All young children drool to some degree, but it is rare for a child to drool after 18 months of age. Many causes of mouth breathing are temporary, such as the common cold, the flu or simply nasal congestion. If your child has chronic mouth breathing, he should be evaluated by a ear, nose and throat physician. Other symptoms found in toddlers with open-mouth breathing can include agitated sleep, blocked nose, daytime irritability, nasal itchiness and snoring.
Allergic Rhinitis
Allergic rhinitis is a hypersensitivity reaction common in children. Allergies may be seasonal or occur year round due to a variety of airborne irritants such as pollens, molds, animal danders, dust mites and molds. Common symptoms of allergic rhinitis include a runny and itchy nose. In addition, children may sneeze excessively, have headaches or excessively sniff and snort. Allergic rhinitis is the most common cause of open-mouth breathing and drooling in young children.
Adenoids and Tonsils
The adenoids and tonsils are a collection of tissue in the back wall of the nasal cavity and in the throat. The adenoids are lymphoid tissues; their function is to respond to infectious material. In children, the adenoids may become excessively enlarged. This may occur suddenly, in response to a single infection, or it may be a chronic response to multiple serial infections. When the adenoids obstruct the respiratory tract, they can block the passage of air from the nose to the lower respiratory tract. When this happens, a child may have mouth breathing, drooling, bad breath and sore throat. She may also expel foul tasting, cheese-like lumps from her mouth. If the infection does not respond to antibiotics, the child might need surgery to remove the adenoids.
Deviated Nasal Septum
The nose is basically a single space split in the middle by the nasal septum. A perfectly midline septum is very rare; all people have a slight deviation of the septum to one side or the other. In some individuals, however, this deviation occurs excessively to one side, and a deviated nasal septum can block the passage of air through the nose. As a result, children with this condition may be forced to breathe through their mouths and may also have drooling. Other symptoms of a deviated nasal septum include noisy breathing, snoring and possibly a runny nose.
Other Causes
A variety of other causes can lead to drooling and open mouth breathing. They are due to more serious conditions, but they are rare. Neurologic causes such as cerebral palsy and congenital supra bulbar palsy can cause this condition. Excessive thumb sucking or pacifier sucking can cause a backward-positioned jaw, leading to mouth breathing. Nasal polyps can also cause obstruction of the nose, leading to mouth breathing as well.
References
- Pediatric Otolaryngology: Nasal Obstruction
- "Grand Rounds Presentation, UTMB, Dept. of Otolaryngology"; Drooling; Sarah Rodriguez, M.D.; January 2003
- "Jornal de Pediatria"; Etiology Clinical Manifestations and Concurrent Findings in Mouth-Breathing Children; R. R. Abreu, et al.; Nov-Dec 2008
- Mouth Breathing; Dr. Sarkissan, D.D.S.
