Are vocalists prone to temporomandibular disorders?

Background As vocalists demand high physical strains of the masticatory system, singing is frequently mentioned as a risk factor for temporomandibular disorders (TMDs). Objectives This study investigated whether vocalists report a higher prevalence of two types of TMDs (viz., TMD pain and temporomandibular joint sounds) compared with instrumentalists who do not load their masticatory system while performing. In addition, we examined which risk indicators are associated with the presence of these TMDs among musicians. Methods A total of 1470 musicians from 50 different music ensembles completed a questionnaire. Of these musicians, 306 were vocalists (mean age +/- SD 37.5 +/- 17.7 years; 63.9% female) and 209 musicians enrolled the control group (mean age +/- SD 42.7 +/- 18.0 years; 40.7% female). Results The prevalence of self-reported TMD pain among vocalists was 21.9%, as compared to 12.0% in the control group. 20.0% of the vocalists reported TMJ sounds versus 15.1% of the controls. The multiple regression models indicated that being a vocalist was not a risk indicator for the presence of self-reported TMD pain nor for self-reported TMJ sounds. Instead, it appeared that the report of TMD pain among musicians was positively associated with female gender, next to the level of physical workload, depicted as frequency of oral behaviours and the hours of daily practice. Musicians' report of TMJ sounds was associated with oral behaviours. Conclusion This study shows that singing is not associated with the reports of TMD pain and TMJ sounds, after adjusting for potentially confounding variables included in the models.