It is common in mouth breathing children to have more colds, infections in the nose, throat and chronic ear infections. Ear infection may lead to hearing loss, speech problems, language delays and vestibular issues. It is important to pay close attention to children in such cases: listen well to determine if they have difficulty hearing in the presence of noise; if they are unable to answer questions or follow direction, or could be considered inattentive. Most common changes are hoarseness in voice. This is because of the constantly open mouth leading to a drying out of all the structures that produce the voice and because the muscles are contracted for a long time, they may also appear to frequently have a cold and a runny nose.