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.