Earplugs, Dentistry, and the Occlusion Effect

[Daniel S.]

Hello, everyone! My apologies for another dentistry thread, but I've got an appointment coming up soon and despite my best efforts, I'm not completely clear on a few things regarding dental work, earplugs, and the potential for hearing damage/tinnitus spikes from the occlusion effect.

A little background: I have some very big and thick teeth, which is great. What's not so great is that some of them are very close together, and so while I'd prefer to avoid to those ultrasonic cleaners, my dentists insists that it's the only way to really get in between some of my teeth (and I believe her, as I sometimes even struggle with getting floss in there). Now I've had this done a few times and didn't wear plugs, and everything was fine afterwards. About a year ago though, I had it done and suffered a noticeable spike afterwards. The spike faded after a few days, thankfully, but it left me feeling nervous. So I decided to wear plugs on my last cleaning 6 months ago. Obviously the sounds in my ears were much louder, but I did not get any spikes after the cleaning.

I'm heading back for another cleaning in a couple days, and I also believe I have my first ever cavity, so I'm sure I'll need to get that addressed in the very near future. So my question is, do ya'll think it is better to go with or without plugs for the ultrasonic cleanings and/or cavity drillings? I keep seeing people talk about the occlusion effect in a negative way, but does it actually pose a significant danger to our ears? I'm on the fence about wearing plugs to my appointment and would be very grateful for some feedback.

For what it's worth, the dentist does routinely take breaks during the cleaning. Also, my ENT told me that dental equipment doesn't operate at a loud enough volume or at the right frequency to pose much of a threat to my ears. I know she's wrong about that, but my last hearing test I had 3 months ago showed that my hearing is right about average for someone my age, so perhaps that's the reason she responded the way she did. Admittedly, her knowledge about tinnitus is noticeably limited, but I've already gone through 3 other doctors who told me to just "live with it." She was the first one who didn't, and that's one of the reasons why I've stuck with her.

Anyways, any feedback/advice/suggestions would be awesome if you have some time to spare!

 

[Vincent R]

So my question is, do ya'll think it is better to go with or without plugs for the ultrasonic cleanings and/or cavity drillings?

Without.

I keep seeing people talk about the occlusion effect in a negative way, but does it actually pose a significant danger to our ears?

Yes.

For what it's worth, the dentist does routinely take breaks during the cleaning.

Good. Breaks should be taken often, though. I recall to have read a recommendation saying five seconds drilling and ten seconds paus or something like that (search the site if you want the exact recommendation and original source). Pausing so often takes a lot of discipline, so you could discuss the possibilite of booking a double appointment with your dentist.

 

[Digital Doc]

Your ENT needs to better understand the risks:

"Results:
Measurements made in the dental operatory revealed dangerous levels when high-volume suction was in use alone and in conjunction with a dental handpiece. Questionnaire results suggested that practicing dentists report sensorineural hearing loss at a rate broadly in line with national averages. However, dentists reported a higher prevalence of tinnitus symptoms than would be expected based on sample demographics.

Conclusion:
Results from sound level measurements and questionnaire responses indicate that dentists are a population that could be placing their hearing health at risk in a typical daily work environment."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5227015/

No earplugs, but can consider noise cancelling headphones to reduce the noise.

 

[Daniel S.]

Good. Breaks should be taken often, though. I recall to have read a recommendation saying five seconds drilling and ten seconds paus or something like that (search the site if you want the exact recommendation and original source). Pausing so often takes a lot of discipline, so you could discuss the possibilite of booking a double appointment with your dentist.

Understood. Thanks for the advice, Vincent! My hope is that my dentist won't have any objections to taking frequent breaks. She's normally quite pleasant though, so I imagine it won't be an issue. And she doesn't have to use the ultrasonic device on all my teeth, so it won't be a full session. If it does take her longer, I'll simply offer to pay for a second appointment if she needs the extra time.

 

[Daniel S.]

Your ENT needs to better understand the risks:

"Results:
Measurements made in the dental operatory revealed dangerous levels when high-volume suction was in use alone and in conjunction with a dental handpiece. Questionnaire results suggested that practicing dentists report sensorineural hearing loss at a rate broadly in line with national averages. However, dentists reported a higher prevalence of tinnitus symptoms than would be expected based on sample demographics.

Conclusion:
Results from sound level measurements and questionnaire responses indicate that dentists are a population that could be placing their hearing health at risk in a typical daily work environment."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5227015/

No earplugs, but can consider noise cancelling headphones to reduce the noise.

Interesting study. I definitely was not aware of that, and I'm guessing my ENT isn't aware of it either.

Unfortunately, I've yet to find an ENT who seems to be very knowledgeable about tinnitus, which is really quite surprising to me given how common the condition has become. That said, my current doc does seem better informed about it than the last 2 ENTs I visited. I had to drop them both because in addition to not knowing anything at all about tinnitus, they also didn't seem to care one bit about helping me with it. My new doctor is at least somewhat familiar with it; she knew enough to tell me about the potential benefits of magnesium, which is more than I can say for the previous 2 doctors. And she's also incredibly kind and accessible, which are both important to me, so that's why I've stayed with her.

 

[Daniel S.]

Understood. Thanks for the advice, Vincent! My hope is that my dentist won't have any objections to taking frequent breaks. She's normally quite pleasant though, so I imagine it won't be an issue. And she doesn't have to use the ultrasonic device on all my teeth, so it won't be a full session. If it does take her longer, I'll simply offer to pay for a second appointment if she needs the extra time.

I should say that I hope she doesn't object to taking *more* frequent breaks. As I said, she's usually very good about taking breaks already, but I think I may need to ask for more breaks than normal, just to be safe.

I'm also wondering if there are any precautions I should take that I'm not already taking. I've got my magnesium and NAC supplements ready to go, and will be popping those before and after the appointment. Will probably take a multivitamin as well just for the extra peace of mind. Anything else anyone would recommend?