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Monday 11 April 2011

Came across this article in the news another day. Although it's not strictly related to teeth, as dentists we are also concerned with the health of all oral tissues and their impact on systemic health. For instrance, research has shown that individuals with gum disease (periodontitis) are twice as likely to suffer from coronary artery disease.

This article explores the link between musical instruments, oral bacteria, and health:
 
That's the provocative suggestion from the Oklahoma State University for
Health Sciences, where researchers found germs galore growing on brass and wind
instruments that were used in high school band programs.

The researchers in Oklahoma City Tulsa swabbed 13 brass and wind
instruments, then rubbed the swabs on petri dishes and waited to see what would
grow. They found 295 different bacteria as well as yeasts and molds. The parts
that musicians put in their mouths were more contaminated than the rest of the
instruments, and the two clarinets showed more contamination than the other
instruments. The results were published in the latest issue of
General Dentistry.
OK, that's gross. But does having bacteria in your bassoon really
pose a health risk?

Yes, says Thomas Glass, a dentist and professor at Oklahoma State who was lead author of the
study. In the past he has tested for pathogens on toothbrushes, dentures, and
athletic mouthguards. So he wasn't too surprised to find gunk growing on band
instruments. "The bacteria can produce local infections in the mouth, in the
gastrointestinal tract, and in the respiratory tract," Glass tells Shots. Molds
can cause allergic reactions, and skin infections are a risk, too, he says.
Glass's study didn't look to see if the high schoolers who played these
grubby instruments had health problems. And there's precious little evidence of
rampant infections associated with practicing "Stars and Stripes Forever."
But a few pulmonologists have reported patients coming in with lung problems.
A letter from 1988 in the journal Chest told the tale of a 67-year-old saxophone
player with a cough and shortness of breath. He was diagnosed with hypersensitivity
pulmonitis
from candida, and it turned out the saxophone mouthpiece was contaminated with that fungus. The symptoms disappeared after the musician started washing the instrument's
mouthpiece with soap and water.
More recently, a 48-year-old French saxophonist with inflamed lungs from a
moldy saxophone also got a write-up in Chest. In the same issue last September, a pulmonologist at the University of Connecticut Health Center reported on a 35-year-old
professional trombone player
who had been suffering from a cough and
shortness of breath for 15 years. Those symptoms cleared up when the musician
started cleaning his instrument with rubbing alcohol.
Now, we have to point out that the General Dentistry study was sponsored by Dr. Lorenzo Lepore founder of Encore Etc., Inc. It turns out that Lepore is a dentist, and Encore Etc., Inc. is a company he founded to sterilize musical instruments.
When Shots asked Glass if he saw a conflict of interest in that funding,
particularly when he recommends sterilizing instruments with ethylene oxide, the
method used by Encore Etc., Glass said:
We are independent of any conflict of interest. All we have to do in the
article is say how we're funded. That has no impact on us in terms of our
findings.
Ethylene oxide is used to sterilize medical instruments, and it does a very
good job. It's also pretty toxic to humans. So we don't think that you're going
to be cleaning your mellophone at home with this stuff.
Glass does say that instrument cleaning products available at music stores
are probably enough to keep the microbes at bay. (Thanks to the magic of the
Internet, Shots just learned how to give a trombone a nice bath. All you need is soap, a bathtub and some fluffy towels.)
Shots can't help but ask if the good doctor isn't being a wee bit alarmist.
"Alarmist? We worry about that, we always worry about being alarmist," he tells
us. "It's not going to hurt anybody to break down their instrument once a week
and clean it." That, he says, is preventive health.
"Playing a musical instrument has a certain level of hazard," Glass says.
"You can minimize the hazard by being fastidious."

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