Tinnitus, a phantom sound in the ears, can manifest as ringing, buzzing, or hissing, and is not caused by an external source. A dental crown is a cap placed over a damaged tooth to restore its shape, size, strength, and appearance. While a direct link between dental crowns and tinnitus is not common, certain crown-related issues can contribute to or worsen symptoms. This article explores these connections.
Understanding Dental Crowns
Dental crowns are custom-made caps that cover a damaged or weakened tooth. Their primary purpose is to restore the tooth’s structure, improve its appearance, and provide protection against further decay or damage. Crowns are used after a root canal, for severely decayed or broken teeth, or to hold a dental bridge in place.
Crowns can be fabricated from several materials, including porcelain, ceramic, or metal alloys. Porcelain and ceramic options are chosen for their natural appearance, while metal alloys, such as gold or other durable metals, are valued for their strength. The choice of material depends on factors like the tooth’s location, aesthetic preferences, and functional requirements.
Potential Pathways to Tinnitus
A dental crown can indirectly contribute to tinnitus through several mechanisms, primarily involving the intricate connection between the oral cavity and the ear.
One significant pathway is through bite misalignment and issues with the temporomandibular joint (TMJ). If a new crown alters how the upper and lower teeth meet, it can create an uneven bite, straining the TMJ, the hinge connecting the jaw to the skull. This misalignment can lead to muscle tension, jaw pain, headaches, and sometimes tinnitus, as the TMJ is located close to the ear and shares nerve connections with the auditory system.
Another possible cause is nerve irritation during or after the crown procedure. The tooth’s pulp contains nerves, and preparing a tooth for a crown can sometimes affect these nerves, leading to sensitivity or discomfort. Irritation or inflammation of nearby nerves, particularly those in the upper jaw close to the ear canals, could indirectly contribute to ear-related symptoms.
Allergic reactions to dental crown materials, though rare, represent another potential pathway. Some individuals may be sensitive to metals like nickel, chromium, or cobalt found in certain alloy crowns, or to components in acrylic-based materials or dental adhesives. An allergic response can cause localized inflammation, redness, or burning sensations in the mouth, which may impact adjacent structures and contribute to tinnitus.
Furthermore, underlying infection or inflammation around the crowned tooth or gums could indirectly affect the ear region. Bacteria can infiltrate the area around or beneath a crown, especially if the crown fits poorly or oral hygiene is insufficient, leading to gum infection or decay. An infection in a tooth can spread to adjacent regions, potentially affecting nerves or creating pressure that manifests as ear pain or tinnitus.
Identifying a Crown-Related Tinnitus
Identifying a potential link between a dental crown and tinnitus involves careful observation of symptoms and professional evaluation. A significant indicator is the onset of tinnitus symptoms relative to the crown placement, particularly if the tinnitus began shortly after the dental procedure. Persistent tinnitus warrants investigation.
Crown-related tinnitus often presents with other accompanying symptoms that point to a dental origin:
Jaw pain or tenderness
Clicking or popping sounds when moving the jaw
Difficulty chewing
Uneven bite, tooth sensitivity, or a feeling that the crown is too high or bulky
Headaches, ear fullness, or facial tension
A thorough diagnosis requires consulting both a dentist and potentially an audiologist or ENT specialist. The dentist will examine the crown’s fit, assess the bite, and check for any signs of TMJ dysfunction, nerve irritation, or infection. This dental examination might involve using articulating paper to identify high spots on the crown or taking X-rays to check for underlying issues. Medical evaluations by an audiologist or ENT can help rule out other common causes of tinnitus, such as hearing loss, ear infections, or circulatory conditions, ensuring a comprehensive assessment.
Addressing Crown-Related Tinnitus
If a dental crown is determined to be a contributing factor to tinnitus, addressing the issue typically involves specific dental interventions.
A common approach is dental adjustments to correct bite issues. If the crown is slightly too high, the dentist can carefully reshape or “shave down” small portions of its surface to achieve a more balanced and comfortable bite. This procedure is often quick and can be completed in a single visit.
In situations where a poor fit or material issue is significant, crown replacement may be necessary. If the crown cannot be adequately adjusted to resolve bite problems or if there’s evidence of an allergic reaction or persistent underlying issues, a new crown made from a different material or with a precise fit would be recommended.
Treating any underlying infection, inflammation, or TMJ disorder is also crucial. If an infection around the crown is identified, treatment may involve antibiotics, root canal therapy, or removal of the crown to address the source of the infection. For TMJ disorders linked to bite imbalance, beyond crown adjustment, a dentist might recommend a custom-made splint or night guard to alleviate jaw strain and muscle tension. A collaborative approach between dental and medical professionals may be necessary for comprehensive management, especially if symptoms are complex or persistent.