Mouth breathing is more than just an occasional habit or a reaction to nasal congestion. When mouth breathing becomes a chronic issue, it can significantly affect facial development, oral health, and overall well-being. This phenomenon, often referred to as “mouth breathing face,” highlights the physical changes associated with long-term mouth breathing, particularly in individuals with tethered oral tissues (TOTs), such as tongue ties, lip ties, and cheek ties.
As a speech-language pathologist specializing in myofunctional therapy, I often work with adults who struggle with the ripple effects of TOTs. This blog will delve into the causes, symptoms, and treatments for mouth breathing face, focusing on the essential role of myofunctional therapy in restoring proper oral function and appearance.
Understanding Mouth Breathing Face
What Is Mouth Breathing Face?
“Mouth breathing face” describes the characteristic changes in facial structure and appearance resulting from chronic mouth breathing. These changes often include:
- A longer, narrower face
- Retracted chin or weak jawline
- Flat or underdeveloped cheekbones
- Dark circles under the eyes
- Forward head posture
- Open lips at rest
These structural changes don’t occur overnight. Instead, they develop over time due to improper oral and nasal function, often exacerbated by untreated TOTs. Chronic mouth breathing prevents optimal tongue posture, disrupts facial muscle balance, and impacts the growth and alignment of facial bones.
Mouth Breather
Nasal Breather
Napoleon Dynamite is a movie character who displays a good visual demonstration of mouth breathing face. Notice the open lips at rest, the longer length of the face and drawn dark circles under the eyes.
In fact his eyes almost seem closed, as if they are too tired to hold open. Compare that to the illustration of nasal breathing face. Eyes are more aligned and open, lips are closed at rest and there is a defined jaw and chin line.
The Role of Tethered Oral Tissues
Tethered oral tissues, such as tongue ties (ankyloglossia), lip ties, and cheek ties, can significantly hinder oral function. These restrictions limit the natural range of motion of the tongue and lips, making it difficult to:
- Seal the lips properly
- Achieve proper tongue-to-palate contact
- Maintain nasal breathing
When these functions are compromised, individuals often resort to mouth breathing, which perpetuates the cycle of dysfunction and contributes to mouth breathing face.
The Connection Between Mouth Breathing and Facial Development
How Mouth Breathing Impacts Growth
Facial development in childhood and adulthood is heavily influenced by tongue posture, breathing patterns, and muscle function. The tongue acts as a natural “scaffolding” for the palate and upper jaw. When the tongue rests on the roof of the mouth, it encourages the proper growth and expansion of the maxilla (upper jaw). Conversely, chronic mouth breathing leads to:
- Low Tongue Posture: Without proper tongue-to-palate contact, the maxilla narrows, and the palate becomes high and vaulted.
- Jaw Misalignment: A low tongue posture and forward head position can contribute to an underdeveloped lower jaw.
- Compromised Airway: Narrow dental arches reduce airway space, perpetuating the mouth breathing habit.
TOTs and Their Impact on Facial Appearance
Tethered oral tissues exacerbate the effects of mouth breathing by restricting the tongue’s mobility and proper oral posture. Individuals with TOTs may experience:
- Difficulty closing the lips without strain
- Habitual open mouth resting posture
- Underdeveloped facial muscles
These issues create a domino effect, leading to visible changes in the face over time.
Recognizing the Signs of Mouth Breathing Face
Adults who have lived with chronic mouth breathing and TOTs may notice:
- Aesthetic concerns: elongated face, weak jawline, or dark circles under eyes
- Oral health issues: frequent cavities, gum disease, dry mouth or chapped lips
- Breathing-related symptoms: snoring, sleep apnea, or fatigue
- Speech challenges: lisps, difficulty articulating certain sounds or fatigue
- Chronic health problems: headaches, neck pain, allergy or sinus issues
If you recognize these signs in yourself, seeking an evaluation from a myofunctional therapist or a multidisciplinary team can be the first step toward improvement.
To locate a myofunctional therapist near you check out this helpful website Tongue Tie Life
How Myofunctional Therapy Can Help Mouth Breathing Face
What Is Myofunctional Therapy?
Myofunctional therapy is a personalized program of exercises designed to:
- Improve tongue and lip mobility
- Encourage proper tongue posture
- Facilitate nasal breathing
- Restore muscle balance in the face and neck
For individuals with TOTs, myofunctional therapy often serves as a foundational step before or after a frenectomy (a surgical release of tethered oral tissues). By strengthening the muscles and retraining oral habits, therapy supports long-term functional and aesthetic improvements.
Key Goals of Myofunctional Therapy
- Lip Seal: Therapy helps achieve a comfortable, natural lip seal at rest, reducing the appearance of an open-mouth posture.
- Nasal Breathing: Exercises promote nasal breathing, which supports overall health and encourages proper facial growth.
- Tongue Posture: Training the tongue to rest against the palate encourages the natural expansion of the upper jaw and improves airway space.
- Facial Muscle Balance: Strengthening facial muscles helps restore symmetry and support optimal function.
You may find our other articles on this topic helpful. Additionally, check out Myofunctional Treatment for Adults: Breaking Free from Tongue, Lip, and Cheek Ties and Orofacial Myofunctional Therapy Exercises to further explore the benefits of myofunctional therapy.
Case Study: From Mouth Breather to Confident Smiler
Let’s consider the story of Sarah (name changed to protect privacy), a 41-year-old woman who sought myofunctional therapy for her chronic mouth breathing, TMJ pain and associated aesthetic concerns (thin upper lip).
Sarah had struggled with frequent nasal congestion, dry/chapped lips and fatigue for years, which she attributed to seasonal allergies. More recently her jaw began to exhibit tension and slight pain that increased when she’s tired or eating steak like textures.
After an evaluation, we discovered a posterior tongue tie, lip tie, and habitual mouth breathing had contributed to her “mouth breathing face.”
She had elongation of the face, dark circles and drifted into open mouth posture frequently.
Through myofunctional therapy and a collaborative effort with oral maxillary surgeon, Sarah underwent a frenectomy for tongue and lip and began retraining her oral posture.
Over six months, Sarah achieved a closed-lip posture, transitioned to nasal breathing, and noticed a visible improvement in her facial symmetry and confidence.
She benefited from 9 weeks of pre-surgery myofunctional therapy followed by 4 months of treatment after.
Let’s take a look at some of the steps involved to restore good oral facial rest posture and function.
Steps to Correct Mouth Breathing Face
1. Evaluation by a Multidisciplinary Team
Addressing mouth breathing face requires a collaborative approach involving:
- Myofunctional therapists
- Dentists or orthodontists Airway centric focused
- ENTs (Ear, Nose, and Throat specialists)
- Oral surgeons or specialists for TOT release
An initial evaluation helps identify the root causes of mouth breathing and guides the treatment plan.
ENT
An ENT will rule out any issues within the sinus and nasal cavities. Looking for things such as turbinate or deviated septum. These conditions can block nasal breathing and make it difficult to move air through the nose.
Addressing this issue is crucial to establishing good nasal breathing.
Dentist
Next, the dentist would assess dentition, palate width and height and bite. If the palate is narrow and high, a referral to orthodontist for consideration of palate expander to allow for comfortable space for the tongue to rest.
Part of mouth breathing face is that the palate is too narrow, widening the palate to create a broader width and bring the tongue up can often be an important piece of the plan.
Myofunctional Therapist
The next step would be a myofunctional assessment. Myofunctional therapy is integral and moves hand in hand with orthodontic changes. There is some debate over waiting to start oral motor therapies if the palate is being widened.
I have found that training the muscles and providing myofascial release as the changes are occurring compliments the orthodontic work. The tongue is ready and more easily pops into the palate once the expander is removed.
Surgeon
Taking us to the final step. The oral maxillary surgeon or dentist who performs the surgical release of tethered oral tissues.
The surgical release is not the final step, but the midway step. Once the frenulum is released there is post operative wound care for two weeks. Then continued myofunctional therapy to fully re-educate these muscles where to live and function!
We like this website Tongue Tie Life to help search for a preferred provider near you. Finding a provider who understands tethered oral tissues leads you to providers who understand mouth breathing face.
2. Transitioning to Nasal Breathing
Switching from mouth to nasal breathing is critical for improving facial function and aesthetics. Strategies include:
- Nasal Hygiene: Using saline rinses or nasal strips to clear blockages. This will be guided by the ENT based on their findings.
- Breathing Exercises: Practices like Buteyko breathing can train the body to rely on nasal breathing. The myofunctional therapists will include diaphragmatic nasal breathing exercise into your program.
3. Tethered Oral Tissue Surgical Release
If a tethered oral tissue restricts tongue mobility, Lip mobility or cheek mobility a frenectomy may be recommended. Myofunctional therapy before and after the procedure ensures optimal healing and functional gains. Knowing if there is more than one tether is key. Releasing just a tongue tie will fully improve mouth breathing face if a lip and or cheek tie remains.
4. Consistent Myofunctional Therapy
Consistency is key to retraining oral habits and reversing the effects of mouth breathing face. Therapy includes daily exercises that gradually improve muscle tone, posture, and breathing patterns. Making it part of the daily routine such as when you brush your teeth ensures consistency.
5. Orthodontic or Dental Interventions
In cases of significant skeletal changes, orthodontics or dental appliances may help realign the jaw and teeth for improved function and appearance. This is specifically addressing the bone structure.
The Benefits of Addressing Mouth Breathing Face
The journey to correcting mouth breathing face requires effort and commitment, but the benefits are transformative:
- Improved Aesthetics: Restoring balance to facial features and achieving a more symmetrical appearance
- Better Breathing: Enhanced airway function and reduced risk of snoring and sleep apnea
- Optimal Oral Health: Decreased risk of cavities, gum disease, chapped lips and dry mouth
- Increased Confidence: Many clients report feeling more confident in their smiles and overall appearance
Final Thoughts Mouth Breathing Face
Mouth breathing face is not just an aesthetic issue—it’s a sign of underlying dysfunction that can affect health and quality of life.
For adults with tethered oral tissues, addressing these issues through myofunctional therapy and a multidisciplinary approach can lead to life-changing improvements in both function and appearance.
At Lynn’s Tied Together Hub we have many resources for you to help along your journey.
If you’ve been struggling with mouth breathing or suspect you have TOTs, take the first step toward healing by seeking an evaluation. Your journey to better breathing, better function, and a better you starts today!