Can mouth breathing cause a relapse after surgery?

[Mark32]

Having kept an eye on this for months I now realize that I breath through my mouth at night. Whether it's due to increased pressure on my lungs, I often find myself having to switch to mouth breathing as soon as I lie down. But even if I manage not to while still awake, I always seem to make the switch whenever I nod off. I know this from the fact that every morning my mouth is open and dry - and I'm breathing through it!

What concerns me about all this is my tongue posture - if that's the right description. In the mornings - and I presume for most of the night - my tongue lies in a sort of low and anterior position in my mouth. I'm convinced that this distorted the balance of muscular forces on my jaws and may have contributed to the jaw misalignment I now have - this was probably going on right throughout the years I was growing. I think it might be part of the reason I've ended up as a class iii.

But what I'm worrying about now is if say my lower jaw was set back, could mouth breathing and a tongue position that puts increased 'forward' pressure on my lower jaw lead to some amount of relapse? Not sure if I've described this clearly enough??!

[MrFox]

Are you thinking that your tongue pressure will make muscles pull the mandible foward or that tongue pressure will actually remodel your lower jaw to grow foward again?

I don't think mouth breathing would effect the results, the elastics keep the jaws together for the time they need to be for the initial bone healing.
Even if your fear of the tongue causing relapse is possible, I don't think there will be any research out there on this for your surgeon to have read so they will likely dismiss it.

I have trouble with my tongue, every time I swallow it catapults itself super hard against the front of my palate or the back or the lower jaw depending on where I keep it. I worry about it ruining things too.

I'm very certain that just resting your tongue on the lower jaw as opposed to the roof of your mouth will be fine. I know someone who had double jaw surgery years ago, they rest their tongue on the lower jaw and the result hasn't altered at all.

[yxcvb]

Bone remodelling is a very slow process, so ultimately if its effects bones it might take years. If you could you should force yourself to breath through the nose as mouthbreathing on the long term can harm the teeth and also cause gum and other mouth infections.

[Mark32]

Are you thinking that your tongue pressure will make muscles pull the mandible foward or that tongue pressure will actually remodel your lower jaw to grow foward again?

I'm concerned that during the healing process my tongue position will push forwards on my lower jaw causing it to somewhat relapse back into a class iii relationship.

The other thing that worries me about what I'd call a 'slack' tongue posture throughout the night is that I think it removes a posteriorly directed pull on the part of the tongue.

It's my thinking that when you're breathing through your nose, and your mouth is closed, the tongue sits as it should in the middle of the mouth and pressing outwardly against both dental arches. But I'm wondering does a tongue position that's 'low' and 'forwards' remove tension - or a restraining force - from the genio-glossus muscles that attach the underside of the tongue to the lower jaw? So throughout the night in the years that I was growing were there two incorrectly directed forces at play: my tongue pushing anteriorly on my lower jaw and 'slacker' genio-glossus muscles failing to pull back enough in a posterior direction?

My worry is that, even after surgery, these soft tissue forces will just remould my lower jaw back into the position it's in. Don't they always say that soft forces determine everything - you just can't work against them??! This all depends though on whether any of the above contributed to the misgrowth of my jaws in the first place.

Bone remodelling is a very slow process, so ultimately if its effects bones it might take years. If you could you should force yourself to breath through the nose as mouthbreathing on the long term can harm the teeth and also cause gum and other mouth infections.

But that still worries me. I don’t want any surgery I have to be reversed, even if it’s over a number of years.

I’m actually thinking of going to the doctor and having my upper airway checked out. Thing is I’ve tried and tried to make myself breath through my nose but to no avail. As soon as I fall asleep I switch to mouth breathing. I’ve since read that for around 85% of people who mouth breath it’s not just a bad habit, they can’t help it. There’s some blockage or restriction in the upper airway. My sister has the same problem so that makes me think it’s congenital.

[Anna5]

Hello Mark,

I have the same problem as you, I always mouthbreathe at night (and also too often during the day....). I went to an myofunctional therapist and she gave me the advise to tape my mouth shut at night, to help my body retrain nosebreathing. It may sound a bit wierd, but for me it really worked! I don't wake up with a dry mouth anymore. I don't tape my mouth completely shut, so that I can always have enough air/ mouthbreathe if it is really necessary. Maybe you can try this as well if you feel it is safe....

[Mark32]

Hi Anna,

That's really interesting as I'd thought about maybe trying something like that. The thing that put me off is what if I really have some sort of blockage and just couldn't continue breathing through my nose while asleep - would I choke??!!

Did you have your upper airway checked out to see if there was any restriction that might have given rise to the mouth breathing in the first place?

Also, do you think mouth breathing had any effect on the development of your bite?

[Anna5]

Hello Mark,

I didn't have my airway checked out to see if there is any restriction, but I just feel that I cannot always get enough air through my nose. I can breathe solely through my nose doing rest, but not during any exercise. When I am in rest or at bed I can breathe through my nose, but naturally my mouth is always open a bit (lip incompetence) and that might be the reason my body automatically switches to mouth breathing unless I tape my mouth shut.
I think my mouth breathing (in addition to thumbsucking) as a kid might be the cause of my narrow deep palate.
I think it is always good to check out if you have any obstruction. But my experience is that you can train nasal breathing. At first I thought I couldn't get enough air through my nose even at rest, but now this is not a problem anymore. The myofunctional therapist told me that the more you practise nose breathing, the easier it will get. During the day it is still a problem for me, but I practise it at night now...
If I were you I would just give it a go. But never shut your mouth completely close, I indeed think that is dangerous, breathing through your mouth is always better than getting no air at all!

Good luck!

Greetings from Anna

[Mark32]

I've sent you another pm, Anna.

[nrelax11]

s**t, I still mouth breath after surgery because my nose is either always stuffed,  or because my left laterla cartilage collapsed years ago. I know i mouth breath when I sleep and I try not to when im awake. Its annoying though trying to always breath through your nose when you cant well. I might get a functional nose job in the future if I can.

Oh and no, my jaws havent relapsed

[molestrip]

I've read that yes it can but the concern is more about relapse during the recovery period. I would think it's a bigger issue if your sleep apnea isn't addressed, since then there's additional strain from tongue thrusting at night. That being said, these are all statistics and nothing is a death sentence here.

[terry947]

I think that if you have a myofunctional disorder , it'd be good to get that fixed before surgery.

[molestrip]

I'd agree but it's not always easy. I have sleep apnea and with an AHI of 50, I need it to sleep. Getting a turbinate reduction would require me to be off it for a week. That not only sounds miserable but I'm concerned about how well I'd heal. Doing it concurrent to jaw surgery is cheaper and saves another round of anesthesia but the drawback is breathing would be harder during recovery and ENTs are probably better at the procedure.