| 1. Visual assessment |
| The dentist should assess at least the presence
of the following characteristics: |
| With the patient standing: |
|
| » Lack of lip seal |
( ) YES ( ) NO |
| » Posture changes |
( ) YES ( ) NO |
| » Dark eye circles |
( ) YES ( ) NO |
| » Long face |
( ) YES ( ) NO |
| With the patient sited: |
|
| » Anterior open bite |
( ) YES ( ) NO |
| » High narrow palate |
( ) YES ( ) NO |
| » Gingivitis in maxillary incisors |
( ) YES ( ) NO |
| 2. Questions |
| Questions should be directed to the child or
parents |
|
| Do you: |
|
| » Sleep with your mouth open? |
( ) YES ( ) NO |
| » Keep your mouth open when you are
distracted? |
( ) YES ( ) NO |
| » Snore? |
( ) YES ( ) NO |
| » Drool on your pillow? |
( ) YES ( ) NO |
| » Experience excessive daytime sleepiness? |
( ) YES ( ) NO |
| » Wake up with a headache? |
( ) YES ( ) NO |
| » Get tired easily? |
( ) YES ( ) NO |
| » Often have allergies? |
( ) YES ( ) NO |
| » Often have a stuffy nose and/or runny
nose? |
( ) YES ( ) NO |
| » Have difficulty in school? |
( ) YES ( ) NO |
| » Have difficulty concentrating? |
( ) YES ( ) NO |
| 3. Breathing tests |
| The child must be sitting. At least two tests
should be performed. |
| a. Graded mirror test |
|
| After the second output of air on the mirror,
mark the halo area with a marker (Fig 1). |
| (Low nasal flow: up to 30 mm; Average nasal
flow: 30-60 mm; High nasal flow: above 60 mm) |
| b. Water retention test |
|
| Place water in the patient’s mouth
(approximately 15 ml) and ask him/her to hold it for 3 minutes. |
| c. Lip seal test |
|
| Seal the patient’s mouth completely with a tape
for 3 minutes. |
| 4. Training to eliminate the habit of mouth breathing |
| Training should be performed at home on a daily
basis until the child is able to return to nasal breathing. |
| Lip seal test |
|
| Seal the child’s mouth with masking tape when
he/she is distracted or focusing his/her attention on another activity.
Progressively increase the time each day until the child is able to
breathe only through the nose for, at least, two consecutive hours. |
