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Orthodontics and Horn Performance.

Braces are now fairly common among music students to straighten teeth for either aesthetic or therapeutic reasons. Braces might ultimately help a wind player if the embouchure is improved. I have worked with students who were successfully treated with braces and offer my experience to those who are going through treatment or are about to start. Repertoire, accessories, and methodologies have been designed to make this process easier and more comfortable.

Braces often result in some discomfort, pain, and even lip bleeding, plus "dirty" articulation, when in place during horn playing. Despite these side effects, which can scare any student or teacher, once it is determined that braces are necessary, the sooner the better. Experts (Williams and Williams, 1998) state that, as you age, your teeth move more slowly and therefore the process is slower. (1) If braces are installed early, less time might be spent wearing them, resulting in less disruption to the learning process.

Wearing braces generally causes playing to be more difficult and, if it becomes too physically demanding, to inhibit improvement and lead to both physical and psychological problems. Students may feel that they are unable to improve and may even be losing what he had already conquered.

Today most orthodontists are aware of the problems musicians face; however, if you find one who is not, the result can be catastrophic. One of the keys to success lies in good communication between the teacher, the student's parents, and the orthodontist, so if major changes are necessary, the treatment does not begin before major concerts or exams. Literature on the subject of musicians and braces states, "[...] double reeds, saxophones, flutes and larger brass instruments [...] can be played with relatively good comfort and natural embouchure adaptation." (2) This statement does not apply to the horn and trumpet--brass instruments with small mouthpieces. According to Souza, the lack of knowledge related to horn and trumpet playing by both parents and orthodontists often leads to the application of braces just before a concert or audition/ exam. Orthodontists often state that they have treated many brass players, "none of whom had any problems." (3)

The shocking lack of parental awareness is often revealed when parents approach a teacher before a concert or exam and mention that their child has just had braces put on or has an appointment scheduled to put them on--only then do they remember to ask whether it has an impact on the student's performance. The lack of planning has been mentioned by several sources. (4) Proper planning is important.

Before choosing braces, students should talk to their orthodontist. Braces come in two types: fixed and removable. Even with removable braces, which have no brackets and therefore do not hurt the lips when playing, the fact that the position of the teeth constantly shift can affect performance. With fixed braces, the brackets usually cause discomfort and can even seriously hurt the lips. It is advisable to keep an open mind and examine the available choices.

Removable braces come in two types: "traditional" and almost invisible, Invisalign, which are more expensive and not recommended for serious dental problems. Not all orthodontists are able to work with Invisalign braces. With removable braces, the amount of daily practice time must be taken in account; long periods without wearing the braces can slow the treatment.

Fixed braces can be traditional, with rubber bands, or the Damon System, which gives faster results but at a higher cost. "Lingual braces" are basically the same as traditional braces except the wires and brackets are on the inside of the teeth, so they do not hurt the lips. The negative aspects of lingual braces include a higher price, difficulty of cleaning, and possibility of tongue pain; also, the regular adjustments take longer and tend to be more difficult than traditional braces. Not all orthodontists are trained to work with them.

Mouthpieces to help horn players who wear fixed braces are available. The Wedge, according to its description, reduces the amount of pressure on the lips, which in turn leads to increased endurance and a clearer tone. (5) The BP Mouthpiece has a wider cushion rim, allowing the pressure to be distributed over a broader area, reducing the problem of cut lips and improving the sound. (6) Although none of my students have tried these mouthpieces, I can see the benefit of a wider rim for comfort and hygiene.

Although not advised nor desired, it is common, especially among young students, to use too much pressure on the upper lip in the higher range. In my experience, students who have been more successful playing with braces have learned to play in a more relaxed manner, using less pressure, to avoid or at least reduce pain.

A simple way to help reduce excessive mouthpiece pressure is to play without using the finger hook. If students use too much pressure, the left hand slips. Once the thumb alone supports the horn, I advise students to sit while playing to avoid excessive tension in fingers of the left hand.

An accessory that may help is "Methodisches Zusatzgerat" (methodic accessory), MZG. (7) Made in Germany, it is a small pressure regulation system with a spring in a cylinder that fits between mouthpiece and leadpipe. When the mouthpiece pressure exceeds a defined limit, the spring collapses enough to allow the air to escape and the sound to stop. When used moderately (for example while warming up), it helps reduce excessive pressure. I recommend that it be set first at the maximum pressure and then the pressure reduced gradually on a defined schedule (one day or one week at a time), reducing the pressure until the minimum pressure needed to play is found. The goal is not to play without pressure but to avoid its excess. With this device, the distance between the lips and leadpipe changes, so caution is recommended. Also, to keep track of progress, I suggest using permanent ink to mark the changes in pressure settings.

Another device is the STRATOS Embouchure Training System, an accessory developed in the United Kingdom by trombone player Marcus Reynolds. It is similar to the MZG; however, here the device fits on the mouthpiece with a screw and a piston and the chin limits the mouthpiece pressure. As mentioned on their website, it is designed to "change their jaw position, and reduce the pressure applied between lips and mouthpiece. You should be able to play without pain--and improve your technique ahead of the day the braces come off." (8) The website also mentions that, when the braces come off, muscle memory may help maintain the feeling of less mouthpiece pressure.

Perhaps the most damaging effect of braces is the difficulty in achieving clear articulation. The tongue releases the air, but with braces, the tongue has to travel a greater distance to set the lips into vibration, thereby creating a "fuzzy" articulation. If students use wax or plastic covers over the braces to reduce the lip pain, these covers, usually suggested by orthodontists, push the lips even further away, making clear articulation even more difficult. Molded plastic covers with 0.01mm thickness have been available since 1998, benefiting articulation while producing minimal interference to the player. If you want to try brace covers, contact the orthodontist and take your instrument with you to the office. Play for the orthodontist using different covers, so that together you can determine the best cover.

Above all, it is important to keep the embouchure and mind in shape! It is difficult enough to play while wearing braces. Without regular practice, it is impossible to maintain minimum quality. A practice routine provides an anchor, an invariable element, that helps to sustain the performance level, even while the teeth are shifting. It is not advisable to practice for long periods of time, but to split practice into brief periods. For example, instead of practicing for a solid hour, distribute that time over two or even three hours; a plan might alternate sessions: 15 minutes playing, 5 minutes doing solfege, 15 minutes playing, 10 minutes singing and fingering, 15 minutes playing, 20 minutes reading a book, and 15 minutes playing.

Braces and Brass, (9) a book for trumpet or horn by Colson and Stoneback, might help students organize their schedules during brace treatment. The exercises and etudes are similar to traditional or "normal" routines. The main difference lies in the way they are presented, including instructions to help students understand the nature of the problems related to playing with braces. The book presents a schedule where progress is notated, so results can be compared when a brace is applied or removed.

It is important to compare the work done in the previous weeks and months. Then, when students go through difficult times, looking back to the previous week(s), they can see the improvement, even if it is not as great as hoped. After one or two months, progress should be obvious, which helps students see the whole picture and estimate achievements.

This book reinforces the learning process by examining both the physical and the psychological aspects of performance. The psychological side is not often included in considering students' achievement, but it is addressed in this book. Another aspect of the book, range, is fine for trumpet, but I recommend transposing the exercises down a fifth to a more comfortable range for horn (horn in B basso).

Posture might be affected when wearing braces. Students whose posture leads them to press the lips too hard on the braces can change the angle of the head in order to reduce pres sure. According to (Hilliard, 2011), this complication can be improved by playing off the leg. (10)

As mentioned, one of the problems related to wearing braces is concerts and auditions/exams, which usually do not fit with the schedule of teeth realignment. As a partial solution that at least can mitigate this problem, I suggest that students focus on intellectual tasks during the treatment, leaving the physical ones until after the braces are removed. Students can work on low transpositions: horn in E, E[flat], D, D[flat], C, B[flat], and even horn in [B.sup.#]. Students can work on the traditional repertoire but in a lower range. This also a good time to practice reading bass clef (both old and new notation) and alto clef (including ledger lines).

The high range is usually most affected by braces. Besides transpositions, several etude books available in the market, at different difficulty levels, focus on the low range:

* Denniss, G. W. (1993). Studies for Low Horn. AU: Graeme Deniss.

* Frehse, A. (1954). 34 Etuden fur tiefes Horn. Friederich Hofmeister.

* Grabois, D. (2009). Twenty Difficult Etudes for the Horn's Middle Register. USA: Daniel Grabois.

* Hackleman, M. (1990). 34 Characteristic Etudes for Low Horn Playing.

* Vuarmarens, Switzerland: Editions Bim.Matosinhos, R. (2013). 15 Low Horn Etudes. Enschede, The Netherlands: Phoenix Music Publications.

* McCoy, M. M. (1986). 46 Progressive Exercises for Low Horn. USA: McCoy's Horn Library.

* Miles, P. (2009). Low Horn Etudes and Drills for the Intermediate Horn Player. Eau Claire, USA: Really Good Music.

* Neuling, H. (1951). 30 Spezial-Etuden fur tiefes Horn, heft1. Pro musica Verlag.

* Neuling, H. (1952). 30 Spezial-Etuden fur tiefes Horn, heft2. Pro musica Verlag.

* Neuling, H. (1986). 18 Studien fur Horn : mit besonderer Berucksichtigung der tiefen Lage. Hans Pizka Edition.

* Pitarch, V. Z. (2002). 20 Estudios para Trompa Bajo. Valencia, Spain: Piles. Ware, D. (2006). Low Horn Flexibility Studies. USA: Cimarron Music Press.

* Weingartner, F. (2009). Etuden fur tiefes Horn, band 1. Freiburg: Mohlin Verlag.

* Weingartner, F. (2009). Etuden fur tiefes Horn, band 2. Freiburg: Mohlin Verlag.

* Weingartner, F. (2009). Etuden fur tiefes Horn, band 3. Freiburg: Mohlin Verlag.

Unfortunately, it is more difficult to find suitable material for solo repertoire and chamber or orchestra music, especially at an advanced level; even if identified as for "low horn," virtuoso passages in this range are not suitable for every student. Considering this lack of repertoire, I have written two pieces: (Matosinhos, Low Horn Suite (no. 1) for Horn and Piano, 2014) (Matosinhos, Low Horn Suite (no. 2) for Horn and Piano, 2015), both with a pedagogical approach and aimed at the intermediate level student.

Students should believe there has been progress during the treatment despite following a different path and learning sequence from students without braces. If students don't have this belief, they will probably become discouraged, in which case it is difficult to maintain the motivation it takes to play the horn well.

Whenever we audition new students and I find candidates who show potential but present a malformation in the mouth, I recommend that they see an orthodontist and correct the problem as soon as possible. Otherwise they might face difficulties not only during the learning process but also in their careers. Many students begin playing the horn around the age of 10 but, unfortunately, the dental development that may require correction tends to occur when the student is 12-13 years old. I have taught students who started playing the horn already wearing braces and students who had them applied after having started playing the horn. Both groups of students feel discomfort when playing, but those who have braces on when they begin tend to learn more naturally how to reduce the pressure, improve their articulation, and accept the whole process more easily.

Of course, each student is different. I remember a student who began to wear braces after playing horn. He performed the Saint-Saens Romance Op. 67 and the E transposition gave him more trouble than the soft b at the end of the piece!

In summary, a dental correction will never be an easy task for a horn player; however, by adopting different methodologies, trying mouthpieces and accessories, maintaining a clear articulation, and keeping a healthy communication between the student, the horn teacher, the family, and the orthodontist, it is possible to achieve good results, especially when done in an early age.

Ricardo Matosinhos currently teaches at ARTAVE, CCM, and at the Academia de Musica de Costa Cabral in Portugal. He has played with the Filamonia das Beiras Orchestra, Orquestra do Norte, Orquestra Nacional do Porto, and others.


(1) Williams, D., & Williams, R. (1998, November). "The Horn/Orthodontic Interface." The Horn Magazine, 6, 30-32.

(2) Balbach, D. R., Wiesner, G. R., & Wilson, M. A. (1973). Orthodontics and Wind Instrument Performance. Washington, USA: Musical Educators National Conference.

(3) Souza, S. (1998, July). "Brace Yourselves." The Horn Magazine, 6, p. 28.

(4) Balbach, Wiesner and Wilson (1973), Souza, 1998, and British Orthodontic Society. (2014). Advice for Musicians. Retrieved 10 2015, 22, from

(5) Harrison, D. (2015). Wedge Mouthpiece. Retrieved 10 23, 2015, from www.wedgemouthpiece. com

(6) Black, G. (2012). Greg Black Mouthpices. Retrieved 11 2015, from horn.htm

(7) Dolling, J. (2005). MZG--The "Methodisches Zusatzgerat." Retrieved 10 22, 2015, from Thomann:

(8) Reynolds, M. (2015). STRATOS Embouchure Training System. Retrieved 10 22, 2015, from

(9) John Colson and Ron Stoneback. Braces and Brass. (San Antonio: RBC Music Company)

(10) Hilliard, H. (2011, May). "On or Off the Leg?" The Horn Call, XLI, no.3, 56-60.

Mastering the Exhale (continued)
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Author:Matosinhos, Ricardo
Publication:The Horn Call
Date:Feb 1, 2016
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