Impact of Temporomandibular Joint Complaints on Tinnitus-Related Distress

Abstract

There is increasing evidence of associations between the presence of temporomandibular joint (TMJ) disorders and tinnitus. It has been recently proposed that tinnitus patients with TMJ complaints could constitute a subtype, meaning a subgroup of tinnitus patients responsive to specific treatments. Tinnitus patients with TMJ complaints are often young women with somatosensory features of their tinnitus. Here, we investigate the socioeconomic factors, phenotypic characteristics and psychological variables of tinnitus subjects from the Swedish Tinnitus Outreach Project, with (n = 486) or without (n = 1,996) TMJ complaints. The prevalence of TMJ complaints was greater in tinnitus subjects with severe tinnitus (36%) when compared to those with any tinnitus (19%), strongly indicating the contribution of TMJ problems to the severity of tinnitus. Comparing subgroups with or without TMJ complaints in the whole sample, differences were found regarding a large number of socioeconomic, phenotypic, and psychological characteristics. Subjects with TMJ complaints were more often women, more often reported stress as the cause of tinnitus, were more severely affected by tinnitus, scored worse in measures of psychological well-being and life quality, and were more often affected by problems tolerating sounds, headache, vertigo/dizziness, and neck pain. In addition, they more often reported pulsating and tonal tinnitus, somatic modulation of tinnitus, and aggravation of tinnitus by loud sounds and stress. When focusing the analysis in subjects with tinnitus as a big problem using the Tinnitus Functional Index cutoff ≥ 48, or with severe tinnitus according to the Tinnitus Handicap Inventory cutoff ≥ 58, the impact of somatosensory modulations and stress on tinnitus were greater in subjects with TMJ complaints in comparison to those without. In light of these results, we hypothesize that stress could contribute to the co-occurrence of TMJ problems and tinnitus and also to the development of severe tinnitus. Our study supports the need of involving dental care and stress management in the holistic treatment of patients with severe tinnitus.

Gender Comparison of Psychological Comorbidities in Tinnitus Patients – Results of a Cross-Sectional Study

“…As proposed by other authors, these findings are supported by the hypothesis that in women homeostasis of labyrinthic fluids may be altered by hormone alterations in the menstrual cycle, pregnancy and menopause causing balance and hearing disorders ( Ishii et al, 2009 ; Reiss and Reiss, 2014 ). Yet, in our study there was no increased prevalence of temporomandibular disorders, which is in contradiction to previously described prevalence rates ( Vielsmeier et al, 2012 ; Algieri et al, 2017 ; Edvall et al, 2019 ). Data from literature reports a greater heritability for bilateral tinnitus in men and young women ( Maas et al, 2017 ; Lopez-Escamez and Amanat, 2020 ).…”

Association between Hyperacusis and Tinnitus

“…This may be due to the fact that the sample size of our severe tinnitus group was smaller than the group used in the TRI (n = 1713), or that the THI ≥ 58 group from the STOP study was much more severe than that of the TRI (THI range; TRI: 41.9-53.6 vs. STOP: 72-73.6). However, in spite of the small sample size of our THI ≥ 58 group, we have previously reported differences in somatosensory modulations in these participants with or without temporomandibular joint (TMJ) complaints or headache [42,52], which we could not reveal here being influenced by hyperacusis. It thus appears from this study on hyperacusis and our previous reports on TMJ and headache, that with greater tinnitus severity, fewer differences are found with or without the co-morbidities.…”

“…Regarding the tinnitus phenotyping study, the methods has been described before [42]. Sociodemographic data was obtained using questions from Svensson et al [43].…”

The Effect of Environmental Stressors on Tinnitus: A Prospective Longitudinal Study on the Impact of the COVID-19 Pandemic

“…More details about the study group at baseline are given in Table 1. 1 : female/male; 2 : right ear/left ear/both ears but worse on left/both ears but worse on right/both ears equally/inside the head/elsewhere; 3 : tone/noise/cricket/other sound; 4 : intermittent/constant; 5 : yes, with the heart rate/yes, different from heart rate/no; 6 : fluctuates/constant; 7 : very high freq./high freq./medium freq./low freq. ; 8 : yes/no/do not know; 9 : yes/no/do not know; 10 : suffers from temporomandibular disorders/does not suffer from temporomandibular disorder; 11 : suffers from neck pain/does not suffer from neck pain; 12 : suffers from pain syndrome/does not suffer from pain syndrome; 13 : stress influences tinnitus/stress does not influence tinnitus; 14 : has hearing problem/does not have hearing problems; 15 : right ear/left ear/both ears/none; 16 : suffers from hyperacusis/does not suffer from hyperacusis; 17 : suffers from headaches/does not suffer from headaches; 18 : suffers from dizziness/does not suffer from dizziness.…”