InquiryMusicians and TMJ disorders
Section snippets
Background
Patients who have temporomandibular joint disorders (TMDs) often complain of pain on function in the TMJ, preauricular area, and/or masticatory muscles; limited or distorted jaw movements, particularly with opening; and TMJ sounds such as clicking or crepitus. Other symptoms include headache, pain in the neck or face, earache, tinnitus, and hearing loss. TMD signs occur about twice as often as pain experiences, with signs seen in 1% to 75% of patients but pain symptoms only seen in 5% to 33% of
Methods
The PubMed search identified 14 articles that met the inclusion criteria. Six were case-control studies or pre-test/post-test designs, 7 were case reports, and 1 was a preliminary report/expert opinions. The Patient/population-Intervention-Control/comparison-Outcome/results (PICO) system was used to analyze the papers that were case control or pre-test/post-test designs, with the others simply summarized and tabulated.
Results
From 5 case-control studies and 1 pre-test/post-test study it was clear that there was a potential association between TMD and playing a musical instrument. This was particularly evident among violin and viola players, who were studied in 4 of the studies.
Discussion
Playing the violin or viola was associated with TMD development. Professional musicians playing these instruments show clinical signs of TMD more often than matched control individuals. The cause appears to relate to the mechanical overload on the orofacial region and/or the tendency to push the mandible toward the contralateral TMJ. How the instrument is held may explain why complaints arise on one side of the orofacial area more than on the other. Future research should target musicians who
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Attallah MM, Visscher CM, Vn Selms MKA, et al: Is there an association between temporomandibular disorders and playing a musical instrument? A review of literature. J Oral Rehabil 41:532-541, 2014
Reprints available from F Lobbezoo, Dept of Oral Kinesiology, Academic Ctr for Dentistry Amsterdam (ACTA), Univ of Amsterdam and VU Univ Amsterdam, MOVE Research Inst Amsterdam, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands; e-mail: [email protected]