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Background <p>Mouth breathing among children represents a prevalent yet frequently overlooked health concern closely associated with various adverse outcomes, including malocclusion, facial dysmorphology, and impaired sleep quality. This study assessed school-aged children’s and families’ awareness of health risks related to mouth breathing, corrective behaviors, and intervention preferences from behavioral and public health perspectives, focusing on revealing the potential disconnect between cognition and behavior.</p> Methods <p>Using a cross-sectional survey with a cluster sampling in a Shanghai elementary school, data from 6-10-year-olds were collected via questionnaire. The questionnaire assessed demographics, behaviors, health, risk awareness, and intervention preferences. Reliability was tested using Cronbach’s α. Descriptive statistics reported prevalence, χ² tests assessed associations with health outcomes, and logistic regression identified risk factors and predictors of corrective behaviors.</p> Results <p>From 124 distributed questionnaires, 117 valid responses were obtained and analyzed, yielding a response rate of 94.35%. The prevalence of mouth breathing was established at 68.38% (95% CI: 59.13%-76.66%). Multivariate analysis revealed that children with poor oral habits had a significantly increased risk of developing mouth breathing. Statistically significant correlations were observed between mouth breathing and malocclusion (χ²=15.43, <i>p</i> &lt; 0.001) as well as sleep snoring (χ²=12.88, <i>p</i> = 0.012). Awareness of associated health risks was moderate (51.29%), yet only 5.98% of participants consistently practiced corrective measures. Female gender and awareness of health hazards significantly predicted engagement in corrective behaviors. Intervention acceptability was notably high (73.5%), with orthodontic intervention and oral muscle training representing the most preferred approaches.</p> Conclusion <p>Mouth breathing is prevalent among Shanghai schoolchildren and linked to malocclusion and sleep problems. Despite moderate risk awareness, uptake of consistent corrective measures is very low, revealing a clear knowledge-behavior gap. Solely stressing health risks may thus be inadequate to change behavior. We suggest early screening, targeted health education, and school-based non-invasive interventions. However, this single-center study with a limited sample yields preliminary findings that require validation through larger, multi-center cohort studies.</p>

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Investigation on mouth breathing behavior of school-age children and analysis of health intervention strategies

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月7日

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  • Wenting Lu,
  • Xiaowei Wu,
  • Shengdan Yu,
  • Lili Hou,
  • Xiaogang Pan

摘要

Background

Mouth breathing among children represents a prevalent yet frequently overlooked health concern closely associated with various adverse outcomes, including malocclusion, facial dysmorphology, and impaired sleep quality. This study assessed school-aged children’s and families’ awareness of health risks related to mouth breathing, corrective behaviors, and intervention preferences from behavioral and public health perspectives, focusing on revealing the potential disconnect between cognition and behavior.

Methods

Using a cross-sectional survey with a cluster sampling in a Shanghai elementary school, data from 6-10-year-olds were collected via questionnaire. The questionnaire assessed demographics, behaviors, health, risk awareness, and intervention preferences. Reliability was tested using Cronbach’s α. Descriptive statistics reported prevalence, χ² tests assessed associations with health outcomes, and logistic regression identified risk factors and predictors of corrective behaviors.

Results

From 124 distributed questionnaires, 117 valid responses were obtained and analyzed, yielding a response rate of 94.35%. The prevalence of mouth breathing was established at 68.38% (95% CI: 59.13%-76.66%). Multivariate analysis revealed that children with poor oral habits had a significantly increased risk of developing mouth breathing. Statistically significant correlations were observed between mouth breathing and malocclusion (χ²=15.43, p < 0.001) as well as sleep snoring (χ²=12.88, p = 0.012). Awareness of associated health risks was moderate (51.29%), yet only 5.98% of participants consistently practiced corrective measures. Female gender and awareness of health hazards significantly predicted engagement in corrective behaviors. Intervention acceptability was notably high (73.5%), with orthodontic intervention and oral muscle training representing the most preferred approaches.

Conclusion

Mouth breathing is prevalent among Shanghai schoolchildren and linked to malocclusion and sleep problems. Despite moderate risk awareness, uptake of consistent corrective measures is very low, revealing a clear knowledge-behavior gap. Solely stressing health risks may thus be inadequate to change behavior. We suggest early screening, targeted health education, and school-based non-invasive interventions. However, this single-center study with a limited sample yields preliminary findings that require validation through larger, multi-center cohort studies.