HMN 2026: How music is transforming dental care

Treating patients who have spent years—sometimes decades—avoiding dental care because of fear, disability, trauma or painful past experiences can be challenging. “They are afraid and don’t want to be treated,” said Adela Planerova, DDS, MS, chair Special Needs Dentistry at University of Rochester Medicine Eastman Institute for Oral Health. “Some are even afraid to enter the room. When they eventually sit in the chair, they often try to push the provider away. Many of our patients move constantly, while others have persistent involuntary movements because of their condition, such as cerebral palsy.”

Because of these challenges, many have been turned away by multiple practices, while others have only ever been treated under anesthesia in the operating room.

But Eastman has introduced an innovative, patient-centered approach that is transforming care for people with severe anxiety and complex needs: music therapy. The results are immediate and measurable: calmer patients, shorter appointments, fewer procedures under anesthesia and more access to care.

For Ron Harrison and his 34-year-old daughter, Coryanne, it’s made all the difference, because finding dental care was never simple. “A lot of dentists won’t take her because she’s disabled,” Ron stated.

Born with fetal alcohol syndrome and legally blind, Coryanne previously received dental care in Seattle where they lived. “She had to be put under every time because she wouldn’t let a dentist touch her,” Ron recalled.

After moving to Upstate New York, Coryanne had several unsuccessful dental visits with different providers over two years. Ron was finally able to get a referral from Coryanne’s physician to be seen by the EIOH’s specialists at University of Rochester Medicine’s Complex Care Center.

“The skills there are amazing,” said Ron, who drives 2½ hours one way from their home in Poland, NY. “She fell in love with their dentists. And that’s a big deal, because she’s normally standoffish. That’s weird for her to love a dentist, but she loves her dentists here, and that’s because they know what they’re doing.”

Ron credits Coryanne’s willingness to comply to the patience and calmness of the doctors, the way they talk to her, and the music.

Because Coryanne went for several years without adequate dental treatment, she needed a lot of work done. “During her first visit, with the music therapist in the room, we were able to perform three extractions,” said Dr. Planerova.

Before settling into the dental chair, Coryanne likes to walk around the room, greet the dentists and dental assistants and look at their badges. During her appointment, she gently rolls a cabasa—a small percussion instrument—that music therapist Madeline Vinolus, MT-BC, gave her. Throughout the procedure, Madeline strums classic rock on her guitar, staying tuned into Coryanne.

Coryanne’s subsequent dental visits with music therapy have been just as successful. Much to Ron’s surprise, she’s been able to receive fillings and extractions without general anesthesia.

“She responds really well to the music,” Ron said. “I even had to buy her a cabasa for home because she enjoys it so much here!”

People with IDD are often disproportionately affected by dental anxiety. Factors like heightened sensory sensitivities and communication challenges contribute to increased anxiety, leading to avoidance of care and reliance on sedation or general anesthesia.

“Many patients come with severe conditions, pain and broken teeth, and usually need a lot of treatment,” said Dr. Planerova.

“A key principle of music therapy is matching people where they’re at,” explained Madeline, a board-certified music therapist with the University of Rochester Medicine Eastman Performing Arts Medicine Center. “Science and music therapy are absolutely connected. Music therapy helps shape the rhythms within helping people calm their nervous system down, in a quicker and sometimes more gentle way.”

If a patient comes in very agitated, Madeline will play something very upbeat to grab their attention and get on the same level. Then, she slowly starts to change the music, perhaps a little slower or softer to see how the patient responds.

“If they follow the music, then maybe we can get to a spot where they can take the next steps toward successful treatment,” Madeline explained. “I’m always watching for body language to gauge their response to the music and to the environment.”

Take 33-year-old Colby, who has Williams Syndrome, a rare genetic neurodevelopmental disorder, who came in for two extractions. His anxiety was extremely high and he kept saying he didn’t want to be there.

“Getting two teeth pulled is anxiety provoking for anybody, let alone someone who may experience the world differently,” Madeline explained.

Madeline started a conversation about music with Colby and she immediately sensed a change in him.

“I could quickly tell how much he loves music,” she recalled. “I took some time and showed him that I’m respecting this thing that he loves and saying let’s use this together to help you go through this process. So, I’m not disregarding his anxiety, but saying, I see it’s here.”

Colby picked a song, Madeline gave him some hand instruments to help him relax, and they started playing.

“Colby started singing, creating his own lyrics as he processed in the moment what was happening,” Madeline said. “I’m playing the guitar, repeating what he’s singing, adding a little bit, and we ended up settling on the theme of ‘when my teeth come out, everything’s going to be all right.” It was amazing to watch the transition.”

“Before music therapy, Colby was always so nervous and fidgety,” said Joyce Helman, Colby’s mother. “Now, with the music, his complete experience is so positive. He feels so happy to see them. Colby gets exceptional care. The dentists and assistants are so kind and genuinely caring. That makes a huge difference.”

Madeline has multiple strategies for patients. She’ll meet with the provider and family member first to better understand the patient and his/her needs. Then she tailors the therapy to the individual and adjusts it if needed throughout the appointment. She plays her guitar. She may sing or hum. She brings other instruments to play or to invite the patient to play during the visit.

For some patients, Madeline sings or plays requested songs, offering the patients control during moments that otherwise may feel overwhelming. For others, especially those who are highly sensory-sensitive or verbally focused, she minimizes her voice and uses subtle instrumental music to avoid adding stimulation.

“Adding another voice can just add more confusion,” she explained. “But for others, it can be very centering to have someone singing.”

Chaz, 23, who is autistic, previously experienced unpleasant dental appointments, including an unsuccessful attempt with nitrous oxide. He was referred for full sedation in the operating room.

But sedation appointments often come with months-long waiting lists. When Chaz transitioned to care at the Complex Care Center, the team suggested trying music therapy.

“They tried it out first,” said Chaz’s mother, Diane Brown. “And it worked. Music soothes everybody. I love it here, it’s a blessing. You don’t know what I’ve been through.”

Now Chaz completes procedures without medication.

The impact isn’t limited to patients with disabilities. EIOH also provides this service to patients in its Prenatal and Infant Clinic.

Eight months pregnant, Juliana Gomez arrived for a cavity filling already tense. The sound of the drill triggered severe anxiety, and she began shaking in the chair.

Madeline initially started playing her guitar matching Juliana’s shaking. Madeline watched Juliana respond as she slowed the music. Soon the shaking slowed and then stopped.

“It took my mind away,” Juliana said. “I wasn’t concentrating on the procedure anymore. Guitar is my favorite instrument. It was very soothing. I didn’t think it would have that much effect—it was very cool. I liked it a lot.”

“It’s amazing to watch the transformation among our patients,” Dr. Planerova added. “There’s usually so much anxiety in the room before we begin, but with the music therapy, it absolutely goes down. It disappears because the patient is distracted and likes to listen to the music.”

The bonus is increased efficiency. “While Madeline is working with the patient,” explained Dr. Planerova, “providers can focus on the procedure. Otherwise, we’re addressing the anxiety and discomfort throughout, and it prolongs the visit.”

Dr. Planerova and Madeline are co-authors of a case study recently published in the Journal of the American College of Dentists, which addresses the benefits of music therapy in whole person care. Despite advances in clinical dentistry and oral health technologies, traditional care models often overlook patients’ emotional and psychological needs. These gaps contribute to poorer outcomes, including untreated decay, periodontal disease, and tooth loss.

Dr. Planerova’s team is tracking appointment times and seeing measurable reductions because of the novel approach. In some cases, extractions once expected to require sedation have been completed in 15 minutes.

That efficiency matters. With thousands of people on dental waiting lists regionally, reducing sedation dependence opens access for more patients to be seen sooner.

For the therapist, the most powerful moments come not during the procedure, but after.

“One of the first patients I worked with here—her mom cried afterward,” Madeline said. “She said, “You don’t understand, seeing my daughter in pain—I feel it in my body. To see her more relaxed and comfortable meant everything.'”

“What greater honor is there,” Madeline added, “than to provide comfort to another human being?”

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