Could the Cause of Tinnitus Be Your Jaw Joint, Not Your Ear?
Prof. Dr. Mehmet Oğuz Öztoprak’s Orthopedic Jaw Joint Approach
When tinnitus is mentioned, most people first think of ear diseases. However, in our clinical practice, we often encounter a different picture.
Tinnitus May Persist Even When Ear Examinations Are Normal
In some patients;
Ear examinations are normal.
No serious problem is detected on MRI scans.
Various medical treatments have been applied.
Despite this, tinnitus continues.
At this point, there is an important question that is often overlooked:
Is the problem really in the ear, or could it be in the jaw joint located close to the ear?
Tinnitus May Actually Be a Warning Signal
Our body often informs us through symptoms when something is not functioning properly.
In some patients, tinnitus may not be only an ear-related complaint, but a warning signal of an underlying functional problem.
Tinnitus May Be the First Sign of a Larger Imbalance
Especially in individuals whose ear examinations are normal but who also experience teeth grinding, jaw pain, neck problems or posture disorders, tinnitus may sometimes appear as the first sign of a larger biomechanical imbalance.
For this reason, tinnitus should not be evaluated only as a symptom that needs to be suppressed, but as an important clinical finding whose underlying cause should be investigated.
The Jaw Joint Is Not Just a Joint
The traditional approach considers the jaw joint only as a joint that opens and closes the mouth.
However, the jaw joint is directly related to many systems.
Which Systems Is the Jaw Joint Related To?
The jaw joint is directly related to:
Skull balance,
Neck posture,
Spinal alignment,
Airway openness,
The chewing system,
Dental occlusion.
A dysfunction in one of these systems may affect the others over time.
Therefore, in some patients, tinnitus may actually be a warning signal from the jaw joint system rather than the ear itself.
What Is Somatosensory Tinnitus?
Recent studies show that some tinnitus cases may be related not only to the auditory system, but also to sensory inputs coming from the jaw joint, chewing muscles and neck region.
In the literature, this condition is defined as somatosensory tinnitus.
In particular, a change in the intensity of tinnitus during jaw movements, or an increase or decrease with neck movements, may provide important clues for clinicians.
In Some Patients, Tinnitus May Be Associated with Excessive Load on the Jaw Joint
In many patients we evaluate in our clinic, we encounter some common findings.
Findings That May Increase the Load on the Jaw Joint
In these patients, it is often observed that:
The lower jaw is not in its ideal functional position.
The dental bite is not suitable for the joint.
The jaw joint carries more load than normal.
Over the years, this situation may create different effects on the jaw joint and surrounding tissues.
What Problems Can Excessive Load Cause?
Excessive load on the jaw joint may lead to:
Pressure on the joint disc,
Stress in the joint tissues,
Excessive activity in the chewing muscles,
Compensations in the head and neck muscles.
Due to the close anatomical relationship between the ear region and the jaw joint, these mechanical loads may appear in some patients as tinnitus, a feeling of fullness in the ear, dizziness or balance problems.
The Jaw Joint, Spine and Posture Should Be Evaluated Together
In Prof. Dr. Mehmet Oğuz Öztoprak’s approach, the jaw joint is not considered only as a problem inside the mouth.
Because the human body is not made up of systems that work independently from one another.
Posture Disorders May Affect the Jaw Joint
Especially;
Forward head posture,
Loss of cervical lordosis,
Shoulder asymmetries,
Scoliosis,
Spinal alignment disorders
may change the loads placed on the jaw joint.
In some patients, imbalances in the spine may affect jaw position, while in others, problems in dental occlusion may affect head and neck posture.
Therefore, in individuals with tinnitus and jaw joint complaints, not only the teeth but also posture, the spine and the musculoskeletal system should be evaluated.
When necessary, multidisciplinary work with physical therapy and rehabilitation specialists may be an important part of the treatment.
Prof. Dr. Mehmet Oğuz Öztoprak’s Orthopedic Approach
We do not evaluate every patient with tinnitus only through the complaint of “ringing.”
First, we try to understand the relationship between the jaw joint, occlusion, posture, airway and musculoskeletal system.
Which Questions Are Asked During the Evaluation Process?
In this process, the answers to the following questions are investigated:
Is the lower jaw in the correct position?
Is the load on the jaw joint balanced?
Does the bite relationship strain the joint?
Does teeth grinding increase joint pressure?
Are airway narrowing and sleep disorders present?
How do neck and head posture affect the system?
Do the spine and body balance influence the jaw system?
Because in this patient group, focusing only on the ear may often not be sufficient. The jaw system, musculoskeletal balance, airway and occlusal relationships should be evaluated together.
The Aim of Treatment Is Not to Suppress Tinnitus, but to Investigate the Underlying Imbalance
The goal of treatment is not only to reduce symptoms.
The main aim is to re-evaluate the functional balance between the jaw joint, chewing muscles and occlusal system, reduce the biomechanical loads on the jaw joint, and create a treatment plan suitable for the patient’s individual needs.
What Does Orthopedic Jaw Position Mean?
By orthopedic jaw position, we mean the functional position in which the jaw joint, chewing muscles and teeth can work together in the most balanced and physiological relationship.
In this approach, the goal is not only to focus on the current complaint, but also to understand why the jaw joint system is being strained.
Which Approaches May Be Included in the Treatment Plan?
Depending on the case, the following may be planned together:
Functional orthopedic treatments,
Occlusal balancing methods,
Orthodontic treatments,
Clear aligner applications,
Temporomandibular joint rehabilitation,
Airway-focused treatments,
Posture and spinal rehabilitation.
When the load on the jaw joint decreases and the system begins to function in a more balanced way, a reduction in the severity of tinnitus and an improvement in quality of life may be observed in some patients.
Not Every Tinnitus Is Caused by the Jaw Joint
Of course, the jaw joint is not the only cause of tinnitus.
Ear diseases, neurological problems, vascular diseases and other systemic causes must also be investigated.
In Which Patients Should the Jaw Joint Be Evaluated?
However, especially in people who:
Have a habit of teeth grinding,
Hear sounds coming from the jaw,
Experience jaw fatigue in the morning,
Have head and neck pain,
Have posture problems,
Have normal ear examination results,
the jaw joint and occlusal system should definitely be evaluated.
Conclusion
Tinnitus may sometimes be a call for help from the jaw joint system, not the ear.
A modern approach requires looking not only at the ear, but also at the jaw joint, bite relationships, orthopedic jaw position, muscular system, spine, posture and airway together.
In our clinic, the aim is not only to suppress symptoms, but to evaluate the patient as a whole and understand the relationship between the jaw joint, occlusion, airway, posture and musculoskeletal system.
Because sometimes what needs to be treated is not tinnitus itself, but the biomechanical imbalance that causes tinnitus.