Can Fullness and Cracking Due to TMJD Go Away?

Hi

I've had cracking when swallowing and fullness in my ears for two months now. It started for me one month into tinnitus and it coupled with bad jaw pain (so bad that eating, smiling and talking hurt). Since I got a mouth guard three weeks ago the fullness has been better and even sometimes the cracking stops.

But I was wondering if it's possible for it to completely go away, or if I have to live with this the rest of my life?

 

Even the tinnitus has lowered in volume and the tone even disappears for a few days (it was the case last week)

 

Hi @paganismos I followed your story since I joined because it very nearly mirrors mine. In my case the ETD was caused by severe swelling from TMD. Since moving towards TMD treatment my ringing has begun to lower. I also notice my ETD is better as I work on reducing inflammation in my TMJ. But I have continued to use allergy medication as well to help swelling. In fact I went from having confirmed ETD via a tympanogram showing negative ear pressure, to one that at least has normal pressure by doing TMD physical therapy. I am also taking NSAIDs, but I wouldn’t recommend that since people on this forum would jump at the thought of that.

I fully expect my ETD to subside and my tinnitus to resolve (which in my case is the level I was born with).

 

My left (TMD) side is hissing. My jaw does seem to feel not right (possible swelling) I need to use my splint every night. Maybe NSAIDS would help the possible swelling. I was going to try a steroid injection possibly if the Dr. will do it. I picked up my new appliance and seen Dr. Hakala for final fitting.

 

I ice three times a day. Rub a cube until it’s totally melted. Check out iontophoresis! It’s a good middle ground. More effective than NSAIDs and not quite the nuclear bomb of a steroid shot. I am getting them through the UofM. I do know long term NSAID use isn’t good. But I’m very confident inflammation is causing my T. And inflammation is my enemy. I’m glad you got in! Beware, the first few weeks can be hell until your muscles adjust. Mine fought the mouth guard like heck for almost three weeks until they finally gave up. Headaches just went away. On my first appointment my opening was 27mm and now I’m up to 43mm! (Been almost six weeks) I can actually feel my ear pressure relax and my ETD improve as more joint space is created.

 

@kelpiemsp, Glad that you are doing better! Yeah steroid injection may be overkill perhaps. My noise could be from noise damage. I got a script for Cymbalta 20mg if all else fails. Head noise is a killer, no doubt about that. Trying to survive. I will try ice cubes on my left TMJ.

 

@kelpiemsp, I need to use sleeping appliance more in case it is causing mainly left side weird noise. I will keep trying ice cubes. I wonder how long it takes to see results if that is the cause? I know MN Cranial is closed today.

 

Tinnitus and disorders of the temporo-mandibular joint (TMJ) and neck



Background
There is a close relationship between certain problems with the jaw joint (temporo-mandibular joint or TMJ) and tinnitus. Scientific studies have shown that people with TMJ problems are more likely to suffer from tinnitus. Similarly, some individuals who have sustained an injury to their neck may also suffer from tinnitus. Some people with either TMJ problems or neck problems are able to alter the intensity of their tinnitus by moving their mouth, jaw, face and neck. Successful treatment of the underlying problem can be associated with an improvement of tinnitus symptoms.

What is the temporo-mandibular joint (TMJ)?
The TMJ is a complex joint as it has to allow for side-to-side and front to back movements that take place during chewing. The muscles that make the jaw move are some of the most powerful in the body. This means that quite large forces have to act through the TMJ. As a result, the joint is at risk of damage just as much as any other weight-bearing joint in the body. TMJ problems can be due to trauma, such as a ‘pulled muscle’ or a dislocation to the fibrous disc that sits in the hinge joint. Other TMJ problems may be due to longer-term problems such as arthritis within the joint. 

What are the symptoms of TMJ problems?
The usual symptoms of TMJ problems are pain, which may be felt as earache, clunking of the jaw, or limitation of movement, causing difficulty in opening the mouth. Other symptoms that may arise are swelling of the joint, headaches, neck pain and tinnitus. Some people notice that when stressed, they grind their teeth - particularly at night - and this can put pressure on the TMJ.

How does the TMJ affect tinnitus?
There are three main theories behind why problems with the TMJ may cause tinnitus, or make it worse. Firstly, the chewing muscles are near to some of the muscles that insert into the middle ear and so may have an effect on hearing, and so may promote tinnitus. Secondly, there can be a direct connection between the ligaments that attach to the jaw and one of the hearing bones that sits in the middle ear. Thirdly, the nerve supply from the TMJ has been shown to have connections with the parts of the brain that are involved with both hearing and the interpretation of sound. The general discomfort associated with TMJ problems can also aggravate any pre-existing tinnitus.

How can TMJ problems be diagnosed?
Your dentist can often diagnose TMJ problems on clinical examination. If necessary, the dentist will refer you for further tests. Disorders of the TMJ may be investigated with Magnetic Resonance Imaging (MRI) scans and even, on occasion, by arthroscopy, which is a small procedure where a tiny camera is inserted into the joint.

What can be done about it?
A variety of treatments are available to treat TMJ disorders. If your tinnitus is related to your TMJ problem, the tinnitus may improve as the TMJ problems get resolved.

There are some simple measures that can help TMJ problems, such as a change to a soft diet, jaw muscle exercises or the use of anti-inflammatory medicines and painkillers. For people who grind their teeth or clench their jaw, a bite-appliance may be made which corrects the way in which the jaw works and reduces the stresses and loads on it. This can be disposed of when normal function is restored. In exceptional cases a specialist dentist, known as a maxillo-facial surgeon, may be required to perform surgery on the TMJ.

How can neck problems affect tinnitus?
Long-term pain and discomfort from conditions in the neck can also aggravate tinnitus in the same way TMJ problems do. Studies have shown that patients who have suffered an injury to the head and neck region, such as from a car accident, or who have neck pain or stiffness for other reasons, such as arthritis, are more likely to experience tinnitus.

Furthermore, there is some scientific evidence to support how the nerve endings in the neck make connections in the hearing centres of the brain, explaining how neck problems may affect tinnitus. Quite often the tinnitus associated with neck injuries may be more severe, and can be combined with other symptoms such as headache, depression, and problems with memory and concentration.

Treatment generally depends on the cause of the neck problem, but the results from treating the underlying neck problem are often good. Treatment options can be discussed with your family doctor, who in some cases will recommend simple measures such as the use of painkillers and physiotherapy. Some people are able to modify their tinnitus by moving their neck. Recently, it has been suggested that in a minority of these individuals, TENS (Transcutaneous Electrical Nerve Stimulation) can help them with their tinnitus.

 

How long does the inflammation of the jaw tend to go away in?? Can it be months or years?? I have T from neck/jaw issues too.

 

I have TMJ also and I’m sure it’s the cause of my tinnitus. What kind of dentist are you guys seeing? I cannot find a tmj “specialist” that will do a consult for under $500! Long term treatment is estimated to be between $3,00--$6,000. My dental doesn’t cover tmj. I’m going to a chiropractor (family friend) who says my jaw is still locked and he’s doing gentle manipulations and cold laser light therapy. Also have an ENT appt next week as the last ENT sucked and told me tmj could not cause tinnitus. How do I go about finding a dentist to treat this?

 

@Stephanie72 - I go to a neuromuscular dentist and have a 24/7 mouth orthotic. Sadly, for most insurance claims this is considered cosmetic and not covered...

Did a Google search for "phoenix neuromuscular dentist" and found these options:

https://www.drsofsmiles.com/tmj/

https://www.desertsmiles.com/neuromuscular-dentist

http://myarizonasmile.com/neuromuscular-dentistry/

 

@housemzk
Thanks for that! I hadn’t seen the one located in Mesa. I’ll call around Monday and get some consultation quotes. Ridiculous that this is considered cosmetic lol. I literally cannot eat anything that requires chewing. Thanks for responding.

 

@Stephanie72 - part of the reason it's not covered is that insurance companies consider it experimental. Sometimes it works and sometimes it doesn't. Also, sometimes it makes the condition worse according to my primary dentist.

 

@housemzk
True. My dentist 15 years go told me that when I had my bite guard made (which wasn’t covered then either through different insurance). But now that my jaw seems to be locked you woukd think that would be medical? Also, I could have a disk out of place. Eh gads. How is your splint therapy coming along? Is your t caused by tmj? I barely have t in the morning but it amps up over the course of the day. I honestly could wrap my mind around habitating to it if I didn’t have all this jaw/face/mouth pain. If I could get that go calm down I feel like the t would go or become much, much less. Even if it didn’t I could adjust but the jaw pain/pressure is what’s getting to me.

 

Hi @Stephanie72 Mine isn’t covered under dental but it is medical under durable medical equipment! Check that out. I have pretty bad tmj at the moment. I have a disc dis placed. I was seeing a TMJ specialist out of a private practice... but unbeknownst to him I can read X-rays and he read my backward I asked for the images and had my reading verified by the local University. So I have moved treatment there. I stopped using my orthotic and instead have an exercise routine for my neck and jaw and weekly one on one PT! But I think both ways are valid! I’m also struggling terrible with oral fullness and have been put on weekly iontophoresis to see if they can reduce joint swelling.

 

It's beyond me why most insurance companies don't cover it and it's way too expensive when we do have to pay out of pocket for treatment. Sorry you're having to deal with that.

I'm coming along ever so slowly after 4 months of this. The neuromuscular dentist said I had a slipped disk and needed the mouth orthotic so I got it just over 2 months ago. I need it for 9 months of 24/7 use; I guess I have a ways to go with it. The orthotic device was a bit awkward initially with eating and speech at times, but you get used to it rather quickly. I also do PT on my neck, jaw, and back 1 time every 2 weeks. My initial symptoms were severe ear, jaw, and neck pain, sensitivity to sound, along with the loud ringing. The pain and ringing seem to be diminishing slightly though. If I'm honest with myself I have to consider my issues being noise induced and I wasted a lot of money on the orthotic. I was in a dark place initially and would have paid 10x what I did for the orthotic for peace of mind.

Here's TMJ exercises that my physical therapist provided for home use.

 

@kelpiemsp
Wow! That’s crazy. You would think a specialist would get that right. Is the university you are going to a dental school? I actually have one of those nearby but I’m not sure if they treat tmj. I’ll have to call and check. That’s great about your insurance covering the appliance. I have terrible insurance through the marketplace so I seriously doubt it but it’s worth a check. Did the x ray show a displaced disk? I think I might have this too. What are they telling you about the fullness and the tinnitus? Are they expecting either to improve or be eliminated? I’m due to see my chiropractor tomorrow and I can’t wait. I felt relief after seeing him last Thursday but I’m pretty much back in the same spot right now. I feel so much better in the morning but by afternoon the pain and t increase. Please keep me updated on your treatment. I wish you a speedy recovery!

 

@kelpiemsp
Also, did they give you any kind of timeline to expect results. I know these things take time.

 

@housemzk
Thanks so much for those exercises! I’m sure they certainly apply to me as well. I’m glad your t and pain seems to be diminishing. I’ve been reading about noised induced t on this site and it looks like it can improve and be eliminated in time. I took a rx anti inflammatory for a few days (less than the recommended time and at a lesser strength dose) before this too (for another health issue) so I do think about that too. I know where you are coming from. It just seems to much of a coincidence that I had the jaw lock, the pressure/pain and the t all within a few days of each other. I’m 100% sure I’ll need splint therapy 24/7 as well. Did they do any injections into the joint for inflammation? The tmj specialist here that costs so much does it routinely.

 

I feel for you. Unfortunately no overnight fix with this, but I hope the exercises provide some relief. Even if minor.

No injections, but I was on prednisone for close to a month at onset. At this point I just eat healthy and use liquid turmeric 2 times a day for inflammation.

 

@housemzk
Ok thanks. I was on prednisone for 12 days at onset. I actually just ordered
turmeric curcumin. Do you take anything for pain or anxiety? We are healthy and active although it seems like anything I do hurts right now. My gp prescribed temazepam at bedtime but I’d really like to not do that more than 2 weeks. I see the ENT Wed do maybe we can try something else. Hopefully this doc knows more about TMJ than the last one.

 

@Stephanie72 - Muscle relaxers seemed to help initially with muscles in/around the neck and jaw. Have you tried that by chance? I was also on Ativan daily for a month for anxiety, but the horror stories with benzo withdrawal were too much so I pulled way back on the usage around 2 months ago. Now anxiety only comes when I really push myself to get back to a normal life which is every 10 or so days. Like going away for a weekend for a college graduation and the subsequent afterparty. I truly feel the sooner you get back to your old life, the sooner you'll move on from this.

 

@kelpiemsp
Are you wearing a night guard? Or were you given the splints and just decided to go the pt route?

 

@housemzk
Well I was given temazepam as my “muscle relaxer”. I’m taking them at bedtime right now (maybe about 5 nights in a row) but it’s a benzo so I’m going to talk to the ENT on Wed about trying something else. I’d like to try amitriptyline as it’s used as an anti depressant and a sedative. I’ve read that it works good for people with tmj as it has muscle relaxing effects. I can’t sleep at all right now and really struggled with sleep before this. You are right about moving on with life. I have a 5 year old who doesn’t let me slow down lol. I also won’t let him see me suffer so I suck it up and try to deal with it the best I can. Thanks for your responses. They have been helpful!

 

@Stephanie72 and @housemzk if you truly believe yours is TMJ related as I do mine, I feel the approach is significantly different than individuals with hearing loss or acoustic trauma. Getting back to your old life is a huge first step, but I also the lifestyle and stress that led to the TMJ need to be removed.

The University I am going to has a TMJ center as well. So on my first visit I was able to be seen by a Dentist in residency, one on fellowship, and then a practicing on professor on oral facial pain. I am currently not wearing a night guard or anything at the moment, though they recommended it. I am not sure whether insurance would cover a separate one. They gave me no time frame as their main focus is treating the TMJ. I will get a custom fit night guard eventually. They said the soft ones can cause your teeth to move. They are very opposed to a re positioning splint since it changes your bite. I was so confused, however I decided to choose the university. I can always go to the orthotic again. I have a little one as well. It so hard to not whip out the DB meter when he is screaming, but I have to "trust the process". I have taken to meditating at night as well.

 

@kelpiemsp
You are so lucky to have that university nearby! That’s awesome. I know what you mean. I attended a pool birthday party for the littles and tried wearing earplugs but was unable to have a conversation. Something I never would have thought of before. I’m going to stick it out with my chiropractor this week and I’ll call around and schedule a dentist appt in the next week or 2 and see what they recommend. Thanks for all the info!

 

Search on youtube DTR meniere
if you have TMJ that is your solution

but be careful with the dental drill, it can maybe worsen your tinnitus if it is not from TMJ

Avoid benzos, they cause tinnitus and hyperacusis

 

https://trainingandrehabilitation.com/association-tinnitus-neck-tmj/

 

Excerpts from very detailed link above:

It is known that the cause of tinnitus and similar disorders may have many causes, such as being exposed to excessive sounds, otitis, otosclerosis, MS, atherosclerosis, tumors, aneurysms and so on. Less known, is the notion that temporomandibular joint, and neck disorders also may cause tinnitus. This article will be addressing the lesser known causes of tinnitus, relating to jaw and neck disorders, how to identify them, and how to treat them. The principles in this article are also applicable when treating vestibular and other otic disorders who have MSK (musculoskeletal) components.

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Several studies have noted the relationship between TMD and trigeminal nerve dysfunction, and some have also noted the specific mechanism of why this occurs. Because the trigeminal nerve greatly contributes to innervation of both the external and middle ear, its impairment can and often will lead to aural symptoms, such as tinnitus, hyperacusis, and even hearing loss.

 

Hi, sorry to hijack this thread, but I'm very interested in your link between TMJ and ETD. Could you tell me whether you are still able to equalize pressure in your ears? If so, is it due to crackling when swallowing or yawning that you attribute T to ETD? Do the NSAIDs noticeably bring down the T volume? Does your jaw crack when chewing? Is it related to the jaw joint hurting when pressing on it (specifically when opening and closing it)?

I ask all of these questions, because I am hoping that I may also solve T by treating TMJ/ETD. I'm seeing a university professor, specializing in the jaw and ear related problems this friday, but I'm wondering if there are any things I should specifically mention. I have jaw cracking when chewing and sometimes opening my mouth, pain in the ears after a meal, crackling tubes when swallowing and yawning and a clogged feeling in my ears. I also regularly have headaches after eating (which I have always attributed to food intolerancies, but it's really with any kind of food), which radiate towards my neck and jaw. My onset of T was during exams, at a time in which I had spent about 5 weeks already in relative silence.

Could it also be relevant that my T is not a constant tone, like many people seem to report. I have a different tone in each of my ears, but they are both intermittent, sort of like morse code. Sometimes they can grow more continuous, but I get relief by voluntary opening of my Eustachian tubes. It's also quite somatic, in the sense that widely opening my jaw, also makes it more continuous.

Excuse me for shooting from the hip like this, but I couldn't contain myself having read about your own experience. Thanks!