COM Nasal Breathing & Airway Function 2 — Questions and Answers
Question 1: During orofacial myofunctional assessment, the mirror fogging test (Glatzel mirror) is used to:
- Assess lip seal strength during rest
- Evaluate tongue posture during quiet breathing
- Detect airflow from each nostril during nasal breathing (Correct answer)
- Measure palatal vault height
Correct answer: Detect airflow from each nostril during nasal breathing
The Glatzel mirror is placed under the nostrils and the fogging pattern on the mirror indicates the presence and symmetry of nasal airflow from each nostril.
Question 2: Which craniofacial characteristic is most commonly associated with long-term habitual mouth breathing in children?
- Increased transverse palatal width
- Reduced vertical facial dimension
- Elongated face with narrow upper arch and high palatal vault (Correct answer)
- Class III malocclusion with anterior crossbite
Correct answer: Elongated face with narrow upper arch and high palatal vault
Chronic mouth breathing allows the tongue to rest low, removing palatal pressure, which leads to a narrowed upper arch, high palatal vault, and increased vertical facial growth.
Question 3: An 'obligate mouth breather' in orofacial myofunctional practice is best defined as a patient who:
- Chooses to breathe through the mouth out of habit
- Cannot breathe nasally due to anatomical or structural obstruction (Correct answer)
- Breathes through the mouth only during physical exertion
- Has been conditioned to prefer mouth breathing through environmental factors
Correct answer: Cannot breathe nasally due to anatomical or structural obstruction
An obligate mouth breather has a physical or structural reason—such as enlarged adenoids, nasal polyps, or severe septal deviation—that prevents nasal breathing.
Question 4: Gingival inflammation concentrated along the upper anterior teeth, in the absence of poor plaque control, most commonly suggests:
- Vitamin C deficiency causing gingival fragility
- Habitual mouth breathing causing localized xerostomia (Correct answer)
- Orthodontic bracket irritation from recent appliance placement
- Aggressive brushing trauma
Correct answer: Habitual mouth breathing causing localized xerostomia
Mouth breathing desiccates the anterior gingival tissues, leading to chronic inflammation in the maxillary anterior region even when oral hygiene is adequate.
Question 5: Forward head posture observed during orofacial myofunctional assessment is most strongly associated with:
- Temporomandibular joint dysfunction in isolation
- Habitual mouth breathing and low tongue posture (Correct answer)
- Proper nasal breathing mechanics with strong neck extensors
- Increased nasal airway volume
Correct answer: Habitual mouth breathing and low tongue posture
Mouth breathers often extend the head forward and upward to open the airway, which becomes a habitual postural compensation linked to low tongue rest posture.
Question 6: The 'adenoid face' associated with chronic mouth breathing in children typically includes:
- Wide nasal passages, low palatal vault, and Class I occlusion
- Narrow upper arch, increased anterior vertical dimension, and open mouth posture (Correct answer)
- Prognathic mandible, deep bite, and wide palate
- Flattened midface, Class III malocclusion, and wide nostrils
Correct answer: Narrow upper arch, increased anterior vertical dimension, and open mouth posture
Adenoid face is characterized by a narrow, high-arched palate, long lower face, incompetent lip seal, open bite, and retrognathic or recessed mandible from chronic mouth breathing.
Question 7: When structural nasal obstruction is suspected during orofacial myofunctional evaluation, the most appropriate first step is to:
- Begin nasal breathing exercises immediately to strengthen nasal airway patency
- Recommend nasal strips as the primary intervention
- Refer the patient to an otolaryngologist (ENT) for evaluation and clearance (Correct answer)
- Prescribe nasal saline rinses and reassess in six weeks before any referral
Correct answer: Refer the patient to an otolaryngologist (ENT) for evaluation and clearance
Structural obstructions such as a deviated septum, enlarged adenoids, or nasal polyps must be medically evaluated and addressed before OMT can be effective.
COM Nasal Breathing & Airway Function 2
During orofacial myofunctional assessment, the mirror fogging test (Glatzel mirror) is used to: