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Jaw Problems Tinnitus TMJ

The Connection Between Tinnitus and TMJ

 

Editor’s Note Updated 2025: This article remains part of our archive. For the most current overview of the TMJ and tinnitus connection, visit: https://www.nytmj.com/tinnitus-jaw-connection/

My dental practice has a unique focus. The majority of our patients come to us suffering from TMJ problems. The TM joint is the hinge connecting your jaw to the temporal bones of your skull, which are located in front of each ear. The healthy function of this joint enables you to chew, talk and yawn. When the joint is inflamed, strained, or unstable it can cause pain, limited jaw movement, and a variety of jaw noises during motion. When the muscles that move the TM joint are compromised, similar symptoms may result, as well.

There is a connection between tinnitus and TMJ problems, too, and we see patients in my practice looking for relief. But before I get into the explanation of how tinnitus and TMJ are linked, I want to be sure you understand the nature and causes of tinnitus itself.

The connection between tinnitus and TMJ is real.

What Is Tinnitus?

Tinnitus Definition: The annoying sensation of hearing a sound when no external sound is present. Patients describe these sounds with words such as ringing, humming, buzzing, roaring, clicking, and hissing. This sensation is constant for some people and intermittent for others, and it can be in one or both ears. For some sufferers, the intensity of the sounds can vary from day to day while for others it is without fluctuation in intensity.

What Causes Tinnitus?

There are many known causes of tinnitus that include identifiable damage to the inner ear hair cells, age-related hearing loss, exposure to loud noises, earwax blockage, and changes in the health of the bones in the middle ear. Less commonly, tinnitus can be associated with Meniere’s disease, trauma to the head and neck region, and/or TMJ disorders. For some people, however, the cause is never discovered.

What Is The Connection Between Tinnitus And TMJ problems?

TMJ problems are essentially orthopedic in nature. The common symptoms of TMJ are many and can include pain in the jaw muscles or specifically in the jaw joints, limited jaw motion, jaw muscle tension and tightness, jaw joint clicking, popping and or locking, headache pain in the temples, and/or a bite that doesn’t feel normal. Tinnitus is a less common symptom. When TMJ problems, however, affect the ear, symptoms can be pain, stuffiness, and/or tinnitus.

The onset of these symptoms may be due to underlying medical disorders, emotional stress which drives muscle tension, disrupted sleep, traumatic events, periods of sustained jaw opening, sleep bruxism, and daily overuse behaviors and or neck postures. All of these factors can result in joint sprains, muscle strains, muscle spasms and /or inflammation.  Less common origins include a “bad bite.”

connection between tinnitus and tmj, donald tanenbaum

Why TMJ Problems Can Lead To Tinnitus (Or Make It Worse)

1. The nerves that serve the jaw muscles and jaw joint are also responsible for the function and tone of muscles that determine the size of the Eustachian tube and tone of the tympanic membrane. Alterations in the function of these two structures can be responsible for tinnitus.

2. There is one specific ligament connecting a middle ear bone (the malleus) to the jawbone.  When a TMJ problem changes the position of the lower jaw the malleus can be altered in its function due to ligamentous traction and that can lead to tinnitus.

3. The main nerve supply from the TM Joint has been shown to have connections to parts of the brain involved with hearing and the interpretation of sound. If TMJ problems alter the function of this nerve, it‘s quite possible that the brain will interpret normal sounds as abnormal and patients report tinnitus.

4. Worth mentioning is that because TMJ problems are often associated with neck problems, evaluations of the neck must be also part of an overall assessment. There is evidence that nerve endings in the neck make connections to the hearing centers of the brain. Ear symptoms, therefore, have been shown to emerge as a result of long-standing neck problems or those created by acute trauma.

Determining If A TMJ Problem Is Driving Tinnitus Symptoms

Try to determine if your tinnitus symptoms are influenced by moving your jaw (chewing, yawning, talking, opening it widely, sticking it forward). If you notice a link, then it’s very possible that TMJ problems are at the root of your tinnitus. The same is true for head and neck movements.

TMJ Neck Treatment To Help Tinnitus

If your tinnitus is related to your jaw or neck, dealing with these problems will be very helpful. There are a host of treatment strategies available including reducing overuse behaviors and or postures (such as teeth grinding, nail-biting, frequent computer work), exercises, home TENS therapy, muscle injections or dry needling techniques, BOTOX®, the use of oral appliances to support your jaw joints and jaw muscles (especially at night), physical therapy, medications, meditation, mindfulness training, and diaphragmatic breathing instruction.

These treatments, if found to be helpful, may require several weeks or months to see maximum results.

Summary

As I mentioned before, tinnitus can be caused by damage to your inner ear, hearing loss, exposure to loud noises, earwax blockage, and more. If your doctor has not found a link between your symptoms to any of the above, it may be time for an assessment of your jaw and neck structures. There may, indeed, be a connection between your tinnitus and TMJ problems.

Here’s a directory of orofacial pain professionals around the world: American Academy of Orofacial Pain.

You can get more information about TMJ and ear problems here: TMJ and its Relationship to Ear Problems and Sinus Symptoms

Live or work in New York City or on Long Island? You can schedule a consultation with me here or call 212-265-0110.

Dr. Donald Tanenbaum is a dentist with offices in New York City and Long Island, NY. He is uniquely qualified to diagnose and treat facial pain associated with jaw problemsTMJreferred painnerve pain, and migraines. You can contact the office here.

Categories
Jaw Problems Tinnitus

TMJ TMD and Tinnitus

Case Study: Barry

In past blogs I made reference to the relationship between jaw problems, TMD and the occurrence of Tinnitus (ringing in the ears). Though I don’t believe that the majority of Tinnitus problems relate to the jaw, there are unquestionably a number of specific Tinnitus complaints that occur as a result of muscle problems in the jaw and upper neck.

The relationship exists as a result of the shared nerve pathways between structures in and associated with the ear and those of the jaw and neck. Tense, inflamed, and hyperactive jaw and neck muscles can adversely impact the Eustachian tube, the tympanic membrane, and the malleus bone, all critical ear structures. In the presence of ongoing TMD problems, aggressive clenching, night bruxism, neck tension, and ear symptoms inclusive of tinnitus can therefore surface. The typical Tinnitus patterns that my patients describe are often present on awakening, vary in intensity from day to day and at times are influenced by opening and closing the mouth, chewing, and jaw/head positions.

Recently Barry, 55 years old, came to the office concerned about his escalating Tinnitus. He was referred from his ENT doctor, as are many of my Tinnitus patients. The tenderness of his jaw, neck, and facial muscles, along with his admitted history of teeth clenching indicated muscles that were in crisis and potentially a driving force behind the Tinnitus.

I starting him on treatment including a combination of muscle injections, dry needling techniques, self-muscle massage, and an oral appliance. This has reduce Barry’s Tinnitus by at least 50%. As a result he is no longer using the Xanax on a daily basis, something that he had come to rely on for a number of months! With the optimism that has been created I will likely continue to see Barry for another month or two to reinforce the achieved benefits.

If your Tinnitus search has reached the end of the line, exploration of a possible muscle origin may not be a bad option.

Dr. Donald Tanenbaum is a specialist with offices in New York City and Long Island, NY. He is uniquely qualified to diagnose and treat facial pain associated with jaw problemsTMJreferred painnerve pain, and migraines. Find out more at www.nytmj.com.

Categories
Ear Pain Tinnitus

What Causes Ringing in the Ears?

Ringing in the ears, or tinnitus,is a symptom often described as a ringing noise heard in one or both ears, that can be present continually at the same level or vary in intensity. The presence of ringing in the ears during the course of a day is based on jaw movements, head positions and tongue activity. In addition to ringing, some people describe sounds such as hissing, buzzing, humming, clicking, whistling or roaring. Along with these perceived sounds individuals often report hearing loss.

Tinnitus can have its origin from a wide number of possible causes. For some tinnitus is short-lived while for others it is ongoing and disruptive to everyday life.

Subjective tinnitus, that which is described by a patient but not heard or detected by an examining physician, is often prompted by factors like exposure to abnormally loud sounds (one bad exposure or of long duration), chronic ear infections, ear pain, trauma to the inner ear, hearing loss, Menieire’s disease, Acoustic neuromas, chronic use of medications like aspirin, antibiotics or antiviral drugs, and neurologic diseases amongst others.

At times it has been suggested that temporomandibular disorders can be responsible for the onset of tinnitus. Though symptoms such as ear pain are commonly associated with TMJ disorders it is my opinion that no greater than 10-15% of all those patients that we see with TMJ problems report the symptom of tinnitus.

Since the histories and examinations of these patients are no different than those without tinnitus, the reason why they are suffering with ringing in the ears remains unclear. It has been proposed that overuse of the TM joints during gum chewing, tooth grinding, or nail biting for instance can sometimes cause tinnitus but this remains more opinion than fact. If, however, the ringing in your ears increases or changes with opening or closing of your mouth, or forward and side-to-side shifts of your jaw, there is a chance that a relationship exists between the tinnitus and your jaw. In addition, if you are a heavy nighttime tooth grinder or clencher and wake up with tinnitus it would be wise to investigate whether there are treatment options available to address this distressing and often disabling symptom.

The final word is that the symptom of tinnitus often cannot be attributed to any one or specific medical disorder or physical cause. As a result patients are often left to wonder whether relief will ever be found! If your tinnitus symptoms seemingly have any relationship to jaw function an investigation with a properly trained dentist would certainly be advised.