Does playing a musical instrument impose a risk for temporomandibular disorders? A review of literature

Playing a musical instrument that loads the masticatory system, such as the violin or oboe, has been suggested to be part of the group of etiological factors for temporomandibular disorders (TMDs). In 2014, a review of literature was published that explicitly focused on the possible association between playing a musical instrument and TMDs. However, though published in 2014, the literature search was performed in 2012, and covered only one search engine, namely PubMed. Therefore, a new comprehensive search of literature was conducted to explore what is mentioned in the English medical literature about the relationship between playing a musical instrument and the presence of TMDs. A PubMed search yielded 23 articles, 15 of which were included in this review. In addition, an extensive search was performed on Google Scholar, which yielded 9 more articles. Of the 24 articles, 11 had a comparative observational study design, and 1 had a pretest-posttest design. These articles were analyzed according to the PICO (patient problem or population, intervention, comparison, and outcome) system. The remaining 12 articles consisted of case reports/case series, literature surveys (2 of which included a case series), and literature reviews, and were only tabulated as brief summaries. While no conclusions could be drawn from these 12 articles, conclusions based on the comparative observational design studies seem to suggest that TMDs and playing a musical instrument are associated. However, no clear-cut conclusion could be drawn as to whether playing a musical instrument is directly associated with TMDs, or whether it is associated only in combination with other factors. More and better research on this topic is needed to better enable counseling, and possibly better treatment, of musicians with TMD complaints. Keywords: musical instrument, literature review, risk, temporomandibular disorders