Dr. Stoll,
I have been experiencing some tinnitus in my left ear and hyperacusis(sensitivity to sound) in both ears since October of 1998. I initially went to my Primary Care Physician who examined me and removed some ear wax accumulation from both ears. I had had this problem in the past and it had caused similar symptoms and removing the wax always corrected it. It didn't help this time. I have since been to two ENT Phyisicians. The first told me I had tinnitus and hyperacusis and said to live with it. He suggested to wear muscian ear plugs to lessen the sensitivity to sound. I also had a hearing test and it was excellent, very little high tone loss but according to him well within normal limits for my age(40). The second ENT physician said I had some eustachian tube dysfunction and prescribed some decogestants. They did absolutly nothing. Went back for a follow up and he said my eustachian tubes were working fine. At the urging of my wife I began exporing the symptoms of TMJ on the net. I also have had ear pain and some pain in the jaw and face. I can cause the pain sensation when I open my mouth or shift my jaw side to side. I have some pain in my teeth and my jaw is sore and tingles, notice this especially when I shave. I had had some dental work done three years ago, had the front two teeth crowns replaced, had chipped these two teeth as a kid. The existing crowns had been on for 20 years. The dentist shortened the new crowns for a better look, acording to him and my bite has never felt right since. Went back shortly after the crowns were put on and he made me a mouth piece, told me I may be clinching at night. Now Doctor, I also am experiencing throbbing in my ears when I lay on them trying to sleep on my side at night. It is the pulsating of my heartbeat. This is very annoying and causes pain in my ear, let alone insominia. I have read some of your information on bracing and I have noticed that at times my teeth are touching. Now I am trying to put my tounge between them to prevent this. I have started to wear the mouth guard again at night. The hyperacusis is awful, sensitive to sounds like music, TV, telephone is umcomfortable, voices can be disturbing. My ears check out fine and I do not believe I have hyperacusis in the sense that I have lost my tolerance to sound. Some sounds, even at loud volumes I can tolerate fine. The snesitivity causes a knocking or shootin pain in my ear and I get this same senstion when I move my heard a certian way or open my mouth. Do you think my problem could be TMJ? I had never seen hyperacusis as a possible symptom of TMJ until I read it as a possible symptom on the TMJ Association Home Page. I would like to purchase your book Doctor for more information. Do you have any short suggestions?
Follow Ups:
Re: TMJ and Hyperacusis (VERY common association)
Posted by Walt Stoll on March 01, 1999 at 10:43:27:
In Reply to: TMJ and Hyperacusis posted by Nick on February 28, 1999 at 10:51:19:
Hi, Nick.
Isn't it interesting that you saw all those "experts" and finally your wife had to make the diagnosis????
Anyhow, ALL of your symptoms are due to TMJ and the unconscious "bracing" of your jaw muscles. It could even be that your TMJ is the reason for your tendency to accumulate wax plugs in your ears. In the long run, the regular practice of SR is your only solution.
In the meantime, doing the little trick with the erasers (see TMJ on the homepage of this 'site)ALL the time---except at night when about the best you can do is the retainer (every night) would give you quick, temporary benefits. You should get almost immediate relief from your ear symptoms and the hyperacusis gradually improving over a period of about 6 weeks.
In the short term a series of deep, total-body, therapeutic massages (at least 3 a week for 2 weeks) would help you get moving in the right direction of breaking the habit of bracing in your jaw. If that is ALL you do, your symptoms will start coming back in a month or so. Rolfing would probabl;y give you a year or so of benefit if that is ALL you do.
Let us know how you do.
Walt
Follow Ups:
Re: TMJ- may I suggest?
Posted by JN on March 19, 1999 at 04:40:26:
In Reply to: Re: TMJ and Hyperacusis (VERY common association) posted by Walt Stoll on March 01, 1999 at 10:43:27:
If your dentist grinded the surface of your teeth, you may experience lateral "sliding" of the jaws, and you may develop bite problems.
This condition is not well evaluated, however your jaw may be sliding laterally only 1/8 of inch, to cause severe tension on the stretched muscles. Consequently the muscle may become also like spasmatic
which are stretching. In deed such may result even in hange of posture. The ringing in the ears may be in "tune" with electromagnetic frequency, as your teeth are acting as antenea, and through the nerves the sound is conducted furher, what may explain your hypersensitivity to some sounds.
When you lay down your jaws are now "off bite" that is why you are experiencing throbbing in ears when you lay on them trying to sleep on side at night.
That is why you hear pulsating of heartbeat.
That is when your teeth are on-off touching.
Your "new" crowns may need to be replaced by once, made by more qalified technician and dentist.
No one grinds the crowns for esthetics. The bite must be exact, or you may have problems as you described.
I am aware about one very severe case like this. Should you need I will provide you with contact (went sucessfully through arbitration against dentist with setlement of
$ 40,000).
Follow Ups:
Re: TMJ- may I suggest?
Posted by Walt Stoll on March 20, 1999 at 08:47:17:
In Reply to: Re: TMJ- may I suggest? posted by JN on March 19, 1999 at 04:40:26:
Thanks, JN.
I felt the need to interject here that the only BASIC known cause for TMJ is total-body bracing that is mainly showing itself in the jaw muscles.
No matter what approach is used, the problem will tend to recur until this basic cause is addressed.
Walt