Distribution of Gingival Inflammation in Mouth breathing patients: An Observational pilot study

  • Post Graduate Institute of Dental Sciences, Rohtak
  • Post Graduate Institute of Dental Sciences.RohtakHaryana India 124001
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Background: Mouth breathing has been reported to affect gingival health in children. However, studies on the effect of mouth breathing in adult patients are scarce. The objective of present cross sectional study was to examine the relationship between mouth breathing and gingival condition and to evaluate the distribution of gingival inflammation in young adult mouth breathing patients. Methods: Study groups comprised of participants with mouth breathing (test group) and nose breathing (control group) patients with gingivitis. Both the groups underwent periodontal examination. PI, GI and BOP % sites were recorded and analyzed statistically for the differences in mean values. Results: Mouth breathing patients showed higher full mouth GI and BOP scores. Upper anterior segment in mouth breathing patients showed highest GI and BOP followed by lower anterior segment, lower posterior and upper posterior region. Conclusion: Within the limits of present study, our findings suggest that relative to control group participants, test group i.e. patients with mouth breathing had higher gingival inflammation and bleeding sites in upper anterior region. Keywords: Mouth breathing; gingivitis; young adult; cross sectional pilot study

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... Mouth breathers inspire and expire through the mouth, as a consequence of reduced patency of the nasal airways. The constant airflow from mouth breathing could dry the teeth and mucosa, especially in the anterior portion of the mouth (Pacheco et al., 2015), leading to chronic gingival inflammation (Sharma et al., 2016), an increased level of Streptococcus mutans (CFU > 10 5 ), and a higher plaque index (PlI), although no significant difference was found in mean buffering capacity of saliva and the salivary flowrate (Mummolo et al., 2018). A higher risk of dental erosion and caries also exist among mouth breathers because of a decrease in intraoral pH compared with normal breathing during sleep (Choi et al., 2016). ...
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Mouth breathing induces a series of diseases, while the influence on microbiota of oral cavity and salivary proteins remains unknown. In this study, for the first time, profiles of oral–nasal–pharyngeal microbiota among mouth-breathing children (MB group, n = 10) were compared with paired nose-breathing children (NB group, n = 10) using 16S ribosomal DNA (rDNA) (V3–V4 region) high-throughput sequencing. The differentially expressed salivary proteins were revealed using label-free quantification (LFQ) method, and their associations with bacterial abundance were measured by canonical correspondence analysis (CCA). The overall bacterial profiles differed between the two groups, and the differences were related to the duration of mouth breathing. The diversity of oral–pharyngeal microbiota was significantly higher, and the nasal–pharyngeal species tended to be consistent (unweighted UniFrac, p = 0.38) in the MB group. Opportunistic pathogens were higher in relative abundance as follows: Acinetobacter in the anterior supragingival plaque, Neisseria in unstimulated saliva, Streptococcus pneumoniae in the pharynx, and Stenotrophomonas in the nostrils. The expression level of oxidative-stress-related salivary proteins (lactoylglutathione lyase and peroxiredoxin-5) were upregulated, while immune-related proteins (integrin alpha-M and proteasome subunit alpha type-1) were downregulated in MB group. The differentially expressed proteins were associated with specific bacteria, indicating their potentials as candidate biomarkers for the diagnosis, putatively early intervention, and therapeutic target of mouth breathing. This study showed that mouth breathing influences the oral–nasal–pharyngeal microbiota and enriches certain pathogens, accompanied with the alterations in the salivary environment. Further research on the pathological mechanisms and dynamic changes in longitudinal studies are warranted.
... 10 Mouth breathing has also been reported to play a role in gingival inflammation. [11][12][13][14] Hydration status has been found to affect wound healing in animal studies. Fast healing response is observed in skin wounds under moist conditions. ...
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Introduction Dryness is known to be associated with inflammatory diseases such as dry eye disease and atopic dermatitis. There is significant water loss from the oral cavity during mouth breathing. This study is conducted to estimate the influence of mouth breathing on the outcome of scaling and root planing (SRP) in chronic periodontitis (CP). Materials and methods CP patients comprising of 33 mouth breathers (MBs) and 33 nose breathers (NBs) were recruited. Thirty patients in each group completed the study. At baseline, plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL) were measured. SRP was done in both groups. At the 4th, 8th, and 12th week, PI, GI, and BOP were recorded. PD and CAL were also assessed at the 12th week. Results At the 12th week, there was significantly less improvement in GI at palatal sites of maxillary anterior and maxillary posterior teeth in MB group. Sixty-nine percent of BOP positive sites with PD >4 mm were converted into BOP negative sites with PD ≤4 mm in maxillary posterior palatal sites in NB. This success was 38% in MB. Conclusion Control of periodontal inflammation by SRP in CP patients is affected at palatal sites of mouth breathers.
Non extraction therapy is NOT a treatment goal. It is merely a means of effectuating a treatment goal. The same mindset applies to extraction therapy – it is a means to an end. The first diagnostic consideration in contemporary orthodontic therapy should be to decide where one wants to place the teeth. This answer is based on a host of considerations that are driven by patient preferences, professional experience and expertise, and evidence based data relating to the clinical issues at hand. Treatment considerations follow and they too are based on a number of factors such as anatomical, physiological, and functional limitations, patient cooperation, and biomechanical expertise to name a few. In the end, the decision to extract teeth or not should support the five goals that provide support for the bases behind professional orthodontic intervention: 1) the creation of a harmonious balance in the alignment of the dentition, 2) maximizing occlusal contacts, 3) enhancing dentofacial esthetics, 4) creating a functional occlusion, and 5) achieving a relatively physiologic stable result.
We investigated the outcome of conventional periodontal treatment in mouth breathing patients with chronic periodontitis, and compared the efficacy of applying salivary substitute to the anterior sextants as an adjunct to conventional treatment in such patients. In this randomized, investigator-blind, clinical study involving parallel groups, 40 mouth breathing patients were divided into two groups: a control group (CG, n = 20) comprising patients who received scaling and root planing (SRP), and a test group (TG, n = 20) who received salivary substitute as an adjunct to SRP for treatment of chronic periodontitis. The patients were followed up at various time intervals, and improvement of the gingival index (GI) was examined as the primary outcome. Student's t-test, repeated-measures ANOVA and Mann-Whitney U test were applied for statistical analysis. Although periodontal parameters were improved in both groups after 8 weeks of follow-up, the test group showed better improvement in terms of GI and percentage bleeding on probing. Within the limits of this study, our results suggest that the use of salivary substitute has a beneficial adjunctive effect for improvement of periodontal parameters in mouth breathing patients with chronic periodontitis. (J Oral Sci 57, 241-247, 2015).