is TMJ responsible for tinnitus?
understanding the connection between tmj & tinnitus
Many individuals experiencing tinnitus—characterized by a constant ringing, buzzing, or hissing in the ears—are often told that there’s “no cure.” However, for some, the source of this discomfort may not originate in the ears but rather in the temporomandibular joint (TMJ). Dr. Gulizio frequently encounters patients whose tinnitus symptoms fluctuate with jaw movements or whose ear sounds become more pronounced during activities like chewing. This connection suggests that the jaw may be influencing what you hear.
How TMJ May Contribute to Tinnitus
Rule Out Other Causes First
Tinnitus can stem from various sources, making it crucial to first ensure the health of your ears, nerves, and auditory pathways. Common factors include:
Hearing loss (due to noise exposure or age)
Middle ear issues (such as fluid buildup or eustachian tube dysfunction)
Ear or sinus infections
Side effects from medications
Head or neck injuries
If these potential causes are ruled out and tinnitus persists, it’s important to consider TMJ-related factors.
Signs That TMJ May Be Involved
Changes in Ear Sounds with Jaw Movement: If you notice that the ringing in your ears changes in pitch, volume, or quality when you open your mouth, chew, or tilt your head, this may be a significant indicator. This phenomenon is referred to as somatic tinnitus.
Tinnitus Aggravation After Jaw Usage: Many patients report an increase in buzzing or ringing after extensive chewing, talking, or clenching, particularly during stressful times. This suggests that the muscles and joints of the TMJ may be affecting the inner ear.
Presence of Other TMJ Symptoms: Tinnitus rarely occurs in isolation when related to TMJ issues. Look for accompanying symptoms such as jaw pain, clicking or popping sounds, limited mouth opening, facial tension, or muscle soreness in the temples or neck.
Severity of Tinnitus: Research indicates that tinnitus associated with TMJ is often louder, more distressing, and more debilitating than tinnitus caused by other factors.
The Anatomical Connection Between TMJ and Ear Structures
The jaw and ear are closely linked both anatomically and functionally. Here are a few ways TMJ can affect sensations in the ear:
Muscle Interactions: Certain jaw muscles are located near ear structures. Tension in these muscles can transmit vibrations or pressure to the ear.
Pressure on the Temporal Bone: The TMJ is adjacent to the temporal bone, which contains the middle and inner ear. Misalignment or inflammation of the TMJ can disrupt the mechanics of ear bones, nerves, or fluids.
Nerve Interactions: The trigeminal nerve, responsible for jaw sensation, shares pathways with auditory nerves. Irritation or abnormal signals in one area can affect perception in the other.
Assessment and Treatment Approaches
When Dr. Gulizio suspects a TMJ connection to tinnitus, the treatment plan typically includes:
Comprehensive TMJ Evaluation: This involves assessing joint motion, muscle tension, bite alignment, and cervical function.
Imaging and Diagnostic Tests: If necessary, imaging such as CBCT, MRI, or joint scans may be ordered to evaluate joint structure and bone health.
Conservative Therapy Trial: Gentle jaw rest, guidance on avoiding hard foods and clenching, and relaxation techniques will be recommended.
Custom Appliance Therapy: A personalized oral splint or appliance may be provided to alleviate stress on the joint and associated muscles, often easing tinnitus symptoms.
Adjunct Therapies: Options may include physical therapy for the neck and upper back, posture correction, breathing exercises, and possibly treatments for nerve or muscle issues.
Monitoring and Adjustments: Progress will be tracked over time, and if changes in ear sounds occur, jaw mechanics may be adjusted accordingly.
In many cases, focusing on TMJ treatment can lead to a significant reduction or even complete resolution of tinnitus.
Self-Care Strategies for Relief
While awaiting professional care, consider these self-care strategies to help alleviate strain:
Follow a soft diet and avoid hard, chewy foods.
Be conscious of jaw rest; avoid holding your phone with your jaw or prolonged chewing.
Practice gentle jaw-relaxing exercises.
Apply warm compresses to your jaw and temple areas.
Engage in stress management techniques such as meditation, gentle breathing, and stretching.
Maintain good posture, especially for your head and neck.
These efforts can help lessen the strain on the TMJ and potentially reduce fluctuations in tinnitus.
When to Seek a TMJ Evaluation
If you experience any of the following, it’s advisable to consider a TMJ evaluation:
Tinnitus that changes with jaw movement
Episodes of TMJ pain, clicking, or tension in the jaw
Increased tinnitus during jaw-intensive activities
Ruling out ear-related issues without success
A combined approach that addresses both the ears and the jaw often yields the best results.
Find Relief Today
Don’t let tinnitus disrupt your life. At Core Smiles, we provide expert, integrated care to identify the root cause of your tinnitus and help you achieve lasting relief.
FAQs
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In most cases TMJ Dysfunction (TMJD) is due to a discrepancy in how the teeth fit together in a comfortable biting position and the “orthopedically-stable” position, or a position in which the jaw joint is properly supported by muscles and ligaments in our skull. This discrepancy causes muscles that move the lower jaw to spasm or tighten. Some of these muscles are connected to a disc that helps cushion our lower jawbone against our skull. When these muscles tighten, the disc is not allowed to move properly and as a result, a “click” may be felt or heard upon opening and closing. This click is your lower jawbone jumping off of the disc - a serious condition that can lead to arthritis and degenerative joint disease - and a condition that needs to be treated immediately.
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Dr. Gulizio believes in a conservative approach to TMJ treatment, especially for vertigo and dizziness. Depending on the severity of your condition, he may recommend one or more of the following treatment modalities:
Myofascial release
Bite splints
Physical therapy
Medication
Simple injections with neuromodulators
Once you have been evaluated by Dr. Gulizio, he will formulate a treatment plan for you that may include myofascial release in addition to the implementation of a TMJ bite splint. In severe cases of TMJ dysfunction, a referral to an orofacial pain specialist may be required.
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A TMJ bite splint is a removable appliance made to release the muscle strain and tension in the area of the TMJ jaw joint. This device helps to “reset” the TMJ jaw joint into the correct position within the skull, thereby eliminating the pain associated with TMJ disorders.
TMJ splints are not nightguards as they function very differently than a nightguard appliance. A nightguard will only help protect your teeth from wear during clenching and grinding, but it will not fix your TMJ symptoms nor will it help correct TMJ dysfunction.
TMJ bite splint therapy requires a visit to our clinic on a monthly basis. These visits are usually very quick and they allow Dr. Gulizio to evaluate the progress of your TMJ treatment. It is important to understand that although a bite splint may eliminate your TMJ pain entirely, additional treatment may be needed to correct the position of your teeth so that your TMJ jaw joint remains stable and pain-free.
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For myofascial pain with localized myospasms, trigger point injections of anesthetic may be considered. Additionally, oral medications to help muscles around the TMJ jaw joint to relax may be prescribed.
“TMJ sufferers, Dr. Gulizio is your guy. He’s head of NYU’s post-doctoral program for occlusion (jaw alignment) and esthetics. Do yourself a favor & make an appointment; you don’t have to live in pain. I wish I’d found him sooner. I was debilitated by TMJ pain before I came to Core Smiles.”
WHY CHOOSE OUR TMJ SPECIALISTS?
Dr. Gulizio, our leading TMJ specialist, has extensive experience in treating TMJ-related vertigo and dizziness. As the head of NYU's post-doctoral program for occlusion (jaw alignment) and esthetics, Dr. Gulizio has the expertise and skill to provide the highest level of care for your TMJ symptoms. Our patients consistently report significant improvements in their symptoms after receiving treatment from our team.
What are the costs involved?
Consultation
A consultation is needed for Dr. Gulizio to accurately diagnose your TMJ condition and suggest personalized treatment options for your care. Consultations are $250.
TMJ Appliances
After the diagnosis, Dr. Gulizio may recommend a custom appliance to help with your TMJ issues, providing relief and supporting long-term oral health. He may also suggest an MRI or CT scan, typically covered by most insurance plans, to ensure a thorough diagnosis for effective treatment.