Tinnitus

Tinnitus is a symptom, not a disease entity. It is a sound heard within the brain, generated by an abnormally functioning hearing mechanism. It may be due to major trauma, as may occur in motor vehicle accidents, assaults, and work-related accidents. It may also be due to "micro trauma" that is, repetitive, low impact insults to the temporal bone (which contains the cochlea or hearing mechanism), such as can occur with bruxism (tooth clenching and/or grinding), an overclosed bite, such as that seen with a loss of posterior teeth, jaw shrinkage under old dentures, etc. It is not infrequently seen in conjunction with vertigo, or dizziness, since the semicircular canals, or balance mechanism, is also part of the inner ear and therefore subject to the same traumatic factors.

Since tinnitus can have many causes, there is no one treatment that has been shown to be effective. However, in cases where the symptoms are the result of an overclosed bite or other orofacial causes, a properly designed craniomandibular orthotic or "splint" can frequently be of benefit by keeping the lower jaw in a position where is not traumatizing the temporal bone. Should the orthotic therapy prove effective, it may be necessary to permanently increase the vertical dimension of the bite, using fixed or removable bridgework, for which the patient is referred back to his or her general dentist.

Also, certain specific injections have been found to be effective, in cases where the symptoms are due to tight ligaments, which run from the temporomandibular joint to the middle ear, called the menisco-malleolar ligaments.