Three cases of focal embouchure dystonia: classifications and successful therapy using a dental splint

Focal embouchure dystonia (FED) is a type of task-specific dystonia affecting wind instrument players, and it frequently ends their professional careers. The results of the treatments of FED in the reported literature are disappointing.

We report 3 patients with FED who were brass instrument players. In 1 patient, we evaluated the usefulness of a dental splint.

Patient 1 was a 28-year-old trumpeter who was suffering from an intermittent tremor of the lower jaw. Following the usage of a dental splint, her symptoms disappeared completely. Patient 2 was a 29-year-old horn player with atonia of the lower facial muscles. In this case, medication with various drugs brought no benefit, and he ended his career. Patient 3 was a 43-year-old trombone player who suffered involuntary contractions and relaxation of the perioral muscles along with clumsiness of tongue movement. Extraction of double teeth and long-term cessation of playing for 20 years did not bring any positive effects.

We propose that FED can be categorized into three subgroups according to masticatory, facial and lingual types, and that the dental splint might be a useful therapeutic strategy for the masticatory type of FED.