TMD Dr. with Tinnitus

Hello All,

I'm a dentist who has done a residency in TMD and these patients along with chronic headache and migraine patients with and without T, represent about 30% of my practice. I developed T about four years ago. It came on after a very strenuous bicycle training ride. I race bikes and our racing and training is often quite intense. I figured it would go away, but of course it did not.

I have treated a number of patients over the years with T and have had success in eliminating it for certain patients. The patients who respond favorably to therapy are typical either acute TMD patients who have only recently displaced a disc or migraine patients who have T as one of a number of collateral symptoms to their migraines. When I cure their migraines, I cure their T. When we treat the acute disc displacement and return them to stability, the T goes as well. We've also treated and helped a number of patients referred by ENTs who have been under their care and sometimes along with a chiropractor to no avail whose chief complaint is pain and fullness in the ear, who we can diagnose with TMD.

However, I never promise anything when it comes to T. For when it came to physician heal thyself, I haven't been able to. Mine is not somatic. Although it began in my right ear the side I have a partially displaced disc, it has recently popped up in my left ear to a lesser extent as well. I originally felt my T was just an occupational hazard that a good number of dentists suffer from thanks to the high frequency hand pieces we use and the years of no protection. Now, I feel my T is tied to stress and cortisol levels. I have flare ups after long and/or hard rides, which have recently reached levels that have made me step away from the bike.

After getting through the first several sleepless nights, I was able to live with it. On one occasion it went away for a week while I was on vacation, totally relaxed. I said to my wife on the last day, my T is gone, I can't believe it. Of course it returned when I did back to my normal life. Up until today, I have not sought any treatment other than my in office TMD therapist and my at home TMD therapy that I prescribe my patients and I did take Naltrexone for several days (doses 20 up to 50mg), but quit because I didn't like the way it made me feel. But, it's time to take the first step to addressing it and my stress levels. I am going to see a craniosacral therapist today in an effort to relieve some stress and am scheduled to see an audiologist in several weeks.

I look forward to sharing anything I discover along my path. And will be happy to answer any questions from any of you who suffer T associated with chronic headaches and migraines or TMD.

 

@PatJ Hi doctor, sorry that you received tinnitus.
What is your thoughts on wearing noise blocking headphones with tinnitus when the dentist is drilling?

 

It certainly cannot hurt. The new electric handpieces are somewhat quieter than the old ones, but if your T is due to hearing loss, then by all means, in fact even if it isn't no need to risk it.

 

@PatJ Are there any patients who experienced acoustic trauma which damaged theirTMJ so they have tinnitus BC of that and not BC of the damage to cochlea? I have had TMD for seven years but I Got my tinnitus after a loud concert.... However, when I woke up I had a pain in my right Jaw and tinnitus in my right ear where the TMJD is.... Now, 2 months later my tinnitus spread to my left ear... I still have Jaw pain pain but now on both sides( but I suppose that is from hyperacusis)... I also tende to have ear fullness....

 

@Apolonia, with it spreading to the other ear, it's more than likely not somatic. if you were my patient, then i'd tell you i can make your jaw pain go away, but no promises regarding the T

 

Is it usually only one ear that's affected if it's somatic?

 

So no matter the tinnitus, can you maybe recommend some exercises I could do for my TMD?
I was planning on seeing the dentist regarding it but I quit bc I myself believe this is an inner ear problem. Although, One guy contacted me. He said that he had an acoustic trauma but he also has TMD. So after the acoustic trauma he got tinnitus and decided to visit his dentist... The dentist gave him a splint and now he has no tinnitus anymore... He told me that if my tinnitus moves from left ear to right, it means I have a TMD caused tinnitus. He said that acoustic trauma "hit" his jaw, and thus caused more misalignment since he already had that problem before.... Now, I did experience a time when my tinnitus literally moved from my right ear to the left and then came back to right... But now it is officially in both ears.... Dunno what to make out of it but I don't believe that my case is the same as his.... I just wanted to inform that the fact that it spread to another ear does not necessarily mean it is more noise induced than TMD caused... Actually, there is a facebook page where people literally went deaf bc of jaw misalignment. One woman, who started the page, had a hearing loss in both ears for decades. Doctors told her that was the Maniere's syndrome. She wore hearing aids for years. And then a dentist noticed her jaw misalignment and gave her splints. After that, her hearing came back... The page is called something Maniere's syndrome caused by TMJD , not sure anymore... But this all true story...

 

exercises without addressing the underlying cause probably won't help. you either need an orthotic or even better a correction of the underlying problem your bite. The exercises are to stretch the masseter and temporalis muscles along with the sternocleidomastoid muscles.

The easiest to describe here are to place three fingers on the right side of your chin and push your chin to the left and hold it for 10 seconds, do the same thing on the other side, then repeat for 20 seconds. Do the same thing pushing your chin out against slight force of three fingers resisting, then push back both for 10 then 20 seconds.

Next for the neck SCM and traps. Put your right hand on top of your head with your fingers just above your left ear. Pull your head down toward your right shoulder, 1o/20 seconds both sides. Then do it again and rather than pulling it toward your shoulder pull diagonally toward your arm pit 10/20 seconds. The put your right hand on the left side of your chin and instead of moving the jaw as above use it to turn your head to the right shoulder, both sides 10/20.

 

I had CT scan and have disc displacement without reduction. Can a splint help me. TMJ dentist says I need a night and day splint at cost of £4500. I have ear pain, reactive tinnitus and sound sensitivity.