INTRODUCTION: Mouth breathing (MB) is an etiological factor for sleep-disordered breathing (SDB) during childhood. The habit of breathing through the mouth may be perpetuated even after airway clearance. Both habit and obstruction may cause facial muscle imbalance and craniofacial changes. OBJECTIVE: The aim of this paper is to propose and test guidelines for clinical recognition of MB and some predisposing factors for SDB in children. METHODS: Semi-structured interviews were conducted with 110 orthodontists regarding their procedures for clinical evaluation of MB and their knowledge about SDB during childhood. Thereafter, based on their answers, guidelines were developed and tested in 687 children aged between 6 and 12 years old and attending elementary schools. RESULTS: There was no standardization for clinical recognition of MB among orthodontists. The most common procedures performed were inefficient to recognize differences between MB by habit or obstruction. CONCLUSIONS: The guidelines proposed herein facilitate clinical recognition of MB, help clinicians to differentiate between habit and obstruction, suggest the most appropriate treatment for each case, and avoid maintenance of mouth breathing patterns during adulthood.

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The objective of this study to evaluate the effect of universal adhesives application time to enamel through shear bond strength (SBS), adhesive remnant index (ARI), and morphological enamel integrity. Bovine incisors were divided into four groups according to bonding system protocol (n=20): (1) conventional etch-and-rise adhesive – Transbond XT Primer (P-XT); (2) one-step self-etching adhesive –­ Transbond Self Etching Primer (T-SEP); (3) one universal adhesive – Single Bond Universal, which were rubbed for 20s (SBU-20) or (4) 40s (SBU-40). Transbond XT composite was used to bond the brackets to enamel. SBS was evaluated in a universal test machine at 0.5mm/minute. ARI was determined under x12.5 magnification and enamel damage was evaluated through scanning electron microscope (SEM) after debonding (n=10). SBS data were compared using one-way ANOVA and Tukey’s test. The Kruskal–Wallis test was used to compare the ARI scores (α =0.05). The P-XT and T-SEP groups showed significantly higher bond strength than SBU-20 and SBU-40 (p<0.05). The ARI was similar for all groups (p>0.05). SEM showed enamel damage only in T-SEP and P-XT groups. Conventional ‘etch and rinse’ and ‘self-etch’ adhesives had the highest shear bond strength, but they were associated with more enamel damage compared to universal adhesives. The application of universal adhesives with the time recommended by the manufacturer — ensure satisfactory bond strength and enamel integrity.