Tinnitus is the medical term for experiencing sound in the ears or head when no external source is present, often described as a ringing, buzzing, or hissing noise. Orthodontic braces are devices used to gradually shift teeth into better alignment, correcting issues with the bite. For some individuals, the mechanical forces of tooth movement may trigger or worsen auditory symptoms. This article explores the indirect connection between orthodontic treatment and the perception of internal sound.
The Core Relationship: Orthodontic Forces and Auditory Symptoms
Braces themselves do not directly generate the sounds associated with tinnitus. However, the process of repositioning teeth and altering the way the upper and lower jaws meet can induce stress that triggers symptoms in susceptible people. Orthodontic treatment introduces mechanical forces designed to change the dental occlusion, or the way the bite aligns. This change in bite can shift the resting position of the jaw and the overall mechanics of the surrounding musculature.
The change in jaw alignment requires the muscles responsible for chewing and jaw movement to adapt to a new sensory pattern. This adaptation process can be slow, sometimes leading to strain on the entire system. When the bite is temporarily destabilized by active tooth movement, the resultant muscular tension can overload the structures that link the jaw to the ear.
The presence of new high points or uneven contact between teeth, particularly early in treatment, can increase the force transmitted through the jaw joint. This mechanical strain can lead to the perception of sound in the ear. This reaction is considered an indirect consequence, rather than a complication of the braces themselves.
The Anatomical Link: How Jaw Stress Impacts Hearing
The connection between jaw stress and auditory symptoms centers on the temporomandibular joint (TMJ), the hinge that connects the lower jawbone to the skull. This joint is located in close proximity to the middle and inner ear structures. Any inflammation or strain in the TMJ region can easily affect nearby auditory components.
The close physical relationship is supported by shared muscular and neural pathways. The chewing muscles, known as the muscles of mastication, are situated near the tiny muscles that insert into the middle ear, such as the tensor tympani. When jaw muscles tighten or spasm due to orthodontic strain, this tension can transfer to the middle ear muscles, potentially influencing the perception of sound.
Furthermore, the nerves that supply sensation and movement to the jaw, most notably the trigeminal nerve, share pathways with the nerves involved in hearing. Irritation or inflammation around the TMJ can cause signals to cross or become amplified within the brain’s auditory processing centers. This neurological overlap contributes to somatic tinnitus, a type of ringing whose intensity can often be modulated by movements of the jaw or neck.
Ligaments also play a connecting role, as some fibrous tissues that attach to the jawbone also connect to the small bones within the middle ear. Strain on these ligaments, caused by a change in the jaw’s resting position from orthodontic forces, can mechanically influence the auditory ossicles. This interplay of bone, muscle, and nerve pathways explains why tooth movement can manifest symptoms perceived as being entirely within the ear.
When to Seek Help and Management Strategies
If a patient develops or notices a worsening of tinnitus during orthodontic treatment, the first step is to inform the orthodontist. The professional can examine the appliance fit and bite alignment to ensure no specific part of the brace is causing excessive or uneven pressure on the jaw joint. Sometimes, a minor adjustment to the wires or brackets can alleviate the mechanical trigger.
It is important to consult a general practitioner or an ear, nose, and throat (ENT) specialist to rule out non-orthodontic causes. Tinnitus can be a symptom of many underlying conditions, including hearing loss, certain medications, or ear infections, which must be addressed independently of the braces. A comprehensive hearing evaluation is often performed to determine if the noise is related to hearing function or is a somatic symptom originating from the jaw.
For tinnitus linked to jaw strain, management requires a multidisciplinary approach involving both dental and medical professionals. Physical therapy focused on the jaw and neck muscles can help reduce tension and improve the TMJ’s function. Specific jaw exercises and techniques for stress reduction are employed to decrease muscle hyperactivity, such as clenching or grinding.
In some cases, an occlusal splint or a custom-made bite guard may be recommended, particularly for use at night, to stabilize the jaw joint and reduce strain on the surrounding muscles. These devices help the jaw find a more comfortable resting position, which may reduce the perception of tinnitus. Using sound-masking devices, such as white noise machines, can also help the brain habituate to the internal sound, making it less bothersome.