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A case series of wind instrument players with cleft lip and/or palate

British Dental Journal volume 234, pages 223–231 (2023)Cite this article

Abstract

It might be more difficult for patients with cleft lip and/or palate (CL/P) to generate sufficient muscle tension of the upper lip and intraoral air pressure to play a wind instrument. We aimed to explore and describe the key aspects of wind instrument playing with a repaired cleft. An in-depth interview was conducted among ten patients with CL/P and one with a functionally comparable problem and we found that: individuals with CL/P can achieve a professional level on a wind instrument; the oboe and trumpet may be less suitable for patients with CL/P because of the high lip muscle tension and intraoral air pressure that must be generated; air leakage through a fistula, unrepaired alveolus or velopharyngeal insufficiency can be troublesome; and for people with CL/P, a brass instrument with a large mouthpiece is easier than a small mouthpiece. While dentists, doctors and music teachers should discuss the probability that wind instrument playing might be more difficult for patients with CL/P, they should not discourage it.

Key points

  • To play a wind instrument, two aspects are important: 1) the amount of muscle tension that can be generated with the lips (especially for high notes); and 2) the air pressure that must be generated in the mouth (without escaping through the nose). For both reasons, the oboe and trumpet may be less suitable (to start with) for patients with a cleft lip and/or palate.

  • Air leakage through a fistula, unrepaired alveolus or velopharyngeal insufficiency can be troublesome.

  • With a brass instrument, the upper lip should be able to vibrate. Scar tissue can be disruptive in this regard. A brass instrument with a larger mouthpiece is, therefore, easier to play for patients with a cleft lip than one with a small mouthpiece.

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Funding

This research received no specific grant from any funding agency in the public, commercial, or non-profit sectors. For this study, no funding was accepted, except for support from the listed institutions.

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Authors and Affiliations

  1. Department of Orthodontics, Academic Centre of Dentistry, Amsterdam, Netherlands

    Fawn N. van der Weijden & Nicoline C. W. van der Kaaij

  2. Dentist and Professional Trumpet Player, Oss, Netherlands

    Cees J. M. Hazenberg

  3. Orthodontist, Orthodontic Practice ‘Northo’, Gare du Nord 1, 1022 LD Amsterdam, Netherlands

    Reinder B. Kuitert

Authors
  1. Fawn N. van der Weijden
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  2. Cees J. M. Hazenberg
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  3. Nicoline C. W. van der Kaaij
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  4. Reinder B. Kuitert
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Contributions

Fawn N. van der Weijden interviewed the patients, analysed all interviews and drafted the manuscript. Cees J. M. Hazenberg analysed the interviews of the brass instrument players and critically revised the manuscript. Nicoline C. W. van der Kaaij and Reinder B. Kuitert critically revised the manuscript. All authors and the patients involved gave final approval. All authors agreed to be accountable for all aspects of work ensuring integrity and accuracy.

Corresponding author

Correspondence to Fawn N. van der Weijden.

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The authors declare that they have no conflicts of interest.

All patients provided written consent to publish their material.

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van der Weijden, F., Hazenberg, C., van der Kaaij, N. et al. A case series of wind instrument players with cleft lip and/or palate. Br Dent J 234, 223–231 (2023). https://doi.org/10.1038/s41415-023-5510-9

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