During my 55 years of practicing pediatric dentistry, I have been an ardent advocate of informal music therapy as an essential tool for enhancing communication and encouraging patient cooperation. I’m not referring to passive elevator music. I’m talking about interactive singing and playing in the dental office environment and in the context of providing dental treatment. I admit I have a special affinity for music, having been a concert pianist since I was a child, long before I became a dentist.
From the moment I began practicing pediatric dentistry, I used my love of music to ease the anxiety of even the most reluctant patients, with great success. In my lectures, I show numerous videos of very young children and adults as well, singing with the doctors and the assistants while getting a shot or having a tooth extracted, playing their favorite instrument, or playing their latest musical creation on the piano in my private office.
The Art and Science
It was 18th century playwright William Congreve who wrote in his play The Mourning Bride, “music hath charms to soothe the savage breast… to soften rocks… or bend the knotted Oak!” It was William Shakespeare in Twelfth Night who wrote “if music be the food of love… play on.”
I spend considerable time playing music at assisted living facilities where I observe firsthand people in an almost catatonic state not moving and not speaking who suddenly begin enthusiastically singing “Yes sir, that’s my baby. No sir, don’t mean maybe,” or whatever familiar song I’m playing and singing.
My evidence of success is mostly anecdotal. However, in recent years, advances in neuroscience have established a scientific basis for the direct relationship between music and its connectivity to brain function.
Oliver Sacks, the famous neurologist who wrote Awakenings and Musicophilia, definitively states, “People with Parkinson’s disease who can barely move become animated. Stroke patients gain words and people with dementia and amnesia become calm and organized…. That’s the power of music.”
Wake Forest Baptist Medical Center neurologist (and concert pianist) Jonathan Burdette, MD, described his MRI studies of the brain while his subjects listened to various kinds of music in an article for Science Daily. His work revealed changes in blood flow and an increased connectivity between the auditory brain areas and those areas that affect emotion and memory.
“You can actually see the power of music,” he said. “People who were just sitting there, not engaged in anything, light up when they start hearing music from when they were 25. It’s fantastic. What else can do that? I can’t think of anything other than music.”
Michael Thaut, PhD, professor of music and neuroscience at Colorado State University and co-editor of the Handbook of Neurologic Music Therapy, states in his book Rhythm, Music and the Brain that “modern cognitive neuroscience can study the brain ‘live’ and we’ve determined that music is a highly complex sensory language that can move us and affect our thoughts and feelings and influence our behavior.”
Thaut also discusses music therapy for people with cognitive, sensory, and motor dysfunctions, as well as Alzheimer’s disease and autism spectrum disorders. He points out that utilizing music and rhythm increases social-emotional responsiveness, reduces anxiety, and promotes social interaction, which is perfect for dentists.
In his book This is Your Brain on Music, Daniel Levitin, MSc, PhD, discusses one of his studies that focused on 2 groups of patients about to undergo surgery. One group received anti-anxiety drugs, and the other listened to music of their choice. The music group was more relaxed, calm, and less anxious, which is perfect for my anti-drug approach to managing reluctant child behavior. For more, you can watch Levitin’s lecture online.
Other studies concern babies in the womb who, after 6 to 7 months in utero, can hear voices and music. Some people think that babies develop a musical preference even before they’re born and that the shared musical experience strengthens the bond between mother and child. You can even buy Developmental Music for Your Unborn Child on Amazon!
Pursuant to this discussion, let me describe an interesting study by a pair of researchers who set up 2 groups of children. The first group comprised children who were read a story (non-musical group). The second group (musical group) were read the same story, but it involved singing and playing percussion instruments. The results? The children in the musical group were remarkably more attentive and more cooperative and helpful to each other.
From My Office
This cute little 6-year-old guy on the autism spectrum had begun to take violin lessons. He was always a little anxious at the beginning of his treatment visits, which involved shots and drilling. But I was able to calm things down when I would sit with him at the piano in my private office and put his fingers on the keys to simulate playing together while he was getting numb.
Every visit I would ask him to bring his violin so we could play a song together. Finally one day he arrived for his appointment carrying his violin with his mom dragging a music stand and bag filled with music. We brought him into the operatory so I could administer the local anesthetic. We decided together that we were going to play “Twinkle Twinkle Little Star,” and then he and his mom went into my private office so he could set up.
“Call me when you’re ready,” I said.
First, the violin came out of the case, which he proceeded to wipe down. Then came the bow, which he carefully tightened. Next, he unfolded the music stand, which he adjusted several times at just the right height, and put the music on it so it was perfectly straight. I sat at the piano and played an “A” so we were in tune. All of this occupied approximately 15 minutes
The boy put his bow to the strings, looked over at me, and said, “I changed my mind!”
“Oh please play with me,” I said “You may as well. You already brought all your stuff. Even just the first couple of notes.”
He did. Two notes became 6, and then we did the whole page. And when I said “Okay, once more,” we did it again.
The payoff was that over the next several years, that little guy got bigger, and at each visit he’d bring his latest instrument like a sax or a clarinet, and I’d spend a few minutes playing with him. Over the years, our dentist-patient relationship was transformed into a friendship, nurtured by our interest in music. That child is a music major in college now. His mother, whom I see on occasion, reminds me of the impact that my personal interest and patience had on their lives. Music really is the universal language.
I would like to encourage you to try using music in one way or another to establish a rapport and connection with your patients, young and old. It’s not about being skilled musicians or singers. It’s about having fun and providing a better experience for the patient.
Dr. Berman is an internationally recognized pediatric dentist with a career as a successful practitioner and as a popular world-class lecturer spanning more than 5 decades. He has been an ambassador for dentistry as a health reporter on CBS (News Radio 78) and via media appearances as a consumer advisor for the ADA, the Chicago Dental Society, and the Academy of Pediatric Dentistry and as co-author of Essentials of Modern Dental Practice. He has published numerous articles and is a member of many professional and service organizations including honorary membership in the Hinman Dental Society. He can be reached at marvy18@me.com.
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