Non-Cochrane · aetiology · PM42026531
Dental arch dimension and palatal morphology in children and adolescents with mouth breathing: a systematic review and meta-analysis.
Lekvijittada Kochakorn, Uengkajornkul Phuntin, Changsiripun Chidsanu · BMC oral health · 2026 · PubMed · doi:10.1186/s12903-026-08349-9
Findings
Population Children and adolescents under 18 years with mouth breathing
17 findings
| Mouth breathing (MB) | Nasal breathing (NB) children and adolescents | Palatal width at canine position (Cs/3s) Clinical and school based samples of children, mostly Brazil | SMD -0.39 [-0.85, 0.07] Very low Downgraded: risk of bias, inconsistency 5 studies · 450 participants |
| Mouth breathing (MB) | Nasal breathing (NB) children and adolescents | Posterior crossbite (prevalence) Clinical and school based samples of children, mostly Brazil · Sensitivity analysis excluding low quality studies | OR 3.34 [1.72, 6.50] GRADE not reported 2 studies · 312 participants |
| Mouth breathing (MB) | Nasal breathing (NB) children and adolescents | Lower intercanine width (LICW) Clinical and school based samples of children, mostly Brazil | SMD -0.17 [-0.72, 0.38] Very low Downgraded: risk of bias, inconsistency 4 studies · 452 participants |
| Mouth breathing (MB) | Nasal breathing (NB) children and adolescents | Upper intermolar width (UIMW) Clinical and school based samples of children, mostly Brazil · Sensitivity analysis excluding low quality studies | SMD -0.41 [-0.89, 0.07] GRADE not reported 4 studies · 563 participants |
| Mouth breathing (MB) | Nasal breathing (NB) children and adolescents | Upper intermolar width (UIMW) Clinical and school based samples of children, mostly Brazil | SMD -0.46 [-0.82, -0.09] Very low Downgraded: risk of bias, inconsistency 6 studies · 711 participants |
| Mouth breathing (MB) | Nasal breathing (NB) children and adolescents | Palatal depth at primary second molar or permanent second premolar position (Es/5s) Clinical and school based samples of children, mostly Brazil | SMD 0.61 [0.30, 0.92] Very low Downgraded: risk of bias, inconsistency 5 studies · 450 participants |
| Mouth breathing (MB) | Nasal breathing (NB) children and adolescents | Palatal width at permanent first molar position (U6s) Clinical and school based samples of children, mostly Brazil | SMD -1.34 [-3.05, 0.37] Very low Downgraded: imprecision, inconsistency 2 studies · 119 participants |
| Mouth breathing (MB) | Nasal breathing (NB) children and adolescents | Lower intercanine width (LICW) Clinical and school based samples of children, mostly Brazil · Sensitivity analysis excluding low quality studies | SMD -0.23 [-0.93, 0.46] GRADE not reported 3 studies · 349 participants |
| Mouth breathing (MB) | Nasal breathing (NB) children and adolescents | Palatal width at primary second molar position (Es) Clinical and school based samples of children, mostly Brazil | SMD -0.41 [-1.29, 0.47] Very low Downgraded: risk of bias, imprecision, inconsistency 3 studies · 279 participants |
| Mouth breathing (MB) | Nasal breathing (NB) children and adolescents | Lower intermolar width (LIMW) Clinical and school based samples of children, mostly Brazil | SMD -0.35 [-0.64, -0.07] Very low Downgraded: risk of bias, inconsistency 6 studies · 695 participants |
| Mouth breathing (MB) | Nasal breathing (NB) children and adolescents | Upper intercanine width (UICW) Clinical and school based samples of children, mostly Brazil | SMD -0.40 [-0.73, -0.08] Very low Downgraded: risk of bias, inconsistency 6 studies · 586 participants |
| Mouth breathing (MB) | Nasal breathing (NB) children and adolescents | Palatal depth at canine position (Cs/3s) Clinical and school based samples of children, mostly Brazil | SMD -0.05 [-0.52, 0.41] Very low Downgraded: risk of bias, imprecision 2 studies · 119 participants |
| Mouth breathing (MB) | Nasal breathing (NB) children and adolescents | Lower intermolar width (LIMW) Clinical and school based samples of children, mostly Brazil · Sensitivity analysis excluding low quality studies | SMD -0.30 [-0.69, 0.10] GRADE not reported 4 studies · 547 participants |
| Mouth breathing (MB) | Nasal breathing (NB) children and adolescents | Posterior crossbite (prevalence) Clinical and school based samples of children, mostly Brazil | OR 4.09 [2.24, 7.47] 214 [100, 356] more per 1,000 Very low Downgraded: risk of bias, imprecision 4 studies · 423 participants |
| Mouth breathing (MB) | Nasal breathing (NB) children and adolescents | Palatal depth at permanent first molar position (U6s) Clinical and school based samples of children, mostly Brazil | SMD 0.44 [0.02, 0.86] Very low Downgraded: risk of bias, imprecision 2 studies · 119 participants |
| Mouth breathing (MB) | Nasal breathing (NB) children and adolescents | Upper intercanine width (UICW) Clinical and school based samples of children, mostly Brazil · Sensitivity analysis excluding low quality studies | SMD -0.40 [-1.00, 0.20] GRADE not reported 3 studies · 344 participants |
| Mouth breathing (MB) | Nasal breathing (NB) children and adolescents | Palatal depth at primary first molar or permanent first premolar position (Ds/4s) Clinical and school based samples of children, mostly Brazil | SMD 0.29 [-0.09, 0.67] Very low Downgraded: risk of bias, imprecision 2 studies · 119 participants |
Included primary studies 17
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Aznar 2006 Dental arch diameters and relationships to oral habits. PMID:16637724 | 2006 | this review only | not stated | not extracted yet |
| Balakrishnan 2025 Clinical and Cephalometric Correlation between Mouth-breathing and Nasal-breathing Children. PMID:41050310 | 2025 | this review only | not stated | not extracted yet |
| Berwig 2011 Hard palate dimensions in nasal and mouth breathers from different etiologies. PMID:22231050 | 2011 | this review only | not stated | not extracted yet |
| Bresolin 1983 Mouth breathing in allergic children: its relationship to dentofacial development. PMID:6573147 | 1983 | this review only | not stated | not extracted yet |
| D'Ascanio 2010 Craniofacial growth in children with nasal septum deviation: a cephalometric comparative study. PMID:20696485 | 2010 | this review only | not stated | not extracted yet |
| De Freitas 2001 Evaluation of the palate dimensions of patients with perennial allergic rhinitis. PMID:11572268 | 2001 | this review only | not stated | not extracted yet |
| Harari 2010 The effect of mouth breathing versus nasal breathing on dentofacial and craniofacial development in orthodontic patients. PMID:20824738 | 2010 | this review only | not stated | not extracted yet |
| Kottayi 2025 Comparison of palatal dimension in children with obstructive and habitual mouth breathing. PMID:40159610 | 2025 | this review only | not stated | not extracted yet |
| Linder-Aronson 1974 Effects of adenoidectomy on dentition and nasopharynx. PMID:4523533 | 1972 | this review only | not stated | not extracted yet |
| Lione 2014 Evaluation of maxillary arch dimensions and palatal morphology in mouth-breathing children by using digital dental casts. PMID:24300946 | 2014 | this review only | not stated | not extracted yet |
| Mattar 2012 The effect of adenoidectomy or adenotonsillectomy on occlusal features in mouth-breathing preschoolers. PMID:22583881 | 2012 | this review only | not stated | not extracted yet |
| Moreira 1989 Evaluation of palatal depth and width in mouth breathers with primary dentition. PMID:2599778 | 1989 | this review only | not stated | not extracted yet |
| Oliveira 2012 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Petraccone 2014 Dental arch dimensional changes after adenotonsillectomy in prepubertal children. PMID:24703284 | 2014 | this review only | not stated | not extracted yet |
| Retamoso 2011 Facial and dental alterations according to the breathing pattern. PMID:21552720 | 2011 | this review only | not stated | not extracted yet |
| Rossi 2015 Dentofacial characteristics of oral breathers in different ages: a retrospective case-control study. PMID:26174032 | 2015 | this review only | not stated | not extracted yet |
| Vieira 2012 Influence of adenotonsillectomy on hard palate dimensions. PMID:22621956 | 2012 | this review only | not stated | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Children and adolescents under 18 years with mouth breathing habits | 2,097 individuals aged 2 to 18 years (1,123 mouth breathers, 974 nasal breathers) in 17 studies |
| Intervention | Mouth breathing (exposure) from any cause, including sleep-disordered breathing, OSA, allergies, tonsil and adenoid hypertrophy | Mouth breathing (n=1,123), mostly due to allergic rhinitis, tonsillar hypertrophy, septum deviation or unspecified causes |
| Comparison | Children and adolescents without mouth breathing (nasal breathers) | Nasal breathing controls (n=974) |
| Outcomes | Maxillary and mandibular intercanine and intermolar widths, palatal width and depth (dental casts, intra-oral or 3D); posterior crossbite | UICW (6 studies), LICW (4), UIMW (6), LIMW (6), palatal width at Cs, Es and U6s, palatal depth at Cs, Ds, Es and U6s, posterior crossbite (4 studies) |
| Study designs | Controlled clinical trials, cohort, case-control and cross-sectional studies | 12 cross-sectional studies, 1 cohort, 1 case-control, 3 clinical control trials (baseline data) |
| Timing | Not specified | Not specified |