Archived blog: The mouth breathing problem part II - tongue position

The mouth breathing problem part II: Tongue position

Correct tongue position plays an important role in how we breathe. It also influences the growth and development of facial structures, chewing, swallowing, speaking, and posture. It is a truly remarkable organ that we can manipulate to our advantage.

The natural position for our tongue when our mouth is closed is for the tip of the tongue to touch the hard palate (the roof of the mouth) behind the teeth (say the letter ‘N’). The remainder of the tongue rests against the roof of the mouth. In addition, our lips should be closed and teeth slightly apart. This has numerous health benefits.

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Unfortunately, when we mouth breathe, our natural tongue position is compromised. To understand the impact that it has, we need to appreciate the benefits that we gain from good tongue posture.

The obvious benefit of the tongue resting on the roof of the mouth is that it promotes nasal breathing—the key to good functional breathing. When we breathe through the nose, we get all the benefits of nasal breathing, such as regulation of carbon dioxide levels, production of nitric oxide, warming of inhaled air, filtering of bacteria, and neutralising of viruses. But it is possible to breathe through the nose with the tongue in the wrong position, which will have a negative impact.

Properly positioned, the muscles of the tongue and mouth support the pharynx (throat), maximising the volume of the airways. A supported throat also makes it easier and safer to swallow. When tongue position is low, the muscles of the throat relax and the airway is compromised. The base of the tongue will release back and down, which will further restrict our airway. This is most noticeable when we sleep and can manifest as heavy breathing, snoring, and in some cases, sleep apnea. This is a serious condition and potentially life-threatening.

In children and teenagers, correct tongue position encourages healthy growth and development of the jaws and face. Specifically, it supports horizontal growth of the jaws and nasal cavity, creating an expanded airway that favours nasal breathing. If the tongue position is poor, growth of the face tends to be vertical, resulting in a narrower face and potentially compromising the airways. The outcome is a vicious cycle of mouthbreathing, causing a compromised nasal passage leading to more mouthbreathing. But tongue position doesn’t only impact our airways.

The hyoid bone, located in the neck, is unique as it is the only bone in the body that does not articulate with (directly connect to) another bone. It is a critical anchor connected to muscles of the tongue and cervical spine (neck bones), helping to stabilise the head and neck. When the tongue is well-positioned, the hyoid bone sits high and forward. This supports the tongue, keeps the throat lifted, and the head back. This prevents food from entering the airways when swallowing and helps keep the airways open. If the tongue sits low in the mouth, the hyoid bone drops. This can affect swallowing, increase the risk of choking, and reduce the volume of the airways. A low hyoid bone can also lead to a forward head posture, leading to neck and shoulder pain.

How we breathe is a learned behaviour. It can be influenced by many factors, including diet, allergens, poor sleep, and stress. Even bottle feeding can have an impact (accepting that there are many reasons why it is necessary). If we breathe with our mouth open, over time, that will become our normal state. Unfortunately, this prevents our tongue from being in the optimal position. The good thing is that we can learn new behaviours that can reset our default positioning of the tongue. Simply closing your mouth and resting the tongue against the hard palate can begin to eliminate the negative impact of breathing through an open mouth.

Even adults can benefit from taking those simple steps. If the issue is severe, myofascial physiotherapy can help retrain the muscles to build new, healthy habits. Anyone getting orthodontic treatment should have this therapy to prevent relapses of a crowded jaw and poor tongue position. With time, it is possible to create a healthy tongue position that will transfer to when we sleep. So, close your mouth to breathe and take a moment to check the position of your tongue.