After a Decade of Habituation, My Tinnitus Is Back After Ultrasonic Dental Cleaning

Fourteen years ago, I first experienced tinnitus. It might have been caused by chronic loud music listening in my youth, but it also occurred after following a prescription for large doses of ibuprofen for a back injury. Since no hearing loss was detected, I didn't receive much help from the medical community. Eventually, I reached a point where it wasn't a significant part of my life. I even had no trouble sleeping and preferred to sleep without any noise.

This May, it came back. I noticed it after a dental cleaning (possibly due to the ultrasonic cleaner or a jaw injury). I had a rough night or two, but I was able to settle down and live mostly unbothered after reintroducing some white noise at bedtime. I made it through June until another rough night on 6/29. I saw my primary care physician on 7/2, who told me I had a lot of earwax. After syringing and removing large chunks of earwax, there was no improvement, and it might have even worsened.

It's worth mentioning that I live on four acres in Oklahoma, and it's been a dry, dusty summer. I've had mild nasal congestion almost nonstop. An ear fullness feeling led me to suspect eustachian tube clogging, so I was using Flonase. The tinnitus kept getting worse, and I had two nights in a row with literally zero sleep. I then went to a walk-in clinic and was diagnosed with an ear infection. A prescription for a Z-Pak cleared that up, but the ringing persisted. I started taking Allegra D and Mucinex, but the tinnitus seemed to worsen after Mucinex, so I stopped it.

I saw an ENT on 7/23. He used a tuning fork and ordered a hearing test, which I will do today, but he didn't scope my ear or anything. He said my eardrums looked perfectly fine and that the clicking I hear when I swallow is normal and I'm just noticing it because I've started paying attention. He didn't seem convinced of any eustachian tube issues but put me on a regimen of Afrin, saline, and Flonase sprays to address any congestion. He had me stop the Allegra D because of the pseudoephedrine and blood pressure. I still feel like there's some eustachian tube issue because where else would an ear infection have come from when I hadn't had any other upper respiratory illness to put fluid up there.

Out of the last ten days:

• 7/15: zero sleep
• 7/16: zero sleep
• 7/17: 8 hours
• 7/18: 3 hours
• 7/19: 8 hours
• 7/20: don't remember
• 7/21: 5 hours (with Benadryl)
• 7/22: 5 hours (with Benadryl)
• 7/23: 5 hours (with Benadryl)
• 7/24: no sleep (with Benadryl)

Tonight, I gave up and went upstairs to spend the night watching YouTube, which I realize isn't likely to help. At this point, I'm worried that lying awake all night in bed is breaking my brain's association between bed and sleep.

I'm constantly filled with anxiety, now over the insomnia as much as the tinnitus. At the ENT, my blood pressure was 130/90, compared to 102/68 three weeks before.

I've been lurking around forums, and for everything I think might help me sleep, I can find posts where people believe it made their tinnitus worse. Cannabis edibles, Ambien... I seem to be a bit anxiety-prone anyway, and this has me freaking out that I'm just never going to sleep again and worrying about all the mental and physical toll that takes on a person. I am in desperate need of hope.

 

I understand what you're going through. I use an app for guided breathing exercises at night, and it has been a lifesaver for me when I wake up in the middle of the night or before bed, as well as throughout the day. Meditation is also essential to me. When I have my teeth cleaned, I ask them to hand-scale it.

I believe your tinnitus will improve over time. You may want to check with your doctor to see if they can prescribe Klonopin for short-term use. You may only need half a pill, which can help you sleep. I take a quarter of a pill nightly.

 

Turn off all the lights an hour before bed, take 2 mg of Melatonin, do breathing exercises, and meditate. This will relax you and help you sleep. Having the same daily routine of turning everything off would help. If you can get Klonopin, it will help you sleep better.

 

Guaifenesin may be a good option for you (instead of pseudoephedrine). I’m going through a similar process in which I’ve been treating my ETD for the past three months; the ringing in my ears appears to come from multiple reasons (I had head trauma in March), and I’m under the care of a general ENT and a Neurotologist.

I found Fluticasone more effective than Mometasone, but your mileage may vary. For the first week, apply two sprays in each nostril twice a day, then only two sprays in each nostril after that.

I also took Cetirizine for over a month and a half before switching to Allegra, which seems to be less drying yet helps keep the inflammation down. I also use a saline nasal spray, spray, not full wash, and Azelastine seems to help.

Regarding the popping and clicking noises when swallowing, it’s true that they get louder with ETD. At least, that’s my experience.

My ringing has decreased considerably over the past three months; it’s still there, but I have to pay attention to it. I went through two rounds of steroids for the ETD and four shots of Dexamethasone in the middle ear so far (due to a suspected inner ear concussion caused by the head trauma). I’m hoping it will eventually resolve. Exercising and making sure all allergy triggers were kept at bay also helped a lot.

Your ENT can stick a camera in your nose to check the function of your Eustachian tube and perform a pressure test with an otoscope.

Do your ears pop if you pinch your nose and blow gently? If it’s ETD, it can take a while to clear up, but oral steroids can definitely help reduce inflammation.

I was prescribed 0.25mg of Clonazepam for sleep (the ringing kept me awake for almost two months), and it works like a charm.

I hope this helps!

 

Update:

Yesterday, I had a routine physical with my primary doctor and discussed what I've been experiencing. She prescribed Trazodone to help with my sleep issues. My blood pressure was 121/80, which is higher than my usual.

Later in the day, I had an audiogram. It showed mild hearing loss at 6k and 8k frequencies—not severe enough for hearing aids but enough to convince the ENT that this hearing loss was causing my tinnitus.

The Trazodone made me feel like I was going to pass out, but I never got past the "weird random thoughts" phase. Eventually, I managed to get about two hours of sleep last night. This was only after giving up at 2 AM and moving to the couch, so my wife could sleep.

I'm considering that the 20 mg of Prednisone and the Flonase might be contributing to my anxiety and sleeplessness. The major sleepless nights didn't start until after I began using Flonase. So, I'm tapering down Flonase in hopes that my body will relax enough to sleep. I'll probably do the same with Prednisone afterward.

I'm noticing my tinnitus a bit more than yesterday. I'm unsure if it's because today was quieter at home or if it's a rebound effect from stopping Afrin and reducing Flonase. I breathed through my mouth all night from stopping Afrin, but I feel only mildly swollen up there now.

The recommendations for Klonopin surprise me. I was under the impression that benzodiazepines are generally ototoxic and can increase tinnitus when stopped. I really dislike the idea of being dependent on a drug long-term.

 

Prednisone will definitely ramp up anxiety. It’s ideal to take it early in the morning to avoid having issues with sleep and always with food. From my point of view, it’s a short-term price to pay for a potential long-term gain. It may also affect your mood. I never had issues with Flonase. Fewer things can lower inflammation, like systemic steroids; I would advise consulting with your doctor before tapering on your own.

I had the same experience with my first ENT. If you can, it may be a good idea to get a second or even a third opinion.

Afrin does work wonders with congestion. It’s too bad it can’t be used for more than 3-5 days. Yet it can be repeated about a week—ten days later.

For using Flonase, I’ve had the best results following this advice.

Clonazepam has reports of ototoxicity, true. In my case, I’ve used it temporarily without any issues, and that’s why I asked my doctor for it. It also seems to dial down the volume of the ringing for about 12-20 hours for me afterward, even at a minimal dose.

During the acute phase, I guess it’s sort of a “choose your own battle” kind of deal.

I wish you a prompt recovery.

 

Flonase and Afrin spike my tinnitus. To each their own. I have a hissing sound, and they seem to ramp it up.

 

Prednisone absolutely gives people insomnia and is probably the culprit. I would have insomnia routinely when I had to take it, along with anxiety attacks. There was a study that showed something like 60% of people experience insomnia on Prednisone.

 

My doctor wouldn't prescribe Prednisone because I was already having major sleep issues when my tinnitus intensity increased 2 1/2 years ago.

It is best avoided and used very sparingly. Some people talk about them stopping working in days or a couple of weeks. I take a different one (lose dose of Lorazepam) occasionally, but I try to limit it to twice per week at the most, and it has a shorter half-life than Clonazepam. If you develop tolerance and dependency, withdrawal can be extremely difficult and increase tinnitus, causing hyperacusis and other withdrawal effects.

Regarding Trazodone mentioned earlier, I tried 25 mg and 50 mg, and it didn't seem to help me sleep at all. Thank goodness for Zolpidem, which is actually for sleep, not anxiety.

 

Have you considered homeopathic medicine? I take some pellets and drops that my homeopathic doctor prescribed me.

 

Yeah. When it first started in May, I was taking Lipoflavonoid. I'm not sure if it worked or not, but I was sleeping, so I'm probably going to start it up again.

I think the Flonase spiked my tinnitus. Before I started it, I was at least sleeping well enough to function.

Unfortunately enough, I think the Prednisone actually lowered the ringing as the ringing had become a secondary concern to the insomnia, and I was able to take it out more easily. I stepped down from 20 mg to 10 mg yesterday and 5 mg today, and the ringing is louder again, BUT I got more sleep last night, without even taking anything to help me sleep, than I had the previous 2-3 nights.

I don't really know what that tells me about the instigator of this flare-up. Maybe it tells me nothing, and it's just a temporary rebound/withdrawal effect.

 

The latest research has shown that hearing damage, whether or not an audiogram is normal, is necessary for tinnitus. This does not mean everyone with hearing loss has tinnitus, but it is necessary for tinnitus (Shore, Djalilian, etc.).

Benzodiazepines are not ototoxic. Ototoxic means it causes hearing damage. Quick discontinuation of benzodiazepine medication can trigger tinnitus, assuming there is also some underlying hearing damage accumulated over the years.

Keep things simple and focus on what we know.

 

OK, so, I'm off the steroids.

The ear fullness sensation and regular compulsion to "yawn" to pop my ears have returned, and my tinnitus is back up to pre-Prednisone level, BUT:

I actually slept last night. I don't remember dreaming; I woke up a lot and tossed and turned a bit, but I didn't have any extended periods of being awake. So, I'm calling that a win.

I kind of feel like crap, though; just want to lie around. I had a Zoom call for work, and by the end, I felt hot, clammy, and weak. This could be any number of things, including the after-effects of the steroids or the fact that I haven't eaten much since I haven't had an appetite. My resting pulse has been down to around 50, which, from what I've read, isn't necessarily dangerous, but it is lower than my normal 59-60. There's also a chance my wife and I have a mild bug as she described having a similar sensation yesterday.

I freakin' hate pharmaceuticals, man. Everything is a trade-off.

 

It takes time to adjust. You mentioned you were taking Trazodone. I didn't like Trazodone. Everyone responds differently.

A 1/4 of 0.5 mg of Klonopin, with 1 mg of Remeron, can help you sleep well. You can gradually back off and take it only when needed. It is the perfect cocktail for me, and a very low dose.

 

If the volume went down with the steroids, I would take it as a good sign that there’s an inflammatory process in your ears or Eustachian tubes and that it will eventually resolve. Being patient and managing your sleep and mental health are good things to focus on.

I also believe it’s important to let your ENT know that steroids helped so he can offer you a course of action.