Tinnitus is sounds heard in the Ear like a high pitched ringing sound or even a hissing, roaring, clicking, or buzzing sound.š
Tinnitus is to some extent an unexplained phenomenon for some patients.š®
Tinnitus can be Subjective or Objective.
Subjective tinnitus is perception of sound in the absence of an acoustic stimulus and is heard only by the patient. Most tinnitus is subjective.
Objective tinnitus is uncommon and results from noise generated by structures near the ear. Middle ear myoclonus is commonly manifest by objective tinnitus that is characterized as clicking (possibly due the tensor tympani movement), or buzzing (possibly due to stapedius movement), Sometimes this tinnitus is loud enough to be heard by the examiner.
Weāre seeing an increase in patients with TMJ and tinnitus as COVID-19 continues. The stress and anxiety from the pandemic could be causing patients to experience TMJ and tinnitus.
People who suffer tinnitus (ringing in the ears) frequently seek help from ENT specialists,
Once the ENT specialist rules out other causes of Tinnitus make sure you also see an Experienced Dentist to rule out Tempro Mandibular Disorders (TMD)
Problem sometimes originates from compressed jaw joints. In these cases, a dentist experienced in treating TMJ issues, may be able to help.
Most audiologists and otolaryngologists studying the normal or pathological aspects of hearing usually focus their efforts on the anatomical, biochemical, or physiological properties of the cochlea and classical auditory pathway while largely ignoring the multitude of secondary or tertiary inputs from other sensory, motor, or autonomic systems that interact with the auditory systems at a number of locations. This fails to take into account the numerous anatomical interactions that need to occur to perform common everyday acts.
Recent functional brain imaging studies in humans suggest that the neural generator(s) for tinnitus may involve both auditory as well as nonauditory centers in CNS.
The contribution of nonauditory centers in the pathogenesis and regulation of tinnitus is reinforced by studies showing that many patients have Somatic Tinnitus whereby movements and manipulations of the eyesš, headš, neck, jaw, teethš¬ and shoulder can modulate the loudness and pitch of their tinnitus.
The acoustic cues must be evaluated in relationship to the position of the head and pinna and its relationship to the rest of the body, as well as knowledge about the location of the head and body with respect to the environment (e.g., lying down, standing up, standing in an open versus closed room).
Highly Experienced Dentists are starting to see evidence that Tinnitus may also be caused by an imperfect bite or occlusal problem. This variation of tinnitus is somatosensory, nonauditory cues like other types of tinnitus associated with muscle tension, primarily in the neck and jaw area and this can be linked to an imperfect bite.
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There are several other possible causes of tinnitus. to be ruled out by ENT specialist. These include:
Inner ear damage
Earwax build-upĀ that blocks the ear
Middle ear infection
Glue ear ā a build-up of fluid in the middle ear
Perforated eardrum
Meniere's diseaseĀ ā a condition that also causes hearing loss andĀ vertigoĀ (a spinning sensation)
Otosclerosis ā an inherited condition where an abnormal bone growth in the middle ear causes hearing loss
Rarer causes
Head injury
Exposure to a sudden or very loud noise, such as an explosion or gunfire
AnemiaĀ ā a reduced number of red blood cells that can sometimes cause the blood to thin and circulate so rapidly that it produces a sound
Reactions to certain medications, such as someĀ chemotherapyĀ medicines,Ā antibiotics, diuretics,Ā non-steroidal anti-inflammatory drugs (NSAIDs)Ā and aspirin (this is more likely to occur at very high doses)
Acoustic neuroma ā a rare non-cancerous growth that affects the hearing nerve in the inner ear
High blood pressureĀ (hypertension)Ā and narrowing of the arteries (atherosclerosis)
Overactive thyroid glandĀ (hyperthyroidism)Ā or underactive thyroid glandĀ (hypothyroidism)
Diabetes
Paget's disease ā where the normal cycle of bone renewal and repair is disrupted
Approximately 80% of these patients also reported that jaw movements altered the loudness of their tinnitus; in most cases, tinnitus loudness increased.
Jaw movements also tended to increase the pitch of the tinnitus substantially in most patients.
It has been reported that tooth abscesses or impacted wisdom teeth can cause tinnitus. In such cases further dental work may cure the condition.
When tinnitus is severe, it can interfere with daily activities and with sleep as well.
Most often, tinnitus is subjective and therefore cannot be successfully tested or quantified. In some cases, however, there is objective tinnitus, where a physiological connection is found.
People who experience tinnitus often experience multiple psychological effects. Depression is common condition, and many pass through anxiety disorders as a result of their hearing problems.
Thus, A vicious cycle sets-Tinnitus causing stressful situations and stress worsening Tinnitus.
When stress triggers tinnitus, temporomandibular joint disorder (TMJ) most often could be the root cause of ringing in the ears.
Tinnitus may also occur when people suffer from chronic teeth grinding and clenching (Bruxism) or Temporomandibular joint TMJ dysfunction.
Tooth movement during fixed Orthodontic treatment may be a factor which may lead to tinnitus in adolescents patients. This occurs due to a change in the contact between maxillary and mandibular teeth which leads to the formation of a new sensory engram.
A misaligned bite (misalignment of the teeth) that affects the head, neck, shoulders and the whole body is due to a ābad biteā, where your upper and lower teeth do not meet correctly causing TMJ issues. Misalignment puts the bones, muscles, joints, and tendons of the head and neck out of alignment as well. and leads to Temporomandibular Joint Disorder (TMD).
TMD creates chronic stress in the jaw muscles and nerve supply contributing to tinnitus.
Itās common for patients with TMJ to clench their teeth when feeling stressed, stressing the jawbone and putting pressure on the teeth and jaw joints. Not only hard tissue, it tenses the jaw muscles as well, and that tension might be the real source of the TMJ tinnitus.
Jaw muscle when tensed causes a lot of strain on the muscles of the ear. !
Yes! The ear muscles āthe tensor tympani and tensor levi palatineĀ ā react to facial muscle tension. The reason for this is because they are both connected to the trigeminal nerve.
The tensor tympani and stapedius middle ear muscles, innervated by the trigeminal (5th cranial nerve) and facial (7th cranial) nerve, respectively, begin to contract before the onset of the vocalization, thereby attenuating self-generated sounds.
{The activity of the stapedius muscle in man during vocalization.
Borg E, Zakrisson JE
Acta Otolaryngol. 1975 May-Jun; 79(5-6):325-33.}
These carefully orchestrated neurophysiological interactions occur subconsciously without a momentās thought.
One should note here that a very Complex multimodal interactions occur between other sensory and motor systems and the auditory system and the potential role of these complex neural networks have impact on the perception of tinnitus.
Thatās not the only connection. Two of the bones in our inner earāthe incus or āanvilā and the malleus or āhammerā are derived evolutionarily from reptilian jawbones. They still retain some of their muscle and nerve connections with the jaw, which can easily cause jaw problems to lead to ear problems.
People with TMJ issues are about three times as likely to have tinnitus than people without, and if you have TMJ issues and headaches, youāre six times more likely to have tinnitus.
Studies have shown, more than 90% of tinnitus cases had links to facial muscles pain, including TMJ.
Pulsatile tinnitus may be more noticeable at night, when you're lying in bed and there are fewer external sounds to mask the tinnitus. Sleeping with your neck at an odd angle can kink the major blood vessels to the head. This causes turbulent blood flow, which you may hear as tinnitus.
Patients often ask me how can jaw movement or teeth misalignment can cause sounds in my ear! Well, The inner ear is actually housed in the temporal bone, which, yes, is part of the temporomandibular joint (the other part is the mandible, the jawbone). This means that vibrations and pressure changes in the jaw have a very direct route to becoming sounds in your ear.
That means getting tested for TMJ is a good idea if you have tinnitus.
look for these
Jaw pain
Headaches
Tooth wear
Neck pain
Difficulty gaping wide
Tiredness in the mandibular joint
An Experienced TMJ dentist can offer a few solutions,
Medications that may reduce pain and swelling and relax your jaw
Correct your grinding and clenching issues
Prescribe antidepressants to relieve stress.
I recommend Erkoloc pro, a kind of splint or night guard which will be custom made for your smile.
May replace or restore certain teeth to balance a bite problem,
For more severe TMJ pain may need a full mouth rehabilitation which can treat TMD and can subsequently stop your tinnitus.
Nutritional Aspect
It can be concluded that patients with tinnitus may have low blood zinc levels (31%), clinical and subjective improvement can be achieved by oral zinc medication.
High cholesterol may worsen tinnitus as it thickens the blood and slows down its ability to transport nutrients to the hair cells.
Magnesium has been shown to relieve the severity of tinnitus symptoms
Bananas and Yogurt are high in potassium, which is helpful for the regulation of fluid flow throughout the body, to flow better to decrease tinnitus. Potassium can help get rid of excess fluid in the ears and body. Less swelling in the ears can help lessen tinnitus symptoms
Patients who have Diabetic symptoms are more likely to notice an increase in tinnitus when they eat sugary foods, such as chocolate or candy.
Ask an Expert Nutritionist for Opinion.
Practicing yoga, relaxation therapy, meditation, and other stress-reducing activities can help reduce your TMJ and tinnitus symptoms.
Summary
Following a thorough assessment and detailed understanding of potential occlusal problems it is possible to realign the bite and lower jaw position, placing less pressure on the middle ear
Yes! With the right TMJ treatment, you can reduce or eliminate TMJ tinnitus. Once we help alleviate stress to the TM joint, it's very likely your tinnitus will go away.
I have worked on Tinnitus patients who experienced painful symptoms and continue to update myself to help them. To Get your Tinnitus issue evaluated, book a TMJ/ Occlusion /Jaw alignment consultation with me
Please book your slot at our website dentistlotusclinics.com
Issued in Public Interest
Disclaimer: Lotus Clinics claims no credit for certain images / Videos featured on our blog site taken from web, unless otherwise noted. This is written for Educational purposes and to bring awareness among public, with case Study pics of my Patients with their written /Audio/ Video Consent
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