Ringing in the ears (tinnitus) is when a person hears sounds that no one else can hear. This is a common problem that can affect a person’s daily life. Ringing in the ears is not a disease. It is a symptom of several diseases, so it is very important to determine the cause of the condition.
What is ringing in the ears?
If you have ringing in the ears, your head is filled with sounds – such as ringing, clicking, pulsation, buzzing, etc., that no one else hears. These sounds can be so quiet that you barely hear them, or so loud that they can block out external sounds.
In very rare cases, ringing in the ears can be audible to other people – such sounds are usually caused by functions of internal blood circulation or defects of ear structures.
People with severe ringing in the ears may have problems with concentration or sleep. Over time, this can lead to nervous disorders and depression. It is important to understand that ringing in the ears is not a disease, it is a symptom of several diseases. Ringing in the ears can occur in anyone, but most often it occurs in people aged 40 to 80 years.
Possible causes
Ringing in the ears is a common symptom of certain diseases.
Age-related hearing loss. Your brain is used to a certain level of sound stimulation, and the auditory nerve is used to a certain level of activity. When hearing loss occurs, the brain receives less stimulation, but the auditory nerve can still work at the same speed as always. Because of this, a person may hear sounds that do not actually exist. Approximately 1 in 3 adults over 65 years old develops ringing in the ears.
Noise-induced hearing loss (NIHL). Loud sounds can cause hearing loss or deterioration and ringing in the ears. This can happen over time or through one incident, such as an explosion or gunshot nearby.
Ear injuries and traumas. Injuries can affect the nerves or areas of the brain that help hear. People who develop ringing in the ears after injury usually have ringing in only one ear.
Ear diseases. Earwax plug or ear infections can cause temporary hearing loss and ringing in the ears.
Medications. Certain medications can cause ringing in the ears, including some antibiotics, antidepressants, cancer medications and non-steroidal anti-inflammatory drugs.
Also, causes of ringing and noise in the ears can be:
- eustachian tube dysfunction (ETD): a pathological condition in which the eustachian (auditory) tube cannot open or close, due to which ventilation is disrupted in the middle ear cavity;
- Meniere’s disease: a non-suppurative disease of the inner ear;
- temporomandibular joint (TMJ) dysfunction: a pathological condition in which the normal work of the joints that connect the lower jaw and the base of the skull is disrupted.
- vestibular schwannoma: a non-cancerous tumor that forms on the vestibular nerve;
- otosclerosis: abnormal bone growth in the ears;
- blood vessel disorders that can cause pulsating ringing in the ears – a rare form of ear ringing that occurs in sync with the heartbeat;
- autoimmune diseases such as lupus or rheumatoid arthritis;
- hypertension;
- diseases of the cervical spine.
People with ringing in the ears may experience flare-ups after exposure to certain triggers, such as stress or lack of sleep.
Care and treatment
Treatment of ringing in the ears depends on the cause. Since ringing in the ears is a symptom of many conditions, it can only be treated by eliminating the underlying cause.
Doctors will need to conduct tests to get an accurate diagnosis.
The doctor may prescribe the following examinations:
- hearing tests, such as pure tone audiometry, speech understanding and tympanometry, if necessary;
- blood tests to check for anemia, thyroid problems, heart disease or vitamin deficiencies;
- MRI (magnetic resonance imaging) or CT (computed tomography).
You may also need an examination by a dentist to determine whether ringing in the ears is a symptom of temporomandibular joint (TMJ) disorder.
Ringing in the ears associated with TMJ
Noise or ringing in the ears is very often associated with age-related hearing loss. This condition becomes more common when people age and begin to lose hearing. Conversely, ringing in the ears associated with TMJ diseases usually affects younger people. It is also more common in women than in men.
The temporomandibular joint connects the lower jaw with the skull on both sides of the face. These joints are located directly in front of the ears and support the jaw muscles necessary for eating, yawning and speaking.
Among the potential causes of TMJ dysfunction:
- teeth grinding during sleep (bruxism);
- arthritis in the jaw;
- head or neck injury;
- incorrect bite;
- TMJ disc dislocation.
Symptoms of TMJ dysfunction:
- clicking or cracking in the jaw;
- pain in the jaw and ear;
- headache;
- difficulty opening the mouth.
How TMJ disorders affect ringing in the ears
A systematic review in 2018 and meta-analysis of many studies showed that the prevalence of ringing in the ears was higher in people with TMJ diseases than in people without TMJ disorders. This may be due to the proximity of the inner ear to the TMJ. A part of the inner ear called the cochlea converts sound waves into electrical impulses that the brain converts into recognizable sounds. Damage to the hair cells of the auricle is a catalyst for ringing in the ears. Since the auricle is located near the temporomandibular joint, irritation and inflammation in the joint can damage the auricle and other parts of the inner ear. This can cause ringing in the ears.
Possible treatment methods for TMJ disorders
There are several types of treatment for TMJ disorders that can help reduce both ringing in the ears and jaw pain.
These include:
- medications, such as muscle relaxants and antidepressants;
- soft diet;
- dental treatment, including bite correction;
- mouth guards to prevent teeth grinding;
- oral splints to align the eardrum;
- physical therapy to stretch and strengthen jaw muscles;
- corticosteroid injections into the joint;
- minimally invasive surgical procedures such as arthrocentesis;
- open joint surgery (arthrotomy).
When to seek help for TMJ diseases and ringing in the ears
TMJ disorders and ringing in the ears are complex conditions that can negatively affect quality of life. Regardless of whether you have TMJ disease or symptoms of noise in one or both ears, talk to a doctor. This is especially important if you have difficulty performing daily tasks or you feel anxiety or depression.
TMJ diseases are often treated by dentists. Specialists of YAREMA DENTAL clinic will be able to help you if ringing in the ears is associated with TMJ dysfunction. Contact us to make an appointment.