Association between Mouth Breathing and Atopic Dermatitis in Japanese Children 2–6 years Old: A Population-Based Cross-Sectional Study

Abstract

As mouth breathing is associated with asthma and otitis media, it may be associated with other diseases. Therefore, this population-based cross-sectional study evaluated the association of mouth breathing with the prevalences of various diseases in children. Preschool children older than 2 years were included. A questionnaire was given to parents/guardians at 13 nurseries in Tokushima City. There were 468 valid responses (45.2%). We defined a subject as a mouth breather in daytime (MBD) if they had 2 or more positive items among the 3 following items: “breathes with mouth ordinarily,” “mouth is open ordinarily,” and “mouth is open when chewing.” We defined subjects as mouth breathers during sleep (MBS) if they had 2 or more positive items among the following 3 items: “snoring,” “mouth is open during sleeping,” and “mouth is dry when your child gets up.” The prevalences of MBD and MBS were 35.5% and 45.9%, respectively. There were significant associations between MBD and atopic dermatitis (odds ratio [OR]: 2.4, 95% confidence interval [CI]: 1.4–4.2), MBS and atopic dermatitis (OR: 2.4, 95% CI: 1.3–4.2), and MBD and asthma (OR: 2.2, 95% CI: 1.2–4.0). After adjusting for history of asthma and allergic rhinitis; family history of atopic dermatitis, asthma, and allergic rhinitis; and nasal congestion; both MBD (OR: 2.6, 95% CI: 1.3–5.4) and MBS (OR: 4.1, 95% CI: 1.8–9.2) were significantly associated with atopic dermatitis. In preschool children older than 2 years, both MBD and MBS may be associated with the onset or development of atopic dermatitis.

Oral Aspects Identified in Atopic Dermatitis Patients: A Literature Review

“…In relation to the severity criteria of AD, 2 studies [ 22 , 27 ] used SCORAD as the criterion for severity of AD, while 2 other studies [ 21 , 28 ] used EASI (Eczema Area and Severity Index) [ 3 ]. The other 2 studies [ 29 , 30 ] did not assess the severity of AD. Yamaguchi et al .…”

“…Yamaguchi et al . [ 29 ] used the mouth breathing criterion from a questionnaire carried out with pre-school children. In this case, atopic dermatitis was evaluated in conjunction with other conditions, such as asthma and allergic rhinitis, among others which were found using the questionnaire.…”

“…Yamaguchi et al [ 29 ] used a questionnaire to evaluate the relationship between mouth breathing and atopic dermatitis, in which the subjects were divided into three groups: patients with AD, asthma and allergic rhinitis. The results showed there were associations between AD and mouth breathing during the day and during sleep.…”

“…Yamaguchi et al . [ 29 ] conducted a study with children (2-6 years old) to verify the association between mouth breathing and atopic dermatitis. These authors used 1036 questionnaires and received 468 replies that indicated that atopic dermatitis was related to mouth breathing in the day and at night [ 26 ].…”

Molar-incisor enamel hypomineralization cross-sectional prevalence evaluation in oral-breathing allergic children

“…[18][19][20]22,25,27,38 Our results confirm the extensive list of local and systemic impairments associated with improper breathing pattern. 27,39,40 Age was also described as a negative modifying factor of MIH prevalence, being statistically significant (p=0.00594).…”