Short Course in Orthodontia for Musicians
Maurice M. Porter
Originally printed in Bandwagon magazine in May, 1966.
Revised and reprinted in Bandworld in December, 1991.
You are an influential dentist. Are you a skillful one?
Orthodontia aims at establishing an ideal relationship between the teeth, but its effect on a growing child are more pervasive then they seem. While the orthodontist works directly on teeth, his appliances influence the development of the face and ultimately of the entire body, particularly the respiratory system.
The orthodontist’s appliances can make great differences in the growth of a child by exerting slight but persistent pressure on his teeth. Now the pressure exerted on the teeth by a wind instrument may not be as persistent as an orthodontist’s braces, but it may be enough to affect a child’s appearance. I want to explain briefly some of the priciples of orthodontia that will help the music teacher control these forces, and even use them to the child’s advantage.
In short, every band director and wind instrument teacher is a kind of orthodontist, whether he knows it or not. It is clearly best for him to know it, and be familiar enough with orthodontia to work with the orthodontist, especially when he sees one of his most serious students getting braces put on.
It seems astonishing at first that so little pressure could do so much, but the principle is familiar in more conspicuous examples. Function influences the growth and development of living tissue.
Any interference with normal function can eventually produce conspicuous effects, including mal- or arrested development, or even atrophy. For instance, a paralyzed arm weakens, withers, and eventually atrophies. On the other hand, a weight lifter’s arms become extraordinarily well developed from exercise.
Now the mouth, jaws, teeth, tongue, lips, etc. are meant by nature to be used for eating, speaking, breathing, and perhaps the occasional blowing. But intensive practice on a wind instrument may be enough to influence function. Naturally, we all want to influence it for the better.
Since no two mouths, as no two faces, are exactly alike, some mouths are suitable for one kind of instrument, while others are not. A few are even more or less susceptible to damage from any one instrument. Most experienced teachers have learned to recognize that the choice of instrument can be the deciding factor in a player’s ability to achieve a high standard of musicianship. But they are apt to be less familiar with an equally important point: just as the embouchure affects the instrument, so the instrument affects the embouchure.. The first point is especially important to the serious student, the second to others. Both should be important to the teacher.
Of course no students attracted to a particular instrument for its orthodontic value. Yet if it is their earnest desire to make a really serious study of music, then attraction to an instrument may be enough. If the instrument can become an obstacle to high achievement, then this problem must be considered as early as possible. In the interest of music, it should concern the student, his teacher, his dentist, and perhaps his doctor as well, since a sound respiratory system is also important.
For the teacher, it is enough to know two chief types of relationship between instrument and player. In the first, the mouthpiece tends to alter the dental arches (that is, the shape of the jaws, the normal position of the teeth in each jaw, and the relationship between the teeth of the upper and lower jaws). In the second, the mouthpiece tends to correct the dental arches or the relationship between the upper and lower teeth. Each wind instrument is able to do one of these in some specific way. Brass instruments tend to move the front teeth backwards. Single reed instruments tend to move the upper front teeth forwards and the lower front teeth backwards. The double-lip embouchure used in playing the oboe and bassoon tend to move both upper and lower front teeth backwards, but less so than the brass instruments. The flute and piccolo have only a slight tendency to move the lower front teeth backwards.
The trumpet mouthpiece is usually centered on the lips. It tends to move all front teeth backwards.
The higher position of the horn mouthpiece produces forces similar to those of the trumpet mouthpiece, but unequal.
The single reed mouthpiece tends to move upper front teeth forward, and lower front teeth backwards.
The flute and piccolo exert slight backwards pressure on the lower front teeth.
The double reed instruments tends to move both upper and lower front teeth backwards, but less so than the brass instrument mouthpieces.It should be apparent from my statements that as an orthodontist, I feel certain wind instruments should be avoided by certain children, especially without careful supervision by a dental surgeon or orthodontist. On the other hand, the orthodontist might well advise a certain type of wind instrument to correct some defect that another instrument would only aggravate.
If the playing of wind instruments is taken up in adult life, when the bones are set and growth has virtually ceased, changes are bound to be negligible (provided routine dental examination and care are regularly carried out). If there are dangers, they will occur during the years of rapid bone development, up to the age of about ten. Then the front teeth can be moved considerably and the jaws molded, perhaps in undesirable ways.
Even through adolescence, careful dental supervision may be important, and in some cases cooperation of student, teacher, parents, and dental surgeon is essential. To illustrate the importance of cooperation, I can point to cases of the orthodontist, unaware that his patient is practicing several hours a day, being puzzled at his failure to move the front teeth forwards. The pressure he exerts with his ingeniously designed braces may be exactly counteracted by the mouthpiece of a wind instrument.
I am not so narrowly professional as to be deluded in this matter. I know that few, if any youngsters ever become enthusiastic musicians for orthodontic reasons. But I am convinced that understanding and teamwork, especially between the dentist and music teacher, can help children profit from the best of both of our disciplines. In view of their investment, to say nothing of their concern, parents will applaud your active interest in such teamwork.