Embouchure dystonia in wind instrumentalists: Diagnostic pitfalls in dental and orofacial pain practice and a case series from an oral and maxillofacial surgery clinic.

OBJECTIVE

Embouchure dystonia is a rare task-specific orofacial movement disorder affecting wind instrumentalists and may mimic temporomandibular disorder-like or dental complaints. This study described its clinical features, diagnostic pitfalls, assessment methods, and management in an oral and maxillofacial surgery clinic.

METHODS

This retrospective case series included 37 patients clinically diagnosed with embouchure dystonia. Diagnosis was based on instrument-specific involuntary contraction, abnormal movement, or loss of fine motor control; task specificity; reproducibility during similar musical tasks; and exclusion of dental, temporomandibular, occlusal, bruxism-related, prosthetic, or structural findings sufficient to account for the symptoms. Temporomandibular disorders and bruxism were assessed clinically.

RESULTS

The study included 27 women and 10 men. All patients reported difficulty playing. Previous diagnoses included temporomandibular disorders, bruxism, and psychiatric disease.

CONCLUSIONS

Embouchure dystonia should be considered in wind instrumentalists with instrument-specific orofacial motor symptoms unexplained by dental or temporomandibular findings.