Choi · Journal of oral rehabilitation 2016 · randomized crossover trial · n=10

Intraoral pH and temperature during sleep with and without mouth breathing.

Cited 48 times in the scientific literature.

Level 2 - randomized trial

Randomized crossover experimental trial in healthy human volunteers

PubMed 26666708 · doi:10.1111/joor.12372 · record verified 2026-08-28

What was done

Ten healthy participants (mean age 25.8 ± 4.3 years) wore a custom-made oral appliance equipped with a pH probe and thermocouple across two 48-hour periods. Continuous pH and temperature measurements were recorded from the palatal aspect of the upper central incisors. To simulate mouth breathing during sleep, participants wore a nose clip for two of the four nights, with sequence balanced across two groups (n = 5 each).

What was found

Mean daytime intraoral pH was 7.3 ± 0.4 and dropped to 7.0 ± 0.5 during normal sleep. During sleep with forced mouth breathing, mean intraoral pH decreased significantly to 6.6 ± 0.5 (P < 0.01), showing a greater and more prolonged fall across the hours of sleep. Mean intraoral temperature was 33.1 ± 5.2 °C during daytime and 33.3 ± 6.1 °C during sleep, with no statistically significant difference between sleep with and without mouth breathing (P > 0.05).

Why it matters

Continuous in vivo monitoring confirms that nocturnal mouth breathing substantially acidifies the oral environment, providing a direct physiological mechanism for the increased risk of dental erosion and caries reported in mouth breathers.

Limits

The study had a very small sample size (n = 10) of young, healthy participants. Nose clips used to force mouth breathing may not fully mirror habitual or pathological mouth breathing, and clinical endpoints like enamel demineralization or caries incidence were not measured.

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