breathing:

6.1. Detailed Orthodontic Examination

Facial profile, jaw relationship, and smile analysis are performed. The way the teeth close, the relationship between the incisors and molars, and jaw narrowness are evaluated. If necessary, panoramic and cephalometric X-rays are used to examine the jaws and tooth roots.

6.2. Observation for Mouth Breathing

During the examination, the child's ability to keep their mouth closed is observed. Difficulty breathing through the nose is assessed. The tongue's position and its relationship with the teeth during speech and swallowing are checked.

6.3. Collaboration with ENT and other Specialties, if Necessary

If there are strong indications of mouth breathing:

1. A referral is made to an ENT specialist.
2. Underlying causes like adenoids, turbinates, deviated septum, or allergies are investigated.
3. Evaluation for sleep-disordered breathing may also be recommended.

With this approach, the mindset adopted is: "Let's address the breath, the jaw structure, and the tooth alignment together," instead of "Let's fix the teeth, and the rest doesn't matter."

6.4. Orthodontic Treatment Plan

Depending on the cause and age:

1. Upper jaw expanders
2. Functional appliances (to support the lower jaw)
3. Fixed braces treatment
4. Clear aligner (Align) treatment

These options can be used alone or in combination. In younger age groups with jaw narrowness due to mouth breathing, Dr. Begüm Ulaşan in Bursa often focuses first on:

1. Widening the upper jaw.
2. Balancing severe problems like crossbite or open bite.
3. Bringing tongue and lip functions closer to normal.

When planning treatment options, the following are taken into account: the child's age, growth potential, severity of mouth breathing, current condition of the teeth, and the family's expectations.

7. Will the Orthodontic Result Be Permanent After Correcting Mouth Breathing?

The answer to this question is largely yes. If:

1. The problem causing mouth breathing has been managed with an ENT specialist.
2. Jaw narrowness and bite problems have been corrected orthodontically.
3. Tongue and lip position have been brought to a more physiological state.
4. The retention (retainer) period after treatment has been followed.

The long-term success of the orthodontic treatment significantly increases.

In the opposite case:

1. Nasal congestion continues, and mouth breathing persists.
2. The tongue is still in the wrong position.
3. The lips do not close comfortably.

Even if the teeth are straightened with orthodontics, the risk of relapse (moving back) over the years increases.

That is why Dr. Begüm Ulaşan emphasizes the following to patients with mouth breathing:

"Orthodontics is not just a wire placed on the teeth; it is a whole that must be addressed together with breathing, muscles, jaw structure, and function."

8. Conclusion: The Question "Am I Breathing Through My Mouth?" is Crucial

Let's return to the question at the beginning of this article: "Does mouth breathing affect jaw structure and orthodontic crowding?"

The Answer:

1. Yes, especially in growing children, mouth breathing can lead to jaw narrowness, facial shape changes, and dental crowding.
2. In adults, mouth breathing can exacerbate existing orthodontic problems and negatively affect the permanency of the treatment.

Therefore:

1. If your child or you often breathe with your mouth open.
2. If snoring, dry mouth, or bad breath at night catches your attention.
3. If you notice a narrow, high palate, crowded teeth, protruding teeth, or a recessed jaw in the mirror;

do not see this as a "minor detail."

If you live in Bursa or can travel to Bursa, you can schedule an appointment with orthodontic specialist Dr. Begüm Ulaşan to:

1. Evaluate your jaw structure,
2. Tooth alignment,
3. Potential problems related to mouth breathing
4. From a holistic perspective, and create a personalized treatment/follow-up plan for you and your child.

Remember: How you breathe shapes not just your lungs, but also your face, your jaw, your smile, and your long-term quality of life.