Should I Spend $8,000 for TMJ Treatment (In Hopes of It Helping Tinnitus)?

Hey all,

I’ve definitely been through a lot trying to figure out my tinnitus (2 ENTs, MRI, PCP, vestibular therapy) and nothing has helped. I recently had the chance to see an accredited TMJ/TMD specialist who claimed she could help me with my tinnitus (I also have dizziness). I don’t have severe jaw pain, just popping. I can modulate my tinnitus with jaw movements, and it’s noticeably worse when chewing something chewy (like a steak or a gummi candy). Treatment is not covered by nearly any insurance.

Should I spend the $8,000 to get the treatment? Or is this a money grab?

Steve

 

Can't these TMJ issues not be diagnosed with a CT scan? If this says everything is okay, I wouldn't go for TMJ treatment.

 

I'm not that familiar with TMJ, but you didn't specify what she was basing on when she decided you should do the treatment. You should ask for a second opinion and possibly have a CT scan before committing to anything major.

 

@stev3po Try this free treatment. Drink more water.

With what you describe and with dizziness, you may have a gas collection around a joint capsule. Jaw movement may be acting like a pump sucking air in and out between the middle ear and your jaw joint capsule.

 

Not unless she guarantees it works! For $8000 “claiming” won’t do it!

 

Is that for a splint (NTI)? Seems awfully expensive and at that rate I'm guessing that they want to do some extensive surgery on your teeth, which cannot be reversed. An upper cervical chiropractor should be able to help with TMJ and is much less expensive and less intrusive.

 

Absolutely not worth the money. Treating TMJ and it ending up curing tinnitus is very rare.

 

I would start with an upper cervical chiropractor first. BLAIR certified and make sure they know their stuff. I’ve seen TMJ people get better with that especially when they have dizziness but not many reports of tinnitus going away.

If $8,000 is a non-issue then go for it but that’s a lot of money for a guesstimate treatment especially you yourself mention you don’t have many TMJ symptoms.

 

I haven't had a CT scan, but that is part of the treatment. The Dr. does two scans, one initial (at rest) and the second after placing the jaw where it would be moved. This allows you to see the changes that would be made by the brace.

It would be a splint. The work up would be neuromuscular with a custom splint included in the price. She mentioned I would likely need braces after the initial work up.

I feel like I've been pretty hydrated, but I can always be drinking more water!!

 

Orion, looking into this now. What is the advantage of BLAIR certification, and has this been known to treat your tinnitus? Thanks!

Steve

 

My oral appliance was mostly covered by insurance. I thought they paid 80% of the $3000. Not sure what code they submitted to my insurance.

You could try prolotherapy for your TMJ. Not sure what that would cost though or if it would work.

Tinnitus, dizziness, headaches and other...

 

If tinnitus is due to TMJ, it goes away after TMJ gets treated. It's the case that most tinnitus isn't due to TMJ.

 

It’s not necessarily known to treat tinnitus but upper cervical chiropractors mostly focus on your neck and upper portion of your spine. I’m not 100% read up on the BLAIR technique but it’s what people in Meniere’s/TMJ groups suggest and I believe these type of specialists take a milder approach to adjustments and are more gentle than regular chiropractors. There have been people who say their hyperacusis and tinnitus “improve” with treatment.

If your tinnitus is in fact stemming from a neck issue or a misaligned atlas or something like that then I don’t see why it wouldn’t help once you treat the cause. But as you may know it’s really hard to pinpoint the exact cause and MOST cases are noise damage!

 

@stev3po

I would get a CT of your jaw first - read by a Oral & Maxillofacial Radiologist D.D.S., M.Sc., M,R.C.D (c).

BLAIR is not the way to first go.

TMJ affects the joints of the jaw, which are located in front of the ears. The effects of TMJ can spread to the ears, including the sensitive inner ears that control your sense of balance. As a result, one may experience dizziness. Vertigo is caused by problems in the inner ear, which is a sensitive part of your ear close to the temporomandibular joint. With TMJ, inflammation can reach the inner ear. Inflammation with modulation of tinnitus with jaw movements disrupts the signals to the brain about your body's position in space, leading to symptoms of vertigo.

Your jaw problem - TMJ joint and inflammation regardless of all jaw problems seen by radiological would point to one of two developments:

Either what I said in a post above which was "with what you describe and with dizziness, you may have a gas collection around a joint capsule. Jaw movement may be acting like a pump sucking air in and out between the middle ear and your jaw joint capsule."

Or, two tiny tiny nerves that serve both the eardrum and jaw. These two nerves also connect to the part of the brain that associates to hearing.

I would consider a upper splint made by a Oral dentist that has a dental lab and years of experience.

 

I highly doubt that it would work. I don't want to lecture, but you've only had the tinnitus for less than six months. Give it some time, many people recover. Eight grand is way too much for an iffy proposition like this.

 

In my 28 years of experience, a professional mouth guard has helped about 30 percent, but more so for those that clench their teeth. With having I can modulate my tinnitus with jaw movement with dizziness, steroid prolotherapy as mentioned by @just1morething has helped 90% for up to six months who don't have hearing loss. This information is based on patient feedback with about a 25% response. I had mentioned steroid prolotherapy to two by PM and it worked for them for six months.

 

Do you have TMJ? @threefirefour has knowledge of TMJ. Get more facts before you spend the money.

 

How does your tinnitus sound like? Is it 24/7? Bilateral? Very somatic?

 

@stev3po

I have some similarities to your experience. I have had tinnitus since January of this year and went through 2 ENT's, PCP, CT scan, brain MRI, as well as a video consult by a neurologist for Trigeminal Neuralgia. Mine started with headaches, right jaw pain, pain around the eyes, then a bout with serious right ear fullness (right ear) that cleared up but the jaw pain and tinnitus continued. I also do click on my right side.

So my evolution has me seeing a neuromuscular dentist (i.e. TMJ specialist). From the consult I went through a bunch of scans (joint vibration, cone beam, (no MRI for TMJ) K7?, etc.) as well as assessment for posture, shoulder compare height, etc. Dr assessed my scans but also sent them off to be read by a Oral & Maxillofacial Radiologist as recommended by @Greg Sacramento and did a treatment plan work up for me.

My diagnosis was a few things, but for me the highlight issue for me was that my right condyle is pushed back posteriorly. My hope is by realigning the condyle forward will help my tinnitus. Possibly with the TMJ being sore and inflammation, etc. that is irritating the inner ear I guess and triggering tinnitus, not sure but hoping.

My cost is not half of your cost to date and I went forward mainly because I am a grinder, have pain in the right TMJ area where my tinnitus is (right ear), can modulate my tinnitus by jutting jaw forward, and pushing my tongue against my right back molar. My dentists made no promises but for my issues I decided to pursue. The treatment plan is 12-16 weeks and I am just past week 4 of dual splint therapy. I know there a no guarantees, but I was unable determine where to go next.

As previously noted, may be worth the money to seek a second opinion from another TMJ specialist before you commit to that cost.

I got some good feedback from @oceanofsound26 who has gotten feedback from many of the responders to your post.

Thanks,
Ken

To footnote, I had to pay out of pocket. You should be able to get an itemized breakdown of the costs to be able to compare with.

 

This is basically what the TMJ specialist explained to me. It made sense, although I DONT have headaches or really much jaw pain, she said I would be a great candidate for the treatment (of course she'd say that). In my case she said especially because I can modulate my T with jaw forward and chewing. Doesn't it seem like MOST people with T can do that?

My other question is, if I do have a pocket of gas in my jaw, how would hydration help? I've been drinking a bunch of water recently

 

I never would've thought I had TMJ. I've always been able to make a click in my right side by moving my jaw farther than normal (effected more with T) but it has never bothered me. It's only since I had T that I've become aware of the slight soreness I have now.

It's also possible that my shoulder injury caused a muscular imbalance that has chained up to the jaw, I've read that can happen. Maybe if that improves, the whole chain will resolve?

 

It started as a high pitched ring in the right ear only. Then that developed to a quieter cricket like noise. I can usually only hear it when I'm going to bed. Then with recent allergies last couple months, I've had fullness, increased T, and even distortion with certain frequencies. When my allergies got better, the fullness subsided, but the ringing increased on my LEFT side. The left side is now louder than the initial right, and it's louder when I chew or modulate my jaw, or even when I yawn, I hear a louder ring in the left side only (WTF ???)

I had an initial audiogram and the ENT denoted a slight bone-air gap which he believed pointed to Otosclerosis. I saw a second ENT and the audiogram showed that slight hearing loss was resolved. I'll attach both audiograms for you to see the difference (it's around the 20 level for the 250 Hz range).

This lead the 2nd ENT to believe I didn't in fact have Otosclerosis. But still, there was no update on the underlying cause of my dizziness (largely described by visual disturbances, trouble reading, discomfort focusing on things far away, light sensitivity, discomfort in grocery stores or visually busy environments). For that I'll be seeing an ophthalmologist, but that's not till September :/

 

@KWC , thanks for your reply!! Fingers crossed that can really end up helping you resolve your TMJ pain and maybe your tinnitus!!

Sounds like I need a second opinion. I don't have headaches or jaw pain, but I do have jaw soreness, clicking, and tinnitus modulation by chewing and jaw movements.

Was there anything like a serious injury that could've started this for you? Like I believe I mentioned, I had a snowboarding injury in Jan where I fractured my humorous at the shoulder.

Additionally, did you ever experience and dizziness or visual symptoms at all?

-Steve

 

@stev3po, also hope you find the path to resolving yours as well. It is tough with tinnitus and pain and other issues as many of the forum members know firsthand. I struggle each day with should I or not keep masking and am trying to do more sound enrichment. (always have sound at night as sleeping without sound and meds does not work for me)

Not that I am aware of that happened right before. My first symptoms were a headache, jaw and ear pain for which I thought it was my annual sinus infection. Went to urgent care got Augmentin and 5 days later had tinnitus. Not sure the Augmentin caused it though, have taken before and it is pretty common I think. I am 52 and have had every joint except knees surgically fixed, so it could be everything caught up with me, not sure. I have learned from other members on this forum how everything is interconnected.

Nothing visual. Every so often would feel a bit lightheaded, just figured that had to do with my allergies, etc.

Also not sure I mentioned both ENT's I went to said my hearing was fine after they tested it.

One "test" I am trying is to ice up the TMJ to see if my tinnitus sound changes... maybe tied to inflammation because my tmj joint on the side with my tinnitus is very sore. Trying to manage the Advil.

One other thing I "think" I learned is the type of imaging needed for TMJ. To date I had one DMD from a teaching hospital do a standard panoramic x-ray and said my TMJ was fine. The TMJ doctor I am going to did a cone beam scan of my jaw which I believe is the better and did scans with jaw open and closed. He reviewed and sent off to be further read by a dental radiologist. Have not had a MRI (soft tissue) done of my TMJ yet as that is the expensive cost and would give more detail about disc position. I understand the conservative treatment is the same (splints) anyway. That might be the next step if splints do not help. The cone beam scan will not show soft tissue.

Just like you I continue to seek to find out what is going on. The only tangible diagnosis I can follow is my TMJ. Have to address it anyway whether it helps tinnitus or not.

Good luck to you. I can provide feedback on my experience with the TMJ process with hope may serve value for others if something helps. Everybody and every situation is different.

Ken

 

TMJ treatments have helped my jaw a lot and my tinnitus a little but mouth guards are not actually that hard to make and the technology to make them very cheaply with 3d printing exists now. I have one guard I paid $400 for in 2007 and one I paid $1800 for in 2016; I think the latter was kind of a scam, and when I was quoted $5000 for an even fancier one at a different place, I instantly walked out. Also the lady who ran that clinic kept saying how treating this was going to "solve all my problems".

If you even need a bite guard you should be able to get all this done for much less money.

Also it's worth noting that I have a long history of tooth grinding and it had progressed to the point that my jaw would click and pop and then actually painfully dislocate. If I hadn't had that other stuff going on, I don't know what I would have done.

 

Completely agree on the cost. No doubt big markup. Like @stev3po I did the round of doctors (2 ENTs, PCP, neurologist, a dental pain specialist at a teaching hospital) and both ENTs said hearing was fine for my age, 52. I was and really still am at a loss of my cause (ear infection, possible, Augmentin, possible I guess, TMJ possible I guess, posture, etc. etc.) to try to purse a fix. I am 6.5 months into tinnitus so who knows as I understand all can take time to improve. Feeling like nowhere else to turn I went forward with TMJ treatment. Both of my splints cost about $2,000 plus the costs for testing, diagnostics, follow-ups,, etc. but as noted nowhere near the $8,000 stev3po was quoted and out of pocket. No clue if the TMJ treatment will help my tinnitus at all but hoping.

I am a long time grinder too. I believe my jaw clicked but not enough to realize it.

One thing to note for me is initially it was jaw soreness, ear ache, then tinnitus set in. But then the headaches and jaw pain came.

Not sure if any of this info helps, but hope it does.

Ken

 

@linearb greetings.

How long before you saw benefit for your TMJ? I am going on 8 weeks (Dr said 12-16 weeks) and have had some pain relief, no tinnitus relief. My jaw just feels very sore at my TMJ joint into my ear. Right below ear on neck I feel like either I have a swollen lymph node or a muscle trigger point. When I press on it, pain shoots around my eyes. So the whole side of my head hurts.

@stev3po hope you are finding help!

Ken

 

Hey @stev3po, I am curious where you are with this.

But, I'm bumping this for another reason. I seem to have misplaced my $1700 guard; I'm likely to find it, but it's 5 years old and headed for replacement anyway. I have no desire to spend that kind of cash again because I know various places are using much cheaper, newer tech.

I found this in 2 mins of googling:

https://jsdentallab.com/products/custom-0-06-day-night-guard-for-light-teeth-grinding

I can't speak to the quality but this looks exactly like the thing I paid $1700 for in a fancy Bethesda clinic in 2015, and the process they describe is the same, it's just that they send the molds through the mail so no office visits (which is a plus in COVID-19 world).

Anyway, I am guessing my guard will pop up in the next couple days, but, if not, or whenever it finally cracks, I'm definitely going to try one of these. $129 isn't nothing, but from what I understand of the current tech I think it's "fair" -- the machines that actually fabricate the splints are in the $10-20,000 range. Printing out a splint only costs $3-4, but, there's also the cost of the molding material, sending it to you, and the time of having someone run molds through the process and QA them.

$129 is less than 10% the $1700 I paid, and less than 3% the $5,000 I was quoted locally.

 

Only my 2p, but spending thousands on TMJ is fool's gold.

 

Yes, that was why I bumped this with a $130 solution