As a dentist, you’re likely familiar with the impact of temporomandibular joint disorder (TMJD) on jaw function and pain. However, what may not be as widely recognised is the strong connection between TMJD and tinnitus (ringing in the ears). Many patients experiencing TMJD also report persistent or intermittent tinnitus, and research suggests that addressing TMJ issues may alleviate tinnitus-related distress.
The Link Between TMJD and Tinnitus
Tinnitus is the perception of sound in the absence of an external source, often described as ringing, buzzing, or humming. It affects a significant portion of the population and is commonly associated with hearing loss or exposure to loud noise. However, somatosensory tinnitus—where bodily movements or conditions influence tinnitus perception—is a well-documented phenomenon. The temporomandibular joint (TMJ) is anatomically and neurologically connected to the ear, meaning dysfunction in the jaw can influence auditory perception.
The connection between TMJD and tinnitus is mainly due to:
- Shared Neurological Pathways – The trigeminal nerve (Cranial Nerve V), responsible for jaw function, also has connections with the auditory system in the brainstem. Dysfunction in the TMJ can alter nerve activity, leading to changes in auditory processing and the perception of tinnitus.
- Muscle Dysfunction – The masseter, temporalis, and pterygoid muscles, commonly affected in TMJD, share functional pathways with the tensor tympani and stapedius muscles in the middle ear, which regulate sound transmission. Spasms or dysfunction in these muscles can contribute to tinnitus.
- Joint and Ligament Displacement – Displacement of the articular disc in the TMJ can exert pressure on surrounding nerves and blood vessels, potentially affecting the cochlear blood supply and exacerbating tinnitus.
- Bruxism and Clenching – Many TMJD patients suffer from bruxism (teeth grinding), which increases tension in the TMJ and surrounding muscles, further aggravating tinnitus.
Prevalence and Clinical Evidence
Recent research, including the Swedish Tinnitus Outreach Project, has found that tinnitus is significantly more common in patients with TMJD compared to those without. Findings indicate:
- 19% of tinnitus patients report TMJ complaints.
- 36% of severe tinnitus patients also suffer from TMJ disorders.
- Tinnitus in TMJD patients is often pulsating, tonal, and more distressing than in those without TMJ issues.
- TMJD patients with tinnitus frequently experience headaches, vertigo, neck pain, and stress-related symptoms.
Recognising TMJD-Related Tinnitus in Your Patients
As a dentist, you are uniquely positioned to identify patients at risk for tinnitus due to TMJD. Consider asking the following:
- Do you experience ringing, buzzing, or humming in your ears?
- Does your tinnitus change when you move your jaw, clench your teeth, or press on your TMJ?
- Do you have frequent jaw pain, clicking, or difficulty opening your mouth?
- Have you been diagnosed with bruxism, or do you notice yourself clenching your jaw often?
- Do loud noises worsen your tinnitus?
Patients who answer “yes” to multiple questions may have TMJD-related tinnitus and could benefit from a collaborative treatment approach.
Treatment Approaches for TMJD-Related Tinnitus
Managing TMJD can significantly reduce the severity and distress of tinnitus. A multidisciplinary approach involving dentists, audiologists, and physiotherapists often yields the best results. Key treatment options include:
1. Occlusal and Jaw Therapy
- Custom oral appliances (splints or night guards) can help reduce bruxism, clenching, and TMJ strain, potentially alleviating tinnitus.
- Bite realignment therapy – Adjusting the occlusion can relieve TMJ stress and associated tinnitus symptoms.
- Botox injections – Reduce excessive muscle tension in severe cases of bruxism.
2. Physical Therapy and Posture Correction
- TMJ physiotherapy – Jaw muscle relaxation techniques and stretching exercises can alleviate tension contributing to tinnitus.
- Postural training – Addressing forward head posture and neck tension can reduce TMJ stress.
3. Stress and Behavioural Management
- Cognitive Behavioural Therapy (CBT) – Helps patients manage tinnitus-related anxiety and distress.
- Biofeedback and relaxation techniques – Reduce jaw clenching and overall muscle tension.
- Mindfulness-based stress reduction (MBSR) has been found effective in both TMJD and tinnitus patients.
4. Medication and Alternative Therapies
- Anti-inflammatory medications – Reduce joint inflammation and discomfort.
- Acupuncture and dry needling – May help alleviate TMJ pain and modulate tinnitus perception.
Why Collaboration Between Dentists and Audiologists Matters
Since TMJD-related tinnitus represents a specific subtype, these patients may respond poorly to traditional tinnitus therapies. Identifying and treating the underlying TMJ dysfunction is critical. Dentists and audiologists can work together to ensure:
- Proper diagnosis and assessment of TMJD and tinnitus symptoms.
- Customised treatment plans addressing both jaw and auditory symptoms.
- Improved patient outcomes, reducing distress and enhancing quality of life.
A New Perspective on Tinnitus Management
Tinnitus is often viewed as an audiological issue, but its connection to dental health and TMJD is profound. By screening patients for TMJ dysfunction, collaborating with audiologists, and implementing targeted TMJ treatments, dentists can play a pivotal role in reducing tinnitus-related distress.
Understanding and addressing TMJD not only alleviates jaw pain and dysfunction but also provides a new avenue for tinnitus relief. Given the high prevalence of tinnitus in TMJD patients, a holistic, interdisciplinary approach can make a significant impact on patient well-being. As a dentist, integrating TMJ assessments into your practice can help transform the lives of patients suffering from this dual burden of jaw pain and persistent ear ringing.
References
Bousema E. J., Koops E. A., van Dijk P., Dijkstra P. U. (2018). Association between subjective tinnitus and cervical spine or temporomandibular disorders: a systematic review. Trends Hear. 22:2331216518800640. 10.1177/2331216518800640
Dipalma G, Inchingolo AD, Pezzolla C, Sardano R, Trilli I, Di Venere D, Inchingolo F, Palermo A, Inchingolo AM (2025). The Association Between Temporomandibular Disorders and Tinnitus: Evidence and Therapeutic Perspectives from a Systematic Review. J Clin Med ;14(3):881. doi: 10.3390/jcm14030881.
Edvall NK, Gunan E, Genitsaridi E, Lazar A, Mehraei G, Billing M, Tullberg M, Bulla J, Whitton J, Canlon B, Hall DA, Cederroth CR (2019). Impact of Temporomandibular Joint Complaints on Tinnitus-Related Distress. Front Neurosci, 13:879. doi: 10.3389/fnins.2019.00879. PMID: 31548840;
Fernandes G., Siqueira J. T., Godoi Goncalves D. A., Camparis C. M. (2014). Association between painful temporomandibular disorders, sleep bruxism and tinnitus. Braz. Oral. Res. 28:1 10.1590/1807-3107bor-2014.vol28.0003
Karolina Institutet (2025): https://ki.se/forskning/forskningsomraden-centrum-och-natverk/forskargrupper/translationell-auditorisk-neurovetenskap-christopher-cederroths-forskargrupp/swedish-tinnitus-outreach-project
