The temporomandibular joint (TMJ) is a complex joint located in front of the ears, where the jawbone meets the skull. It enables essential movements for activities like talking, chewing, and yawning. TMJ disorders, commonly referred to as TMJ, encompass a group of conditions that cause pain and dysfunction in the jaw joint and associated muscles.

Several times, TMJ disorders can be linked to tinnitus, a condition characterized by perceiving sound without any external source. This article explores the relationship between TMJ and tinnitus, the unique characteristics of TMJ-related tinnitus, diagnostic approaches for TMJ disorders, and potential treatment options to provide relief for individuals experiencing TMJ-related tinnitus.

What is the TMJ? 

As aforementioned, the temporomandibular joint (TMJ) is one of the most complex joints in the human body. It’s located on both sides of your head in front of your ears, where the jawbone (mandible) meets the skull. This joint is unique as it allows for both rotational and translational movements, or in simpler terms, it enables the jaw to open and close and move side-to-side and forward-to-back. These movements are essential for various activities, such as talking, chewing, and yawning.

TMJ disorders, often simply referred to as TMJ, are a group of conditions that cause pain and dysfunction in the jaw joint and the muscles controlling jaw movement. The exact cause can be challenging to determine as it may arise from multiple issues such as a jaw injury, genetics, arthritis, or a habit of grinding or clenching the teeth.

It should be noted that Temporomandibular Disorders (TMD) and Temporomandibular Joint Disorders (TMJD or TMJ disorders) essentially refer to the same group of conditions. Both terms describe various problems affecting the temporomandibular joint (which connects the lower jaw to the skull). This article will use the term TMJ to refer to the TMJ disorders.

Symptoms of TMJ disorders typically include pain or tenderness of the jaw, aching pain in or around the ear, difficulty chewing, facial pain, and a clicking or locking of the joint that can make opening and closing the mouth difficult. The clicking sound isn’t necessarily a cause for concern unless accompanied by pain or limited movement. In some cases, TMJ disorders may also lead to headaches, earaches, tinnitus (ringing in the ears), and neck pain [1]. 

According to the National Institute of Dental and Craniofacial Research, TMJ disorders are estimated to affect over 10 million people in the United States. Moreover, the prevalence is significantly higher in women than men, and the peak age of onset is between 20 to 40 years. Tinnitus, one of the auditory disturbances linked with TMJ, is highly prevalent, with the American Tinnitus Association estimating that over 50 million Americans experience some form of tinnitus [2].

Research has identified a substantial link between TMJ and tinnitus. A study published in the Journal of Oral Rehabilitation in 2007 found that nearly 33% of patients with TMJ also experienced tinnitus. Moreover, a study published in The International Tinnitus Journal in 2012 found that 56% of individuals with TMJ reported tinnitus, suggesting a clear association between the two conditions [3].

Anatomically, this association between TMJ and tinnitus can be attributed to the close proximity of the TMJ to the structures of the ear, as well as shared nerve pathways and muscle connections. In particular, the tensor tympani muscle, which has a role in dampening chewing sounds, is thought to be involved. When there’s a dysfunction in the TMJ, this muscle can be affected, leading to tinnitus symptoms. Furthermore, alterations in the muscle tension and pressure changes associated with TMJ disorders can affect the auditory system, leading to hearing problems such as tinnitus. Therefore, effective management of TMJ disorders may help alleviate tinnitus symptoms in some patients [4].

Symptoms of Tinnitus 

symptoms of tinnitus

Tinnitus is the perception of sound without any external auditory stimulus. The symptoms of tinnitus can vary among individuals, but they commonly include a ringing sensation in the ears. However, the perceived sound can differ, encompassing buzzing, humming, hissing, whistling, or clicking. Tinnitus can occur in one ear (unilateral) or both ears (bilateral), depending on the underlying cause and individual factors. It can persist continuously throughout the day or present intermittently. The volume and pitch of tinnitus can range from faint to loud and intrusive, and individuals may have varying perceptions of these sounds.

Tinnitus can have a significant impact on a person’s quality of life. It can hinder concentration, making focusing on tasks or engaging in conversations difficult. Sleep patterns can be disrupted, leading to fatigue and mood disturbances. Emotional distress, including anxiety, frustration, irritability, or even depression, can be experienced due to coping with the constant sound and its potential interference with daily activities.

It’s essential for individuals experiencing tinnitus to seek professional medical evaluation and management to determine the underlying cause, explore suitable treatment options, and clarify whether it is related to a TMJ disorder. Understanding the specific characteristics and impact of tinnitus can assist healthcare providers in developing personalized strategies to alleviate symptoms and improve quality of life.

How To Know If TMJ Is Causing Tinnitus?

As aforementioned, research has identified a substantial link between TMJ and tinnitus. Specific unique symptoms or characteristics might be observed to determine if tinnitus is related to TMJ disorders.

  1. Fluctuating Tinnitus: In some individuals with TMJ disorders, the intensity and quality of their tinnitus might fluctuate. This change could correlate with the degree of their TMJ symptoms. For instance, the tinnitus might worsen during times of high stress, when TMJ symptoms like jaw clenching and teeth grinding are more likely to increase.
  2. Somatosensory Tinnitus: This is a type of tinnitus where the intensity or pitch of the tinnitus changes when the person moves their neck, jaw, or eyes. This can occur with TMJ disorders, as the movement of the jaw might affect the intensity or frequency of the tinnitus. For instance, a person might notice that their tinnitus gets louder when they clench their jaw or move it in certain ways.
  3. Correlation with other TMJ Symptoms: Tinnitus linked to TMJ disorders often correlates with other TMJ symptoms. This could include pain in the jaw joint, difficulty chewing, a clicking or popping sound in the jaw, headaches, and even neck pain. These symptoms might appear together, and changes in one (like an increase in jaw pain) might lead to changes in another (like an increase in tinnitus).
  4. Relief with TMJ Treatment: Another characteristic of tinnitus related to TMJ disorders is that the tinnitus often improves when the TMJ disorder is treated. For example, if a person uses a bite appliance to correct a misaligned jaw or stop teeth grinding – common contributors to TMJ disorders – they might notice their tinnitus symptoms decrease.

Can TMJ Cause Tinnitus In One Ear?

Yes, TMJ (temporomandibular joint) disorders can potentially cause tinnitus in one ear. When the TMJ is not functioning correctly, it can create changes in the surrounding muscles, ligaments, and nerves, impacting the auditory system. This can result in tinnitus that is perceived predominantly in one ear. The exact mechanism by which TMJ disorders contribute to tinnitus is not fully understood, but several theories have been proposed.

One theory suggests that the chewing muscles, which are close to other muscles that insert into the middle ear, can influence hearing and trigger tinnitus when not functioning correctly. Another theory suggests a direct connection between the ligaments attached to the jaw and one of the hearing bones (ossicles) in the middle ear. These ligaments can impact tinnitus perception if they become strained, sprained, or inflamed. Furthermore, the nerve supply from the TMJ has been found to connect with the parts of the brain involved in hearing and interpreting sound. Any disruptions or abnormalities in this neural pathway can contribute to developing tinnitus symptoms.

It’s important to note that not everyone with TMJ disorders will experience tinnitus, and the relationship between TMJ disorders and tinnitus is not fully established. Tinnitus can have various causes, and it’s essential to consult with a healthcare professional to assess your specific symptoms and determine the appropriate diagnosis and treatment plan.

Why Does TMJ Cause Tinnitus?

The exact mechanism by which TMJ (temporomandibular joint) disorders can cause tinnitus is not fully understood. However, there are several theories that attempt to explain the potential relationship between TMJ and tinnitus:

  1. Muscle Dysfunction: TMJ disorders often involve dysfunction or imbalance in the muscles that control jaw movement. These muscles are located near the ear structures and are connected to the temporomandibular joint. It is possible that abnormalities or tension in these muscles can affect the auditory system and contribute to tinnitus.
  2. Eustachian Tube Dysfunction: The Eustachian tubes, which connect the middle ear to the back of the throat, play a role in equalizing air pressure and draining fluids from the middle ear. Dysfunction in the TMJ can potentially impact the function of the Eustachian tubes, leading to changes in pressure or fluid accumulation in the middle ear. These changes can affect the perception of sound and potentially contribute to tinnitus.
  3. Nerve Pathway Interactions: The nerves that supply the TMJ have connections with areas of the brain involved in both hearing and the interpretation of sound. Disruptions or abnormalities in this neural pathway due to TMJ disorders may influence the perception of tinnitus. The exact mechanisms of how these interactions occur and contribute to tinnitus are still being studied.

It’s important to note that not all individuals with TMJ disorders. Tinnitus can have various causes, including other underlying medical conditions, noise exposure, and age-related hearing loss. If you are experiencing tinnitus or TMJ-related symptoms, it is recommended to consult with a healthcare professional who can evaluate your specific condition and provide appropriate diagnosis and treatment options.

How to diagnose TMJ

Diagnosing TMJ (temporomandibular joint) disorders typically involves a comprehensive evaluation by a healthcare professional, such as a dentist, oral and maxillofacial surgeon, or a specialist in orofacial pain. The diagnosis process may include the following steps:

  1. Medical History: The healthcare professional will start by gathering information about your medical history, including any symptoms you are experiencing, the duration of the symptoms, and any previous injuries or treatments related to your jaw or facial region. They may also inquire about your oral habits, such as teeth grinding or clenching.
  2. Physical Examination: The healthcare professional may palpate the jaw joint to identify areas of tenderness or discomfort. He will listen for clicking or popping sounds during jaw movement and evaluate your jaw’s range of motion. They may also examine your bite and observe any signs of misalignment.
  3. Imaging Tests: In some cases, imaging tests may be ordered to obtain more detailed information about the TMJ and its surrounding structures. Standard imaging techniques used for TMJ evaluation include:
    • X-rays: Plain X-rays can help identify issues like arthritis, bone abnormalities, or changes in the jaw joint’s alignment.
    • CT scan (Computed Tomography): A CT scan provides cross-sectional images of the TMJ, offering more detailed information about the joint’s bony structures and alignment.
    • MRI (Magnetic Resonance Imaging): An MRI can provide detailed images of the soft tissues, such as the discs and ligaments within the TMJ, allowing for a more comprehensive evaluation of the joint.
  4. Additional Tests: Depending on your specific case, additional tests may be recommended. These can include dental impressions, electromyography (EMG) to assess muscle activity, or joint fluid analysis in rare cases.
Image Credit: Research Gate

It’s important to remember that diagnosing TMJ disorders can sometimes be complex, as the symptoms can overlap with other conditions. Therefore, seeking evaluation from a healthcare professional experienced in TMJ disorders is crucial to ensure an accurate diagnosis. 

How to cure TMJ tinnitus?

Treatment options for TMJ-related tinnitus focus on addressing the underlying causes of TMJ, which can also help alleviate tinnitus symptoms. The appropriate treatment approach may vary for each patient. Here are several potential strategies that can be considered:

  • At-home therapy techniques play a crucial role and can include applying heat or cold therapy to the affected area, adopting a softer diet to reduce strain on the jaw, practicing stress relief techniques such as meditation, utilizing specific TMJ massage techniques, and eliminating habits like chewing gum or nail-biting.
  • Transcutaneous electrical nerve stimulation (TENS) is a therapy that employs electrical pulses to the TMJ-related muscles. This technique helps to relax tense muscles and stimulate the release of natural pain-relieving compounds.
  • To manage TMJ disorders, healthcare professionals may prescribe a variety of medications such as pain relievers, nonsteroidal anti-inflammatory drugs like ibuprofen, and muscle relaxants. These medications can help alleviate pain and improve joint function, especially when combined with other treatments. Their use should always be supervised by a healthcare professional to manage potential side effects and effectiveness.

Physical therapy administered by a trained TMJ specialist may involve massage techniques and exercises targeting the musculoskeletal structures associated with the jaw. These therapies can help alleviate pain and loosen tight jaw muscles [5].

TMJ and Tinnitus Takeaway 

In conclusion, comprehending the link between TMJ disorders and tinnitus is essential for mitigating these intertwined conditions. The close proximity of the TMJ to ear structures, combined with shared nerve pathways and muscle connections, can contribute to tinnitus symptoms.

Often characterized by a ringing sensation in the ears, these symptoms can significantly affect the quality of life. Understanding specific symptoms such as fluctuating tinnitus, somatosensory tinnitus, correlation with other TMJ symptoms, referred pain or sound, and relief with TMJ treatment can help ascertain if TMJ is the root cause of tinnitus. It is crucial to seek professional medical evaluation and treatment to effectively manage TMJ-related tinnitus.

Treatments may include at-home therapy techniques, oral appliances, transcutaneous electrical nerve stimulation (TENS), and physical therapy. Addressing the root causes of TMJ disorders can lead to relief from both conditions, enhancing overall quality of life. Lastly, it’s important to remember that the information provided in this article is intended for educational purposes only and should not replace professional medical advice. Always consult with a healthcare provider for accurate diagnosis and treatment.

References: 

[1] British Tinnitus Association. Tinnitus and TMJ. Retrieved [5.6.2023], from https://tinnitus.org.uk/understanding-tinnitus/living-with-tinnitus/tinnitus-and-tmj/

[2] American Tinnitus Association. (Understanding the Facts. Retrieved [5.6.2023], from https://www.ata.org/understanding-facts

[3] MSK Neurology. The Association of Tinnitus, Neck, & TMJ. Retrieved [5.6.2023], from https://mskneurology.com/association-tinnitus-neck-tmj/

[4] C. SkogJ. FjellnerE. EkbergB. Häggman-Henrikson (2018). [Tinnitus as comorbidity to temporomandibular disorders – A systematic review]. Journal of Oral Rehabilitation. Wiley Online Library. https://onlinelibrary.wiley.com/doi/10.1111/joor.12710

[5] Mick, D. The Connection between TMD and Tinnitus. Retrieved [5.6.2023], from https://drmickdds.com/the-connection-between-tmd-and-tinnitus/

Eleftheria Georganti
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Eleftheria's world revolves around sound - whether it's designing high-quality audio applications, crunching numbers in audio signal processing (DSP), decoding room acoustics, listening to music or crafting the latest hearing aid technology and new features. She has a professional career spanning over 15 years and a strong research record (over 40 articles and patents) and has been the driving force behind top-notch products at leading hearing aid and audio tech companies. But what really makes her enthusiastic is sharing what she knows. As an avid writer, she loves spreading the word on the science of hearing, hearing aids and health technologies. Her ultimate goal? To give people with hearing impairments the insights they need to live their best life.

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