Professional Musicians with Craniomandibular Dysfunctions Treated with Oral Splints

Abstract

Craniomandibular dysfunction (CMD) symptoms occur frequently in violin/viola and wind players and can be associated with pain in the neck, shoulders and arm. In the current study, the effect of oral splint treatment of CMD on reducing pain and symptoms especially in these areas was investigated. Thirty (30) musicians undergoing CMD treatment with oral splints participated in this study. They completed a questionnaire that addressed CMD symptoms, localization of pain, and subjective changes in symptoms. Pain in the shoulder and/or upper extremity was the most frequent symptom reported by 83% of subjects, followed by neck pain (80%) and pain in the teeth/TMJ regions (63%). Treatment with oral splints contributed to a significant decrease in neck pain in 91%, teeth/TMJ pain in 83%, and shoulder and upper extremity pain in 76% of the musicians. Eighty percent (80%) of the patients reported improvement of their predominant symptoms. CMD can be a potential cause for pain in the neck, shoulders, and upper extremities of musicians. It is paramount that musicians with musculoskeletal problems be examined for CMD symptoms. Treatment with oral splints seems to be valuable. Further prospective, randomized controlled studies are necessary to confirm efficacy of oral splint treatment in CMD-associated pain and problems in the neck, shoulder, and the upper extremities in musicians.

Additional information

Notes on contributors

Anke Steinmetz

Dr. Anke Steinmetz is a specialist for physical and rehabilitation medicine. She has professional training as a violinist in Klagenfurt/Austria and is a consultant in the “Klinik für Manuelle Medizin Sommerfeld,” a hospital for musculoskeletal medicine and pain therapy near Berlin, Germany. She did her doctoral thesis on craniomandibular dysfunctions in violinists in 2003. Dr. Steinmetz also won a research award from the German Music Medicine Association in 2003 and the Alice Brandfonbrener Young Investigator Award of the American Performing Arts Medicine Association in 2006. She does international conference presentations and teaching activities at various music universities and with Dr. Ridder in a special Music Medicine curriculum in Freiburg. She also works at a special outpatient clinic for musicians in Berlin.

Paul H. Ridder

Dr. Paul H. Ridder is a specialist in orthopedic and manual medicine, and he is a singer. He has special training in osteopathy, applied kinesiology, acupuncture, physical therapy, and neuraltherapy. Dr. Ridder leads the interdisciplinary Therapy Center of St. Urban with a special focus on performing arts medicine and craniomandibular dysfunctions. He is involved in various teaching activities in osteopathy, applied kinesiology, and performing arts medicine and often lectures internationally.

Götz Methfessel

Dr. Götz Methfessel has an M.D. degree and is a dental surgeon in private practice in Niederwiesa, Germany. Since 1985, he has worked at an outpatient clinic at the University of Music in Dresden. In 1989, he authored a five-year dental study on dental development in adolescents who play wind and brass instruments. Also since 1990, he is a professor at the Music University of Dresden, specializing in treatment of craniomandibular dysfunctions in musicians.

Burkhard Muche

Dr. Burkhard Muche has an M.D. degree. During his studies, he also worked on imaging of temporomandibular joint disorders, and his doctoral thesis covered MR imaging of the sacroiliac joints in spondyloarthropathies. Currently, he is a specialist in internal medicine with a special focus on osteoporosis and other bone metabolic diseases at the rheumatologic hospital, Immanuel-Krankenhaus, in Berlin. He also works at the teaching hospital of the Charité Medical University in Berlin. Dr. Muche has been a researcher in more than ten multicenter clinical trials and lectures nationally and internationally in the field of bone study, e.g., at the American Society of Bone and Mineral Research Annual Meeting in Montreal in 2008.