Dentist Tips: How to Prevent Tinnitus from Getting Worse During Dental Procedures

[JohnJohnJohn]

Hi all!

I have to go to the dentist soon, and have been combing through these forums to accumulate the best tips to avoid worsening tinnitus when going to the dentist, I think I have them collected below:

1. You want them to use an electric drill (electric handpiece rather than an air-driven handpiece), ideally run at the lowest speed possible in order to be as quiet as possible.

2. Ask them if there is anything they can do to make the drill quiet, i.e., using a different drill bit, etc.

3. You want them to drill for five seconds on and ten seconds off.

4. Apparently, its also possible to use a manual instrument to scratch/scrape away some softer parts of bad tooth, so you could ask them to do that whenever possible to limit any unnecessary noise exposure.

5. Ask them to use the drill as little as possible (likely the same point as the above).

6. For any dental cleaning etc., ensure that they use manual tools and avoid ultrasonic or sonic tools (such as tooth scalers).

7. Close your mouth when possible to rest your jaw.

8. Keep a straight neck (inline with your back), try pushing your head back into the dentists chair headrest if necessary.

9. No earplugs or builders headphones as this will make the noise louder, because it can't escape from your teeth through your ears (the occlusion effect), you can bring a pair of builders headphones to have with you just in case you change your mind in there.

10. Tell the dentist that you're really anxious about the sound and ask his/her opinion on how to limit your sound level and time exposure as much as possible? Maybe there are other ways to do the procedure that are perhaps harder/more time consuming but that you would prefer because of less noise?

11. Most importantly, tell them "I am happy to pay for the extra time/effort needed to accommodate this."

What do you think? Is there anything you might add or take away?

Thanks,
John

 

[JohnJohnJohn]

Any thoughts on the above? How can I improve it?!

Thanks,
John

 

[TinaRuns]

I asked a very experienced oral surgeon about drilling in short bursts then waiting. He wasn't receptive. He was friendly but basically said I treat lots of people with tinnitus. Then suggested we just wait until my tinnitus improved (not totally unreasonable at the time because I was about to undergo tympanoplasty surgery).

Still, even offering to pay them more, I doubt most will be receptive. And I can already hear them saying that their techniques shouldn't bother tinnitus.

I'm so frustrated with the medical establishment at this point. Basically everyone says that nothing should worsen tinnitus, including many things that clearly do.

 

[Baker]

My tinnitus has gotten worse when being exposed to loud noises. i.e. drilling something for a few minutes and forgetting to put on my ear muffs. Really powerful magnets from a hard drive clanging together and making a loud ping noise. When I've held my nose and blew, the pressure would make my tinnitus temporarily louder. Though one time I shook my head hard while doing that and it permanently got worse. And slapping the sides of my head have made it permanently worse.

I would put on earplugs as being around drills has made my tinnitus worse. I don't get the thing about not wearing them so the sound can escape as the noise will have plenty of other areas to "escape" to.

 

[Exit]

Find a dentist who uses a laser for hard tissue. It can be used on everything except old silver coloured fillings (amalgam).

Sure they must drill some to shape the filling but that's not very hard tissue compared to teeth.

 

[K.A.]

I don't get the thing about not wearing them so the sound can escape as the noise will have plenty of other areas to "escape" to.

It is called the "occlusion effect".

How to Measure Earmuff Volume Regarding the Occlusion Effect?

 

[K.A.]

Any thoughts on the above? How can I improve it?!

Thanks,
John

Number 9: When using "builders" ear muffs, use the ones with least occlusion effect (usually the ones with the largest physical inner volume)?

Number 2 should be first, when on the phone with them. To make sure it is not one of those that suddenly says "no, this will only take a minute, don't think about this I have done this 1000 times with no problems" when you sit in the chair... Also might have one bullet point about just leaving the premise if you they do not follow your request when in the chair.

I have argued with a lot of dentists online and offline, and in my experience about 90% have no understanding of this issue, and just think of it as a "mental anxiety" not to be taken seriously - most just says no problem we can give you a benzo-pill so no need to be afraid. Like that would limit the noise...

 

[Sayeed]

My tinnitus isn't due to hearing loss or acoustic trauma. Probably due to medication and stress. My hearing is fine. I also have cochlear hydrops in my left ear.

I'm getting scaling and root planning done on all 4 quadrants tomorrow. Praying for the best.

 

[K.A.]

My tinnitus isn't due to hearing loss or acoustic trauma. Probably due to medication and stress. My hearing is fine. I also have cochlear hydrops in my left ear.

I'm getting scaling and root planning done on all 4 quadrants tomorrow. Praying for the best.

Do you have to do it with an ultrasonic tool? (Never done root planing myself...)

Also, have you considered dividing the procedure into two separate sessions?

 

[Darktale]

First sorry for my english, I am French and technical vocabulary in dentistry is not common for me.

For yearly tartar cleaning my dentist is using a dental laser.... so no noise except small "tic tic tic" from the machine and the dental suction.
I struggled to find a dentist accepting to do it it with laser but finally found one that I have now been visiting for 5 years

Laser is not primarily designed for tartar cleaning but it can prefectly do it with proper tips. For my dentist additional benefits are that laser purifies and disinfect at the same time.
Cons are that it is a bit painful, taking more time and it is much more expensive that's why it is difficult to find a dentist equipped with laser who accepts to do tartar cleaning with the laser.

 

[Sayeed]

Do you have to do it with an ultrasonic tool? (Never done root planing myself...)

Also, have you considered dividing the procedure into two separate sessions?

I just got it done without anesthetics, knocked it out in one go. That was brutal. Glad it's over. No increase in tinnitus.

 

[K.A.]

First sorry for my english, I am French and technical vocabulary in dentistry is not common for me.

For yearly tartar cleaning my dentist is using a dental laser.... so no noise except small "tic tic tic" from the machine and the dental suction.
I struggled to find a dentist accepting to do it it with laser but finally found one that I have now been visiting for 5 years

Laser is not primarily designed for tartar cleaning but it can prefectly do it with proper tips. For my dentist additional benefits are that laser purifies and disinfect at the same time.
Cons are that it is a bit painful, taking more time and it is much more expensive that's why it is difficult to find a dentist equipped with laser who accepts to do tartar cleaning with the laser.

Very interesting information! Does the laser equipment that can do this have some specific name you remember?

 

[K.A.]

I just got it done without anesthetics, knocked it out in one go. That was brutal. Glad it's over. No increase in tinnitus.

Thanks for the update! Glad you are okay. How many minutes did it take to do it, and did your ears hurt while doing it (or only your teeth/gums)?

 

[Darktale]

Very interesting information! Does the laser equipment that can do this have some specific name you remember?

Last time I remember the dentist told me the name of the tips used with the laser... I think it was Erbium... but not fully sure. I will ask her next time as I will go for my yearly check by the end of the year.

I also had one appointment a few years ago to change a dental amalgam. She was able to do 90% of the treatment (amalgam removal, cleaning of the dental cavity...) with the laser. At some point she had to use the standard drill for a few seconds as the enamel was a bit too hard but it was ok.

This dentist equipped with laser was a game changer in my dental life and my ability to cope with my tinnitus/hyperacusis.

 

[Sayeed]

Thanks for the update! Glad you are okay. How many minutes did it take to do it, and did your ears hurt while doing it (or only your teeth/gums)?

No problem. It took about 2.5 hours. I took .25 mg of Xanax beforehand.

Interestingly enough the noise from the machine almost made like a Neuromodulation therapy sound. So it was like I was used to it, just a higher frequency.

I can see how this would impact someone with hyperacusis though. It only hurt my gums.

 

[Moss]

I have severe hyperacusis and tinnitus. I've had three fillings replaced this year, and also had some cleaning done. I didn't realise they could do the cleaning manually and it's only over time that I have managed to build some good communication with the practice and have been reassured that they can do it manually in the future.

Unfortunately it takes time for people to understand the problems I have and also I only recently started to see a female dentist at the practice who is super friendly and accommodating (i.e. more empathic than the men). I decided to just grin and bear all the sound exposure because the work really needed to be done and now I can hopefully go on for another ten years.

I personally found that wearing earplugs and earmuffs was helpful but it could be an illusion or that my ear damage is different from someone else's. From my perspective, at least the amount of sound coming in from the outside is lessened.

I did find that spreading the treatments out over a longer period of time was better. So a four week resting period was more helpful than trying to get the treatments done quickly and only having two week's rest in between.

As to whether it was worth having cleaning and drilling done during the same appointment, it's difficult to say. I like to get things over with so I've been trying to reach some sort of compromise. In my particular case, all that hard core drilling doesn't seem to cause more of a setback than some random high pitch metallic squeak in the environment. Perhaps it's just so bad it causes numbness.

Sorry if this is a bit unclear, now that I try and explain all this I realise it's quite unclear to me, as well. The ups and downs seem a bit random.