The Wind Instrument Patient

ISSN: 2254-8521


The Wind Instrument Patient


This is a very interesting article that talks about something wind musicians pay little to no attention to… our dental structure.

Alexandre de Alcântara

A dental surgeon with over 20 years of experience and attends to the specific needs of musicians that play wind instruments. He is certified through the Brazilian Musicians Order and was responsible for a proposal (717/2012) that was approved by the Federal Council of Odontology, by unanimous vote, that recognized musicians of wind instruments as patients that needed specialized treatment. He is also a columnist for the Portal Educação, and author of various articles on websites and magazines dealing with the special needs of musicians and music.

There are many types of wind instruments: the trumpet, saxophone, oboe, flute, tuba, or the trombone, among various other wind instruments. In all of these instruments, musicians look for a way to transmit air through the instrument, allowing this air to aid in the production of sound. One may find other similar parts within the mouth and its annexed structures, where the muscles have a specific part to play within the production of sound. The balance between these muscles and the air stream is fundamental, so that the muscles are not over-worked and lose their advantage. The displacement of the jaw, dystonia, dental inclusions (contact with the teeth while the jaw is in open position), an imbalance of the dental structure, or the grinding of teeth can all cause severe pain in the long run, as well as difficulty for the player at the time of performing on their instrument. Good research on the part of a dentist could prolong the career of any musician of wind instruments, including, and not limited to, singers and speakers.

The position of the teeth, and the way they are positioned, are a direct relation to the setup of the instrument and musician involved. The trajectory of the air column toward the instrument could also cause minor or severe friction during execution. A change within the dental structure and/or the form that the teeth have taken on, could dramatically affect the register one is able to execute.

Because of this, the wind instrumentalist may need a detailed study regimen before any treatment may occur. Due to this direct influence, any changes made could dramatically affect the patient. It is of paramount importance that the dentist first observe the patient play their instrument in order to analyze the musician’s muscular movements and instrument placement, as well as their dental structure at the moment of execution.

The evaluation would vary depending on the exact instrument that is played.  Using saxophone for an example: the player places the top part of the mouthpiece on the top teeth, and the tongue (with the bottom lip curled into the mouth — above the bottom teeth.

The embouchure is the forming of the mouth (both muscles and teeth) that the musician uses to aid the mouthpiece or the tongue — or in another way, as with a traverse flute, where the air direction is emitted from the musician without the aid of the teeth or muscle manipulation surrounding the embouchure (as if blowing over a soda bottle).

(Within these images, one can see various jaws in the closed position — showing different types of embouchures. During the time to play, the musician will slightly open the mouth — separating the teeth — so that the air may freely pass through to the instrument).

The embouchure of every wind instrument musician is different, depending on the structure of their mouths. The mouthpieces used also have different sizes, but whatever size or circumstance the result is the same — a “sandwich” of the lips between the teeth and the mouthpiece — with frequent and constant pressure against the front teeth, this may cause injuries with the passage of time.

How can I put it? The wind musicians need special dental treatment. Not every dentist may prescribe a treatment, or what may be perceived as normal treatment, for a musician. The greatest challenge for a dentist and a dental prosthesis technician have is to make clear what it takes for the wind instrumentalist to have a successful and healthy career. Perhaps even a better one.

Generally, a wind instrumentalist would start their studies around 7-8 years of age and play their instruments until the age of retirement. During all this period of time, the doctor must detect their needs and functions, but based on their age. For example; a beginner may have any type of dental treatments without too much recourse, now that the doctor understands the beneficial nature of the future needs of the musician, and the musician will have time to adapt to any changes or treatments. The musician of greater age may have larger dental needs, or false teeth, that may only permit them to perform in small amounts for their own enjoyment. However, a mature musician in an orchestra or professional ensemble that benefits from a salary will surely not play around with the idea of major dental changes, for fear of losing their ability to play their instrument.

In the next article, we will explore how we should give our attention to a wind instrumentalist, as well as how to analyze during the consultation.