Dental Caries and Periodontal Outcomes in Mouth-Breathing Children and Adolescents: A Systematic Review

Abstract

Background: Mouth breathing may lead to changes in the oral cavity.

Aim: To compare dental caries and periodontal outcomes in children and adolescents with and without mouth breathing.

Design: This systematic review, registered in PROSPERO (CRD42024536891), included the following: Population: children and adolescents; Exposure: mouth breathing; Comparison: non-mouth breathing; Outcome: dental caries and periodontal/gingival conditions; Study design: observational studies. Electronic searches were conducted in five databases. Risk of bias was appraised using the Newcastle-Ottawa Scale.

Results: Of the 838 records identified, 11 cross-sectional studies were included. The studies showed low bias in exposure, outcomes, and statistical analyses, though few met criteria for non-response and sample size adequacy. Individuals with mouth breathing exhibited increased gingival bleeding, plaque accumulation, and gingival alterations. Associations with dental caries were observed for initial lesions and for ICDAS scores 5 and 6.

Conclusion: Mouth breathing in children and adolescents might be associated with gingival outcomes and plaque accumulation. Regarding dental caries, limited evidence suggests that the association is confined to initial and advanced lesions.

Keywords: dental caries; mouth breathing; oral health; periodontal diseases; respiration disorders.