Tinnitus

Tinnitus, Ear Pain, and Stuffiness Treatments in Raleigh, NC

It’s common for many of our patients who suffer from ear problems to have had a visit to an ENT physician. Often, if the problem is not caused by infection or wax buildup, the physician suspects some sort of TMD problem and refers patients to their general dentist for an evaluation. 90% of the time a general dentist will recommend some type of night guard, perhaps some anti-inflammatory over the counter medicine, soft diet and heat. The problem with this way of thinking is that these problems are not limited to night time but are 24/7 problems. If you are reading this now you no doubt have some type of ear pain, ringing in the ears, ear pressure or a swooshing sound. Let’s break each of these symptoms down and see what causes them:

Swooshing sound, plugged ear:

The Eustachian tube, which is designed to drain, ventilate and protect the inner ear, can get “stuck open”. This is caused by several muscles the exert influence on the tube: tensor veli palatin, levator veli palatine, and to a lesser extent a portion of the medial pterygoid. These are all muscles associated with TMD. If the muscles force the eustacian open and it remains open, patients will often experience an echo of the voice and their breathing, which bounces off the eardrum. Patients frequently complain of decreased hearing, aural fullness, humming tinnitus, flapping, popping or clicking sounds in the ear. Fortunately, a simple test for this condition, called patulous eustacian tube, involves placing the head in a downward position between the legs. This position increases gravitational eustacian tube mucous congestion and temporarily simulates the closure of the tube. In addition, any testing by an audiologist can rule out any permanent hearing loss.

Tinnitus:

Ringing or roaring noises in the ear can have several causes. Loud noises or clogging of the ear canal with wax, inflammation of the ear drum and overdoses of Aspirin can cause tinnitus. But often the problem is related to TMD. If you are suffering from tinnitus in Raleigh, NC, contact Dr. Harold today.

Tinnitus arises from traction of the hammer bone of the inner ear caused by a ligament (Pinto’s ligament) and/or associated musculature to the ear and Eustachian tube. When these muscles spasm, traction is placed on the bone and tension is increased on the tympanic membrane or eardrum. The connection with TMD is this: The muscle involved gets it’s innervation from the Trigeminal Nerve, a large cranial nerve that is responsible for many of the muscles used for jaw movement. Pinto’s ligament attaches to the disc that keeps the upper and lower jaws from rubbing against each other. When the disc is pushed forward due to a misalignment of the jaw, tension is placed on the ligament, pulling on the hammer bone, increasing the tension on the eardrum…causing ringing

Ear pain:

Ear pain can have several origins. One is from inflammation of the tendon that attaches the lower jaw to the upper skull. This Temporal Tendon is large and can become easily inflamed in patients with bad bites who clench. The temporal tendon is easy to palpate by opening wide and placing the index finger on the upper jaw opposite the upper second molar or back teeth. It is painful to palpate and can be numbed in many cases to determine if it’s the source of the ear pain. In addition, temporal tendonitis, as it is referred, can also cause temporal pain, tmj pain and eye pain as well as sensitivity to the upper teeth. Ear pain can also come from trigger points in the neck muscles, trigger points in the deep masseter muscle that closes the jaw. Clenchers are usually predisposed to ear pain because of spasms in these muscles.

An additional cause of ear pain is the lower jaw pressing against sensitive tissue in the back of the ear socket. Often when the misalignment of the jaw pushes the jaw too far back, the bone of the lower jaw presses on these sensitive tissue in front of the ear, radiating pain to that area.