Knowledge is everything.
The way I wear a mask and what it causes me to do with my nose, my mouth, and my fingers is a complete 180-degree reversal from what masks cause others to do habitually.
I believe it’s because my brain is inundated with knowledge: I understand the harms of mouth breathing and the risks touching my face, and I appreciate the glorious benefits of the hairs in my nose.
And if you think education won’t work for kids, think again, at least if we’re talking a little bit older kids.
My daughter Leah is 12 and a very observant little person.
For the last two years, she’s been having orthotropics treatments, which is a little bit like orthodontics, but with the goal of the face growing around the appliance instead of braces just pulling the teeth around.
One of the major problems orthotropics addresses is a high palate and gummy smile caused by mouth breathing.
Leah watched one boring introductory video two years ago at orthotropics and saw some before-and-after pictures of people with gummy smiles and receding chins and how orthotropics helped them.
Immediately she began saying things like this when we were out in public.
Whispered: “Mom. That kid is mouth breathing so badly.”
“Mom, look at that billboard. The doctor in the picture has such a gummy smile.”
“Mom, John’s not breathing through his nose while he’s reading.”
The entire world suddenly had a filter of open mouths and gummy smiles for her. She started seeing everything through the lens of her new knowledge.
This is powerful.
You don’t need to tell kids to change their habits. You need to educate them first so that they begin to notice things in their world and in themselves — and then their habits will change.
The collective knowledge we have as a society based on research and anecdotes is ever-changing when it comes to both the COVID-19 virus and regular mask-wearing. What we do know, however, is that there are some risks to the mask-wearer.
In today’s post, we will cover some risks that you can be completely in control of by changing your habits, and in the last post of this series, I feel the need to go into some dangers of mask-wearing that really can’t be helped as long as one has to wear a mask all day.
Masks Are Causing Dehydration for Some
Anecdotally, I’ve heard a few people say that they are having trouble remembering to drink as much water when they have a mask over their mouth.
Dehydration may be a risk of regular mask-wearing.
Science Behind the Mask Risk
It just makes sense that if you are used to sipping on water all day, the physical barrier of the mask will create just enough of a roadblock to your sipping that you will naturally drink less water.
We also know that because it’s slightly more difficult to draw a breath through a mask, people are tending toward breathing through their mouths. This can cause “dry mouth” and dehydration, and we will get more into mouth breathing in a bit.1
Create a Healthy Mask Habit
This one is easy enough to fix, folks:
If you don’t already have a water-drinking habit or a goal of enough liquid every day, now is the time to start!
Figure out how you can intentionally drink more liquids. (Caffeine doesn’t count!)
If you need to fill multiple water bottles or glasses at the beginning of the day so that you have a benchmark for quantity, do it.
Some people fill a whole gallon jug and make sure they drink it during the day.
If you tend to drink a lot of coffee or other caffeinated beverages, I just heard a neuroscientist on a podcast say that the optimal way for caffeine to help you stay alert and focused is a 4:1 ratio, water to coffee. That means four cups of water for every cup of coffee. You can hear more in this Broken Brain podcast with Dr. Andrew Huberman.
So this one’s on us — make a special effort to ensure that you are staying hydrated so that your body is at your best. This of course gives your immune system its best chance of being in tip-top shape, which we all want right now.
Just remember, when you take those sips or gulps or guzzles, only remove your mask with the ear loops, no pulling it down by the middle and bringing more germs to your face! (We’ve already talked about safe mask-wearing habits to keep you less at risk. Remember?)
Wearing Masks May Be Killing Your Posture
I’m a highly sensitive person, which means that when I wear a heavy overcoat or something that’s scratchy on my neck, after a couple of hours, I begin to get a stiff neck and even a headache.
Does it seem crazy that just wearing a coat can cause a headache? It’s my life.
And it’s happening with masks, too.
Science Behind the Mask Risk
I loved this news interview with functional nutritionist Shelley Gawith on “mask mouth” and some of the risks of wearing masks all day.
She talked about how when people are wearing masks, we are tending to tighten our shoulders, clench our jaws, and even begin to hunch over, and this may be permanently (or at least consistently) changing our posture.
Not only could this cause you a headache, as my wool winter overcoat does for me, but posture is important for so many day-to-day and long-term health optimizations.
I’ve listened to Dr. Ryan Wohlfert emphasize posture many times, citing not only pain in the joints, but brain health, longevity, and even Alzheimer’s Disease on the list of risks of bad posture.
Our posture as a society of desk-sitters isn’t great to begin with, so anything that’s going to make it worse needs to be red-flagged. What can we do?
Create a Healthy Mask Habit
This one is a little more tricky than just remembering to hydrate because some of these posture reactions to masks are involuntary. However, education can help you be more aware and make some changes.
First, try to think about your posture.
If you catch yourself with tight shoulders or hunching forward, especially if you work at a computer all day, begin to draw your awareness to that. Like my daughter with the open-mouth breathing, you can train your brain to believe that when your spine isn’t all stacked up straight and tall, that’s bad for you.
And then when you notice it, it will matter more and help you change your behavior.
Second, once you are aware, you can make a conscious effort to improve your posture. Try these simple strategies:
- Every 30 minutes or so, take a posture stretching break to pull your shoulders back, stretch out your neck side to side with slow 10-count stretches, and raise your arms to the sky and stretch backward. This isn’t a quick neck-popping, half-second stretch in all directions, but a good heart-opening, spine-extending, well-held stretch.
- Take a mask break. Shelley recommends that at least every hour or so you go into a room by yourself and take that mask off. This is another time where you should be stretching out your shoulders at the same time. Focus on your breathing, reducing any feelings of anxiety, as we’ll talk about later in this post, and pay attention to relaxing those shoulders.
Some great resources for posture include Margie Bissinger, Katy Bowman, and Dr. Krista Burns, who did a wonderful TED talk on digital dementia and posture.
Poor posture is an incredibly hard bad habit to break!
I know this because I have both adults and children in my house with bad posture. But get this: after I did that interview with Margie Bissinger, I taught my family to “wake up their shoulders.”
We did it just a few times before dinner. And still, a full year later, my 5-year-old kindergartner will sometimes call out at the beginning of a meal, “Everybody wake up your shoulders!”
He has excellent posture, as most young children do before we let the bad habits set in.
He’s also a great example of how just a little education and building a tiny habit can help even the youngest of children.
These kids are capable! Proper posture is a great conversation to have at the dinner table and something that will affect kids their entire lives — for good, or otherwise.
Do Masks Make You Touch Your Face More?
As I’ve discussed before, one of my big concerns with masks is that they seem to be causing most people to touch their faces more.
We mustn’t rely on masks to make us feel comfortable and “safe.”
According to the Canadian Centre for Occupational Health and Safety, of the three habits recommended most often to prevent the spread of the novel Coronavirus, handwashing is the most effective line of defense.2
Their website lists a number of other practices to slow the spread of infections, with mask-wearing coming in last.3 The public health officials in Canada agree.4
So could following the least effective practice (mask-wearing) be ultimately harmful if it causes us to neglect a more effective practice (avoiding touching our faces)?
How to Wear a Face Mask Correctly with Mask C.O.D.E.
Use this memory tool to teach kids (and adults!) how to wear a mask safely and correctly.
Would you like a printable version of the Mask C.O.D.E. to post as a reminder in your home, business, classroom or church along with hacks to keep the masks clean and more?
Read all the safe mask wearing posts:
Science Behind the Mask Risk
This one comes down to simple germ theory.
Our hands are touching more objects than any other part of our body.
If we touch a bacteria or virus, and then our face, our hands are simply the delivery system. If those masks are causing us to touch our faces more, the mask becomes the delivery system.
Create a Healthy Mask Habit
Because I’m so aware of the importance of not touching my face, certain situations remind me to be hyper-vigilant.
I touch my face all the time when I’m at home, definitely more than the average of 23 times per hour, partially because I’ve had an autoimmune disease for the last six months that is causing my face to flake and itch like crazy.
(What timing, right? Just when I’m supposed to touch my face less, it’s calling me to touch it more.)
However, no matter how itchy my face is, when I’m in a grocery store during corona-times, I’m hyper-aware.
I never touch my face, mask, or no mask.
When I’m wearing a mask, it also creates a sense of hyper-vigilance in me. I absolutely keep my fingers away from my eyes, nose, mouth, cheeks, chin, and mask. I always use the ear loops only to adjust.
This was not a hard habit for me to adopt, because I had such an influx of education and information.
I knew the risks of bringing germs to my face.
I think this one is a lot harder for kids but still possible with consistent conversation.
Bottom line, if your mask is causing you to touch your face more than usual, it has the potential to cause more harm than good, both to yourself and to the rest of society, since the whole point is that we’re supposed to stop the spread of this virus.
Face Masks Cause Mouth Breathing
Because it’s harder to draw a breath through fabric or plastic masks than unimpeded air, doctors and scientists are finding that people switch to mouth breathing when wearing masks.
Our bodies are designed for us to breathe through our noses. And for most people, that’s the default.
For people like my boys with dust allergies and others with an ill-formed palate or any sort of congestion, it’s very easy, unfortunately, to adopt the habit of breathing through one’s mouth. And there are so many risks to this!
Science Behind the Mask Risk
You can read my post on why we are taping our kids’ mouths shut at night for some more of the science behind mouth breathing causing health issues.
Some of the long-term health effects of mouth breathing include:
- Malformation of the face, jaw, and airway
- Less restorative sleep which leads to a host of further issues
- A study showed that 50% of children with ADHD were mouth breathers, perhaps there’s a connection
- Low levels of HCG in children
- Gingivitis, bad breath, and cavities
- Chronic snoring which we know isn’t healthy
There are short-term effects as well, and dentists are seeing them more than ever now that people are regularly wearing masks.
“Mask mouth” was coined to describe the increase in cavities dentists are seeing. Why would wearing a covering over your face cause more cavities? If people switch from the proper nasal breathing to mouth breathing, the mouth gets more dried out.
Our healthy oral bacteria that keep cavities at bay need moisture to thrive. In a dry mouth, the oral microbiome balance is thrown off. Our healthy bacteria are less able to thrive and fight off the unhealthy bacteria that cause cavities. So masks may cause people to breathe through their mouths and mouth breathing may cause cavities.
Here’s a bit more from Trina Felber, CEO Primal Life Organics, RN, BSN, MSN, CRNA:
“The term ‘mask mouth’ is being used to describe what is happening inside the mouth because of the increased time spent breathing though the mask. Symptoms of mask mouth include bad breath, tooth decay and gum inflammation that is happening to people who previously did not suffer from these issues. All of these can lead to internal health issues including heart disease, digestive disorders and diabetes.
As we are wearing the mask, instead of breathing thought the nose, people begin breathing through their mouth which lacks humidity. This causes dry mouth, less saliva and increases bacterial growth.”
According to dentist Dr. Marc Sclafani, “People tend to breathe through their mouth instead of through their nose while wearing a mask, [and] the mouth breathing is causing the dry mouth, which leads to a decrease in saliva — and saliva is what fights the bacteria and cleanses your teeth.”
These child-sized organic masks from Etsy are what we bought for some of the kids, and Gabe loves the fit.
Mouth breathing also may have a negative effect on your body’s ability to keep out and fight viruses and bacteria. Ironic again.
Because humans were created to breathe through their noses, we have helpful little hairs to filter out the environmental pollutants, bacteria, viruses, and mold spores that are flying through the air at any given time. Our nose is our first line of defense against fighting toxins and illnesses.
The mouth, luckily, is not full of tiny hairs. That means it’s not a good way for air to get into your body!
When you start mouth breathing, you circumvent your first line of defense against illness and disease.
Create a Healthy Mask Habit
I just learned at age 39 that I also have a dust allergy like my kids. And as I learned about mouth breathing through orthotropics, I realized that I, in fact, do mouth breathe, sometimes during the day and often at night. (Sigh.)
All of this knowledge means that when I put on a mask, I am the best nose breather in the Midwest! It reminds me to adopt a better habit than I have in my normal life.
Unfortunately, people who don’t have all this education default to what’s easier — breathing through their mouths. That means they’re opening themselves up to potential cavities, an unbalanced microbiome, and a less strong line of defense for the immune system.
Mouth breathing is a big deal, and if your mask is causing you to let those lips hang open, time to seal them up.
May education be your inspiration!
Trina Felber recommends: “Frequent and increased hydration is extremely important, as well as brushing your teeth twice a day with a clay based toothpowder to detox the entire mouth. Skip mouthwash, gum and mints which will make the situation worse. I suggest the Dental Detox Kit by Primal Life Organics which has all of your essential mouth needs to prevent mask mouth.”
Are Masks Causing an Increase in Anxiety?
I asked friends and colleagues in my online community if they had experienced any negative effects from wearing masks.
Some, including teachers and hairdressers wearing masks all day, reported no problems at all.
Others said their kids had adapted easily, and they were seeing no ill effects. Of this I am glad!
Unfortunately, others had a different story.
We’ll get into some of their stories in the next post. But I will say that a handful of friends experience an increase in anxiety, some mild, some extreme, when they put on the masks.
In the case of Marcie P., a childhood trauma resurfaces when she wears a mask. She was abused, and her abuser would cover her mouth so that she couldn’t scream. Putting something over her face brings all of that rushing back. And I do believe that there’s really nothing she can do.
This person should be allowed to be exempt from wearing a mask.
For the rest of us who don’t have that kind of childhood trauma, there still may be a good reason why masks cause an increase in anxiety.
Science Behind the Mask Risk
Science has shown us that the way we breathe affects our heart rate, and our heart rate determines how our brain assesses the risks in the world. When our heart rate goes up, our brain goes into fight or flight mode.
Our heart rate increases when our rate of respiration increases. And how are people in general breathing with a mask on?
Perhaps this is the reason why Crystal C. feels a definite “spike in anxiety” after 20 minutes with a mask on, although she attributes it to claustrophobia.
Although there may be other reasons for a mild feeling of panic or anxiety with the masks, I do believe that this knowledge of breath could be a game-changer for those experiencing this symptom.
Create a Healthy Mask Habit
As we’ve already discussed, because it’s harder to draw a breath through a face covering than with unimpeded air, some people compensate by opening their mouths. Others may be compensating by extending the inhalation of breath and quickening the exhalation.
The science of breaths teaches us that the inhale initiates the sympathetic nervous system — that’s our stress response.
Our exhale initiates the parasympathetic nervous system, or the “rest and digest”.
If you’re feeling stressed out, experts recommend extending the length of your exhale. This will more quickly initiate your parasympathetic nervous system, get you out of fight or flight, and help your body respond to stressful situations with less physical stress.
Many mask-wearers are doing the exact opposite. They’re breathing harder, and therefore longer, on the inhale, and then executing a fairly quick exhale so that they can get to their next inhale. This may be the easy way out, but it’s causing an increase in heart rate. And you’re spending more time in fight or flight.
That unexplained feeling of anxiety or panic may be less because you hate the idea of everyone wearing masks (like me) and more because you’re allowing your breathing to be automatic and get away from you. It’s time to take control back!
If you can focus on your breathing and make sure that you’re taking measured breaths with an appropriate length of inhale and an equal length or slightly longer exhale, you can get your heart rate and your brain back in your control. You’re no longer running from the metaphorical tiger. 🙂
You can learn more about breath and its effect on stress in this introduction to stress mastery Healthy Parenting Connector episode, where I explain the basics of my training as a certified stress mastery educator. You can also learn more about breath, anxiety, and the specific effect of masks in this NPR episode.
My friend Sarah shared:
“I have anxiety and asthma and have practiced meditation for a while, and really started to pay attention to my breathing. I think it has helped tremendously in preparation to wear masks for most of my workday and also learn to speak and project through them and really control how I use my diaphragm.
I’m glad I had that foundation built because I think it has helped curb some of the problems that I have heard about for others. I still feel some anxiety at times, but I’m getting better at catching it quickly and focusing on my breath to counter it. I think it’s important to also remember that it doesn’t need to be a black or white situation.
We are all just doing our best to mitigate risk with the information that we have right now. There are always quiet corners or aisles of stores or even a restroom break if one begins to feel overwhelmed. I would completely understand and advocate for someone who needs a mask break. I encourage and model it for my students all the time by stepping away from everyone else.”
The bottom line is that many people are feeling a sense of stress, anxiety, or even panic when they wear masks, whether for a short or extended period of time. It’s possible that this one is within your control!
With this information and an awareness of your breath, practicing that control, you could avoid the anxious feeling when wearing a mask all day.
To be fair, it’s also possible that this anxiety is out of your control, or at least beyond the realm of a simple solution. There are many psychological and physiological factors that play into that feeling of anxiety in our chests or stomachs.
Mask anxiety is a good example of one of those health risks that may be out of our control (beyond getting the mask off our face). And that’s exactly where we’ll start in the next post, as I explore the health risks and dangers of wearing masks all day.
Bottom Line: Some Mask Habits to Protect Your Health
You know I love information.
You know I love education.
You know I’m such a science geek!
And although sometimes ignorance is bliss, in this case, we can control our own health (to an extent) with a little bit of knowledge and some new habits.
Try to focus on the following if you are stuck wearing a required mask all day:
1. Focus on hydration. If you don’t already have a habit of hydrating, start one now, 4:1 ratio of liquids to caffeine and simply reminding yourself to take that mask off by the ear loops and drink a non-sweetened beverage all day long.
2. Wake up your shoulders. Posture is so important to our brain function, our spinal health, and even something as simple as neck pain or headaches. If you are wearing a mask all day, be sure to take a full mask break every hour and do some good neck and shoulder stretches. Bring awareness to your shoulders if you are causing tension to compensate for the new feeling of a mask on your face. And every half hour, wake up your shoulders by stretching the shoulder blades backward and together, along with some other deep, long stretches.
3. Hands off! We’ve been hearing it since March: Don’t touch your face. Don’t allow your hands or your mask to be an Uber Eats style of delivery for bacteria or viruses to your nasal passages. This is just silly. We are smart enough to touch ear loops only and keep our hands off of our masks and our faces. Let your mask be a reminder to create this better habit.
4. Breathe through your nose. To avoid dry mouth, cavities, and an unbalanced microbiome, focus hard on nose breathing only when you’re wearing your mask. Imagine your nasal hairs to be as important or more as that mask as a line of defense against the virus and any environmental toxins. Get this habit set in stone: breathe through your nose.
5. Focus on the exhale. Don’t let your mask determine how you breathe; stay in control and have an intentional inhalation and an equal or longer exhalation. If you’re feeling some unexplained anxiety, it really could be the way you’re breathing. Take some time during the day, perhaps when you are waking up your shoulders, to really focus on your breath and count a five count in and a five count out. This may make a massive difference in the way you feel and in your general health as well.
You know I’m not in favor of children especially wearing masks all day.
I do not believe this is our new normal, but rather a new temporary solution that we need to learn to deal with for a while. While we are required to wear masks, let’s do it safely for ourselves as we try to protect others.
I hope to empower you with this knowledge: there are risks to masks, but there are some that are within your control.
May your new healthy habits be easy to adopt, one at a time, and part of a family endeavor. Be sure to take safe mask breaks and give your body and brain a rest regularly.
Perhaps one of our coronavirus silver linings is that people who are mouth breathers will learn to breathe through their nose!
Perhaps some of us who don’t hydrate well (raises hand) will begin a new intentional habit and improve our overall health.
Perhaps we can focus on our posture and reduce our risk of dementia when we are old.
And maybe, just maybe, we can learn to breathe better and realize that a process we thought was just automatic actually could use a little bit of our attention. If this can bring down stress levels, it will improve health one at a time.
Like we have flattened the COVID-19 curve, maybe we can start to flatten the curve of lost work time for depression and anxiety, the curve of adults suffering from dementia and Alzheimer’s, and the curve of back pain, which is fast becoming the most common concern among middle-aged adults.
Let’s allow these masks to be a temporary reminder to take control of our own health.
And then when we are rid of them, we can keep these healthy habits.
- Wearing a Mask? Watch for Dryness of the Mouth and Bad Breath. (2020, July 28). Retrieved from https://www.ameritasinsight.com/wellness/health-and-wellness/wearing-a-mask-watch-for-dryness-of-the-mouth-and-bad-breath
- Canadian Centre for Occupational Health and Safety. (2020, July 10). Hand Washing: Reducing the Risk of Common Infections. Retrieved from https://www.ccohs.ca/oshanswers/diseases/washing_hands.html
- Canadian Centre for Occupational Health and Safety. (2020, July 10). Good Hygiene Practices – Reducing the Spread of Infections and Viruses. Retrieved from https://www.ccohs.ca/oshanswers/diseases/good_hygiene.html
- Non-medical masks and face coverings: About. (2020, July 24). Retrieved from https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/prevention-risks/about-non-medical-masks-face-coverings.html