Abstract
As mouth breathing is associated with asthma and otitis media, it may be associated with other diseases. Therefore, this population-based cross-sectional study evaluated the association of mouth breathing with the prevalences of various diseases in children. Preschool children older than 2 years were included. A questionnaire was given to parents/guardians at 13 nurseries in Tokushima City. There were 468 valid responses (45.2%). We defined a subject as a mouth breather in daytime (MBD) if they had 2 or more positive items among the 3 following items: “breathes with mouth ordinarily,” “mouth is open ordinarily,” and “mouth is open when chewing.” We defined subjects as mouth breathers during sleep (MBS) if they had 2 or more positive items among the following 3 items: “snoring,” “mouth is open during sleeping,” and “mouth is dry when your child gets up.” The prevalences of MBD and MBS were 35.5% and 45.9%, respectively. There were significant associations between MBD and atopic dermatitis (odds ratio [OR]: 2.4, 95% confidence interval [CI]: 1.4–4.2), MBS and atopic dermatitis (OR: 2.4, 95% CI: 1.3–4.2), and MBD and asthma (OR: 2.2, 95% CI: 1.2–4.0). After adjusting for history of asthma and allergic rhinitis; family history of atopic dermatitis, asthma, and allergic rhinitis; and nasal congestion; both MBD (OR: 2.6, 95% CI: 1.3–5.4) and MBS (OR: 4.1, 95% CI: 1.8–9.2) were significantly associated with atopic dermatitis. In preschool children older than 2 years, both MBD and MBS may be associated with the onset or development of atopic dermatitis.
Highlights
The prevalence of mouth breathing among children remains controversial but is at most reported to be 50–56% [1,2,3,4,5,6,7,8]
The subjects were divided into 3 groups according to the main diseases reported: atopic dermatitis, asthma, and allergic rhinitis
Children with atopic dermatitis were significantly associated with a history of asthma and/or allergic rhinitis
Summary
The prevalence of mouth breathing among children remains controversial but is at most reported to be 50–56% [1,2,3,4,5,6,7,8]. The functions of the nasal cavity are air-conditioning, olfaction, and defense [11], but mouth breathing causes environmental air to bypass these nasal functions, allowing air to directly enter the lower respiratory tract, which can cause airway hyperreactivity and chronic bronchial inflammation [12,13,14]. Two case–control studies showed that children suffering from asthma exhibit more mouth breathing behaviors than controls [15, 16]. A cohort study revealed that the risk of otitis media with effusion is 2.4 times higher in mouth breathers than nose breathers [17]
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