Clinical Signs and Subjective Symptoms of Temporomandibular Disorders in Instrumentalists.
OBJECTIVE
Most of the reports on instrumentalists' experiences of temporomandibular disorders (TMD) have been reported not by clinical examinations but by subjective questionnaires. The aim of this study was to investigate the clinical signs and subjective symptoms of TMD in a large number of instrumentalists objectively.


METHODS
A total of 739 musicians from a diverse range of instrument groups completed a TMD questionnaire. Among those who reported at least one symptom of TMD, 71 volunteers underwent clinical examinations and radiography for diag-nosis.


RESULTS
Overall, 453 participants (61.3%) reported having one or more symptoms of TMD. The most frequently reported symptom was a clicking or popping sound, followed by temporomandibular joint (TMJ) pain, muscle pain, crepitus, and mouth opening limitations. Compared with lower-string instrumentalists, a clicking or popping sound was about 1.8 and 2 times more frequent in woodwind and brass instrumentalists, respectively. TMJ pain was about 3.2, 2.8, and 3.2 times more frequent in upper-string, woodwind, and brass instrumentalists, respectively. Muscle pain was about 1.5 times more frequent in instrumentalists with an elevated arm position than in those with a neutral arm position. The most frequent diagnosis was myalgia or myofascial pain (MFP), followed by disc displacement with reduction. Myalgia or MFP was 4.6 times more frequent in those practicing for no less than 3.5 hours daily than in those practicing for less than 3.5 hours.


CONCLUSIONS
The results indicate that playing instruments can play a contributory role in the development of TMD.
Department of Orofacial Pain & Oral Medicine, Yonsei University College of Dentistry, Seoul, Korea.
Jae Young
JY
Jang
Department of Orofacial Pain & Oral Medicine, Yonsei University College of Dentistry, Seoul, Korea.
Jeong Seung
JS
Kwon
School of Medicine, University of California-Irvine, Irvine, CA, USA.
Debora H
DH
Lee
Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Center, Yonsei University College of Dentistry, Seoul, Korea.
Jung Hee
JH
Bae
Department of Orofacial Pain & Oral Medicine, Yonsei University College of Dentistry, Seoul, Korea. k8756050@yuhs.ac.
Seong Taek
ST
Kim
D000328:Adult; D005157:Facial Pain / Q000209:etiology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009146:Music; D009784:Occupational Diseases / Q000209:etiology* / Q000503:physiopathology; D010808:Physical Examination; D016059:Range of Motion, Articular / Q000502:physiology*; D013016:Sound / Q000009:adverse effects*; D013704:Temporomandibular Joint / Q000503:physiopathology*; D013705:Temporomandibular Joint Disorders / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology
Temporomandibular disorders (TMD); arm position; clinical sign; instrumentalist; subjective symptom