Orthodontics - April 30, 2014 - Vol. 28 - No. 5
The likelihood of having tinnitus was 8 times higher in individuals with temporomandibular disorder (TMD) symptoms than it was in those without TMD symptoms.
Article Reviewed: Is There a Link Between Tinnitus and Temporomandibular Disorders? Buergers R, Kleinjung T, et al: J Prosthet Dent; 2014;111 (March): 222-227.
Background: Patients who have temporomandibular joint and masticatory muscle disorders (TMD) also are reported to frequently have tinnitus. Reports range from 2% to 59% of TMD patients also having tinnitus. Are TMD and tinnitus related?
Objective: To investigate if there is an association between tinnitus and TMD, and to examine if therapy for TMD has an effect on tinnitus symptoms.
Design/Methods: This was a prospective clinical study in which the prevalence of TMD and tinnitus was investigated in 951 consecutively referred prosthetic patients with a mean age of 54 years. Thirty patients with both TMD and tinnitus were the test sample examined in the study. A baseline examination was performed on each symptomatic patient by one experienced dentist. The examination consisted of a functional analysis of the masticatory system, an evaluation of the temporomandibular joint and associated musculature, and a tinnitus questionnaire. Each patient received dental functional therapy, which consisted of physiotherapy and intra-oral splints. The patients were evaluated at 3 to 5 months to determine the effects of functional therapy on the TMD and tinnitus symptoms.
Results: 8.6% of the 951 subjects were diagnosed with TMD and 7.2% were diagnosed with tinnitus. In total, 3.2% had both TMD and tinnitus simultaneously. The likelihood of having tinnitus was 8 times higher in individuals with TMD symptoms than in those without TMD symptoms. Eight patients had unilateral TMD symptoms and unilateral tinnitus; all were on the same side. Stomatognathic TMD therapy improved tinnitus symptoms in 44% of the test subjects.
Conclusions: This trial showed a significant correlation between tinnitus and TMD. Dental functional TMD therapy may have a positive effect on subjects with simultaneous symptoms of both TMD and tinnitus.
Reviewer's Comments: Previous studies and this report appear to support a connection between tinnitus and TMD. With an incidence of tinnitus that is 8 times higher in patients with TMD symptoms, perhaps a question about tinnitus in addition to TMD would be appropriate in our patient health history forms. A significant placebo treatment effect has been reported in TMD and tinnitus patients, and I agree with the authors that it would be interesting to assess the TMD/tinnitus treatment effects with a longer-term randomized trial including controls.(Reviewer–John S. Kanyusik, DDS, MSD).
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