Is temporomandibular disfunction an occupational disease of flautists?

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription Access

Abstract

Wind instrumentalists are prone to a number of occupational hazards that can lead to occupational diseases. C. Zaza defined these diseases as playing-related musculoskeletal disorders (PRMD). Such occupational diseases are devastating for musicians in terms of psychological health and financial state.

According to various epidemiological studies, 62–86% of orchestra musicians experienced PRMD. Particularly the pressure of the mouthpiece on the lower incisors of wind instrumentalists leads to their movement and provoke periodontal diseases. Moreover, wind instrumentalists place themselves at risk of allergies and galvanism. Musicians do not seek for dental help due to the fear of spoiled embouchure (habitual position of the cheeks, tongue, and lips while playing) in spite of the range of specific oral pathologies. Flautists are of particular interest to dental practitioners because they are subjected to several risk factors; in addition to the mouthpiece pressure, they often hold instruments in an asymmetric posture, and in constrained spaces, being surrounded by the other orchestra musicians.

To learn more about the occupational hazards of flautists, we searched for the relevant literature in the central research medical library and for articles in databases eLIBRARY, PubMed, and ResearchGate using the following keywords: “wind instrumentalists”, “flute”, “temporomandibular disorders”, and “playing-related musculoskeletal disorders”.

Some studies claim that the asymmetric posture of flautist, especially in cramped conditions, affects the musician’s health and leads to PRMD. Nevertheless, this research topic has been neglected, and published studies lack a strong methodology, explaining why they fail to show a strong association between TMD and flute playing. Therefore, further research is needed.

About the authors

V. A. Parunov

Peoples' Friendship University of Russia (RUDN); National Medical Research Centre of Dentistry and Maxillofacial Surgery, Ministry of Health of Russia

Email: tafedd@gmail.com
Russian Federation, 117198, Moscow; 119021, Moscow

Tatiana M. Fedotova

Peoples' Friendship University of Russia (RUDN)

Author for correspondence.
Email: tafedd@gmail.com

PhD student of the Prosthodontics Department of Medical Institute of RUDN University

Russian Federation, 117198, Moscow

I. Y. Lebedenko

Peoples' Friendship University of Russia (RUDN); National Medical Research Centre of Dentistry and Maxillofacial Surgery, Ministry of Health of Russia

Email: tafedd@gmail.com
Russian Federation, 117198, Moscow; 119021, Moscow

References

  1. Poore GV. Clinical lecture on certain conditions of the hand and arm, which interfere with the performance of professional acts, especially pi-ano-playing. Br. Med. J. 1887;1(1365):441–4. doi: 10.1136/bmj.1.1365.441.
  2. Singer K. Diseases of the musical profession: a systematic presentation of their causes, symptoms and methods of treatment. New York: Greenberg; 1932.
  3. Dommerholt J. Performing arts medicine — instrumentalist musicians part I — general considerations. J. Bodyw. Mov. Ther. 2009;13(4):311–9. doi: 10.1016/j.jbmt.2009.02.003.
  4. Zaza C, Charles C, Muszynski A. The meaning of playing-related musculoskeletal disorders to classical musicians. Soc. Sci. Med. 1998;47(12):2013–23. doi: 10.1016/s0277-9536(98)00307-4.
  5. Gasenzer ER, Klumpp MJ, Pieper D, Neugebauer EA. The prevalence of chronic pain in orchestra musicians. Ger. Med. Sci. 2017;15:Doc01. doi: 10.3205/000242.
  6. Woldendorp KH, Boschma H, Boonstra AM, Arendzen HJ, Reneman MF. Fundamentals of embouchure in brass players: towards a definition and clini-cal assessment. Med. Probl. Perform. Art. 2016;31(4):232–43. doi: 10.21091/mppa.2016.4038.
  7. Kok LM, Huisstede BM, Voorn VM, Schoones JW, Nelissen RG. The occurrence of musculoskeletal complaints among professional musicians: a sys-tematic review. Int. Arch. Occup. Environ. Health. 2016;89(3):373–96. doi: 10.1007/s00420-015-1090-6.
  8. Kok LM, Vlieland TP, Fiocco M, Nelissen RG. A comparative study on the prevalence of musculoskeletal complaints among musicians and non-musicians. BMC Musculoskelet Disord. 2013;14:9. doi: 10.1186/1471-2474-14-9.
  9. Cruder C, Falla D, Mangili F, Azzimonti L, Araújo LS, Williamon A, Barbero M. Profiling the location and extent of musicians' pain using digital pain drawings. Pain Pract. 2018;18(1):53–66. doi: 10.1111/papr.12581.
  10. Kok LM, Vliet Vlieland TP, Fiocco M, Kaptein AA, Nelissen RG. Musicians’ illness perceptions of musculoskeletal complaints. Clin. Rheumatol. 2013;32(4):487–92. doi: 10.1007/s10067-013-2199-1.
  11. Nyman T, Wiktorin C, Mulder M, Johansson YL. Work postures and neck-shoulder pain among orchestra musicians. Am. J. Ind. Med. 2007;50(5):370–6. doi: 10.1002/ajim.20454.
  12. Clemente M, Mendes J, Moreira A, Bernardes G, Van Twillert H, Ferreira A, Amarante JM. A new classification of wind instruments: orofacial consider-ations. J. Oral. Biol. Craniofac. Res. 2019;9(3):268–76. doi: 10.1016/j.jobcr.2019.06.010.
  13. van der Weijden FN, Kuitert RB, Berkhout FRU, van der Weijden GA. Influence of tooth position on wind instrumentalists' performance and embou-chure comfort: a systematic review. J. Orofac. Orthop. 2018;79(3):205–18. doi: 10.1007/s00056–018–0128–2.
  14. Khrynin SA. Features of orthopedic treatment with fixed structures for periodontitis of musicians playing wind instruments. [dissertation] Moscow; 2013.
  15. van Selms MK, Wiegers JW, van der Meer HA, Ahlberg J, Lobbezoo F, Visscher CM. Temporomandibular disorders, pain in the neck and shoulder area, and headache among musicians. J. Oral. Rehabil. 2020;47(2):132–42. doi: 10.1111/joor.12886.
  16. van Selms MK, Ahlberg J, Lobbezoo F, Visscher CM. Evidence-based review on temporomandibular disorders among musicians. Occup. Med. (Lond). 2017;67(5):336–43. doi: 10.1093/occmed/kqx042.
  17. van Selms MKA, Wiegers JW, Lobbezoo F, Visscher CM. Are vocalists prone to temporomandibular disorders? J. Oral. Rehabil. 2019;46(12):1127–32. doi: 10.1111/joor.1284.
  18. Jang JY, Kwon JS, Lee DH, Bae JH, Kim ST. Clinical signs and subjective symptoms of temporomandibular disorders in instrumentalists. Yonsei Med. J. 2016;57(6):1500–7. doi: 10.3349/ymj.2016.57.6.1500.
  19. Adeyemi TE, Otuyemi OD. Relationship between playing of wind musical instruments and symptoms of temporomandibular joint disorders in a male Nigerian adult population. West Afr. J. Med. 2019;36(3):262–6.
  20. Nishiyama A, Tsuchida E. Relationship between wind instrument playing habits and symptoms of temporomandibular disorders in non-professional musicians. Open Dent. J. 2016;10:411–16. doi: 10.2174/1874210601610010411.
  21. Pampel M, Jakstat HA, Ahlers OM. Impact of sound production by wind instruments on the temporomandibular system of male instrumentalists. Work. 2014;48(1):27–35. doi: 10.3233/WOR-131621.
  22. Akoev ZU. Clinical and instrumental assessment of the functional state of the temporomandibular joint in musicians playing the violin. [dissertation] Moscow; 2010.
  23. Amorim MI, Jorge AI. Association between temporomandibular disorders and music performance anxiety in violinists. Occup. Med. (Lond). 2016;66(7):558–63. doi: 10.1093/occmed/kqw080.
  24. Lonsdale K, Laakso EL, Tomlinson V. Contributing factors, prevention, and management of playing-related musculoskeletal disorders among flute play-ers internationally. Med. Probl. Perform. Art. 2014;29(3):155–62. doi: 10.21091/mppa.2014.3032.
  25. Stanhope J, Milanese S. The prevalence and incidence of musculoskeletal symptoms experienced by flautists. Occup. Med. (Lond). 2016;66(2):156–63. doi: 10.1093/occmed/kqv162.
  26. Ackermann BJ, Kenny DT, Fortune J. Incidence of injury and attitudes to injury management in skilled flute players. Work. 2011;40(3):255–9. doi: 10.3233/WOR-2011-1227.
  27. Inoue A, Shoji A, Fujita T. Flautist’s chin. Br. J. Dermatol. 1997;136(1):147–7. doi: 10.1111/j.1365-2133.1997.tb08778.x.
  28. Prokopova MA. Prevention of galvanism in dental prosthetics of musicians playing wind instruments. [dissertation] Moscow; 2015.
  29. Pais Clemente M, Mendes J, Cerqueira J, Moreira A, Vasconcelos M, Pinhão Ferreira A, Amarante JM. Integrating piezoresistive sensors on the embou-chure analysis of the lower lip in single reed instrumentalists: implementation of the lip pressure appliance (LPA). Clin. Exp. Dent. Res. 2019;5(5):491–6. doi: 10.1002/cre2.214.
  30. Kislitsyna AV. Features of the dental status of musicians of various specialties. Rossiiskii stomatologicheskii zhurnal. 2017;21(5):287–90. doi: 10.18821/1728–2802–2017–21–5-287–290.
  31. Mantel T, Altenmüller E, Li Y, Meindl T, Jochim A, Lee A, et al. Abnormalities in grey matter structure in embouchure dystonia. Parkinsonism Relat. Disord. 2019;65:111–6. doi: 10.1016/j.parkreldis.2019.05.008.

Copyright (c) 2020 Eco-Vector


 


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies