Prevention of Lip Injuries in Clarinet and Saxophone Players

Objectives: To examine whether the use of an oral appliance would affect short-term injuries in the inner region of the lower lip caused by the execution of clarinet and saxophone in adults.
Methods: A quasi-experimental study was done. We designed and implemented an oral appliance for 54 students selected from three music schools in Bucaramanga (Colombia). The students had music experience playing either clarinet or saxophone. Those with orthodontic treatment and dental prosthesis were not included. Age, gender, type and size of oral injury, type of instrument played, type of mouthpiece, weekly hours and years of practice, protector use, time of oral injury appearance were analyzed. The variables related to the oral appliance were adaptation, breathing difficulty, sound and technique changes and personal satisfaction.A brief oral examination was done after three hours of music practice; impressions were taken and the appliance was made. This was fabricated with an acetate plate and was given to the students the next day. They were instructed to wear it for all the music classes during the following week. After that time, a second oral exam was performed and a questionnaire was applied to the subjects. Evaluations were carried out using Chi-square, Fisher Exact test, paired t test or Wilcoxon when appropriate. Statistical significance was estimated at p<0.05.
Results: Mean age was 21.5 ± 7.2 years, 63% were male and 55.5% played the clarinet. The most common injury was erythema (51.8%) followed by hyperkeratosis (42.6%). A significant difference was found between the presence of oral injury with respect to sex (p=0.002) being the women the subjects with more oral injuries.
Conclusions: The use of this oral appliance reduced the size of the oral injury, improved the sound quality of the instrument and the technique. However, it is necessary to conduct a longer study.