ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Wind Instrument Playing is Not a Major Etiologic Factor in the Occurrence of Malocclusion
Clinical Question In an adolescent to adult musician, does long-term playing of a wind instrument cause movement of the anterior teeth, as opposed to a non-wind instrument player?
Clinical Bottom Line Professional wind instrument-playing is not a major etiologic factor in the development of malocclusion and has little effect on the position of the anterior teeth. This is supported by a cross-sectional study of professional musicians, which showed no statistically significant difference in the occlusion of wind players compared to non-wind instrument players. These findings are applicable to general dentists and orthodontists because they can inform parents on the effects of playing a musical instrument on their child’s dentition.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 22284280Grammatopoulos/2012170 professional wind and non-wind instrument musiciansCase Control Study
Key resultsFor brass and single reed instrument musicians, no statistically significant differences in occlusion were found. Overjet (P=0.75), overbite (p=0.55), crowding (maxillary arch, P=0.31; mandibular arch, P=0.10), Little’s irregularity index (maxillary arch, P=0.99; mandibular arch, P=0.16), and the prevalence of incisor classification (P=0.15) all showed no significantly significant differences from the control group.
Evidence Search ("wind"[MeSH Terms] OR "wind"[All Fields] OR "flatulence"[MeSH Terms] OR "flatulence"[All Fields]) AND instrument[All Fields] AND ("malocclusion"[MeSH Terms] OR "malocclusion"[All Fields])
Comments on
The Evidence
Validity: This cross-sectional observational study compared a control group (percussionists and string players from the same orchestras) and three groups of musicians each playing a specific instrument type. All groups were similar in that all musicians played their instrument for at least 3 hours daily for the last 4 years and began playing by at least age 14. Each group was treated with the same standards. All measurements were performed by one person and were repeated 9 days later to confirm accuracy. There were no competing interests. This case-control study did not measure change in tooth position over time or have a follow-up. All musicians with previous orthodontic treatment were excluded from the study. Perspective: The study measured musicians who practiced at least 3 hours per day, but the average time required to produce movement is at least 4-8 hours per day. This means that some of the musicians may not have practiced long enough to produce movement; musicians take breaks in practice sessions, so 3 hours of a practice session does not necessarily mean there were 3 hours of continuous playing. The musicians’ baseline occlusion, before they started playing the instrument at age 14 or earlier, is unknown. This study type is considerably weak evidence; stronger evidence may be necessary to determine a link between instrument playing and movement of the anterior teeth.
Applicability The study comprised of 170 Caucasian adult musicians from Britain. Subjects were excluded who had previous orthodontic treatment, retained primary teeth, large anterior restorations, pathology, periodontal disease, and previous trauma to the maxilla or mandible. Subjects who had a thumb sucking habit in the past were also excluded. This study is applicable to professional and amateur musicians in the dental office. The dentist can inform the concerned parent of these findings around the typical time of starting to play an instrument in middle school or high school.
Specialty/Discipline (General Dentistry) (Orthodontics)
Keywords orthodontics, malocclusion, tooth movement, wind Instrument, musicians
ID# 2862
Date of submission: 03/31/2015spacer
E-mail flynnl@livemail.uthscsa.edu
Author Lauren Flynn
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Clarence C. Bryk, DDS, MS
Faculty mentor/Co-author e-mail brykc@uthscsa.edu
Basic Science Rationale
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