In Figure 2, 3 you can see the magnitude of the misplacement (Photo 2, 3). Because of the length difference, the pressure has always been higher on the left tooth,  causing its movement outwards, more than the other incisor. This caused the length difference to increase even more, making me lose the focused sound that I wanted. 

 

To make up for the inconvenience of having to place the clarinet diagonally (Photo 1) I came up with the idea of attaching some rubber shims on the side of the mouthpiece under the tooth that was struggling to reach the mouthpiece. But as I expected, it was not a sustainable solution, although it helped me finish my bachelor's. Soon I started treatment with clear aligners with the intention of solving the problem.

 

After the treatment, the misalignment has been restored to the initial stage, but my teeth are still slightly different and I’m sure that the pressure could move them again within a big period. Therefore, I started my research to find a way to prevent this problem and to help other clarinet players who deal with malocclusions.

Insight dossier

What Initiated the Problems

Figure 1.

Before we dive into the world of dentistry and clarinet playing, there are a few theoretical concepts that you should be familiar with.


The Embouchure 

The clarinet is a wind instrument that uses a reed to produce sound. The reed is attached below the mouthpiece, and it comfortably rests on the lower lip, while on the top, the mouthpiece is held against the teeth. When the airflow passes through the gap between the reed and the mouthpiece causes the reed to vibrate and therefore the air inside the instrument will resonate. The whole system is kept in place by the muscles around the lips, the cheeks and by the jaw, which together maintain in shape the embouchure.

 

Types of Occlusions

In general, there are three types of occlusions or bite:


Class I: Neutral


Class II: Overbite


Class III: Underbite

My Scientific Research: Interesting studies supporting the connection between playing a wind instrument and tooth movement

What made me start questioning the relationship between dental health and clarinet playing was when I realised that I had to significantly adjust the position of the mouthpiece in my mouth to have a good fit between my teeth. Already for some time, I started to notice a relevant discomfort on all my front teeth. The left upper incisor (maxillary) would feel numb and painful after my usual 4/5 hour of daily playing, while my lower incisors (mandibular) were often sore, and they started to feel loose to the point that I could make them wiggle with my fingers. I can assure you that trying to sleep after experiencing those sensations was not really pleasant, especially when my often-occurring nightmare was losing all my teeth and having to adapt to playing without them. Luckily during those sleepless nights, I can up with the solution that I'll present to you later.

 

To be honest, originally, my teeth were not visibly crooked or misaligned. The only problem was that my incisors had a very small difference in length: one was longer. This is very common and not necessarily a problem since often the front teeth have small length differences which every player tends to cope with, by placing the embouchure slightly angled. In addition to this asymmetry though I also have an overbite, and as I learned from this research, the overbite is the main cause of tooth movement. The pressure of the embouchure pushed my upper incisors outward and my lower incisors inwards.

Figure 2.

Figure 3.