Hyperacusis and the Dentist — Invisalign

[Juan]

Just wanted to make a short entry to tell how my visit to the dentist went, having tinnitus and hyperacusis. I had been avoiding the dentist for a long long time, many years already... and my teeth were misaligned, so I wanted to get that fixed in order to avoid losing a teeth in the future (this happened to a relative of mine).

After asking about which options there were to align my teeth, and specifically asking about noise, my dentist recommended to do an Invisalign treatment. She said it would not be very noisy. During the treatment frequent dental cleaning is needed, but this has been done manually to avoid noise.

The only issue is Invisalign attachments have to be removed using a sort of dental drill and this is noisy.

As my dentist knows about my hyperacusis, she suggested using the drill at a lower speed (like one third of the usual speed so that the sound it makes is lower, not so high frequency), and taking breaks during the process.

She asked me if I wanted cotton in my ears, and I had also my own earplugs, but I decided to do the whole thing without earplugs due to the occlusion effect and the fact the dental drill would be touching my teeth and therefore driving sound through bone conduction...

Well, removing attachments with the drill was still quite noisy, and I was uncomfortable all the time during the process, but more or less bearing it... until the last bit just felt awful, and now my ears have been hurting for a few days.

There are still new attachments to be placed on my teeth next month and these will have to be removed at the very end of the treatment. I will try then to use earplugs but not blocking the ear, not "properly inserted" but half inserted only to dim noise... see how it goes. I will update this post then.

The thing I learnt during the first removal of attachments using a drill and not using earplugs are that my ears were more or less bearing the noise and the vibration etc but in the end they got hurt. So this is in part a matter of time of exposure. I should have been wiser and broke up the removal process in two sessions. Also, the dental drill makes different sounds at different frequencies depending on the angle the dentist is using, and some frequencies are easier to tolerate than others...

I noticed my ears were hurt because the dentist is talking while removing the attachments and suddenly I hear hear voice sort of drop, and like I cannot understand her that well... and that's the clear symptom that something went wrong.

The other classical symptoms of something going wrong is - oddly - for two or three days after the dentist, my hearing felt "enhanced" but "unbalanced". This probably means recruitment kicking in, this is "angry" hair cells, over-stimulated hair cells playing up. After 48 hours I started getting a massive headache and in a week or so my hearing was more or less stable, but felt a bit muffled... so pretty bad experience overall.

 

[Freerunner]

@Juan, I am sorry that you had to go through this.

I have an appointment for implant. I have already done the first part in the summer when I did not have ear issues, and now what's left only is putting a crown. However I am still scared as my hyperacusis got severe and I am homebound for almost a month now.

How do you think it's best to handle my situation? I must go as the implant might not survive for long without a crown.

 

[florian_89]

Just wanted to make a short entry to tell how my visit to the dentist went, having tinnitus and hyperacusis. I had been avoiding the dentist for a long long time, many years already... and my teeth were misaligned, so I wanted to get that fixed in order to avoid losing a teeth in the future (this happened to a relative of mine).

After asking about which options there were to align my teeth, and specifically asking about noise, my dentist recommended to do an Invisalign treatment. She said it would not be very noisy. During the treatment frequent dental cleaning is needed, but this has been done manually to avoid noise.

The only issue is Invisalign attachments have to be removed using a sort of dental drill and this is noisy.

As my dentist knows about my hyperacusis, she suggested using the drill at a lower speed (like one third of the usual speed so that the sound it makes is lower, not so high frequency), and taking breaks during the process.

She asked me if I wanted cotton in my ears, and I had also my own earplugs, but I decided to do the whole thing without earplugs due to the occlusion effect and the fact the dental drill would be touching my teeth and therefore driving sound through bone conduction...

Well, removing attachments with the drill was still quite noisy, and I was uncomfortable all the time during the process, but more or less bearing it... until the last bit just felt awful, and now my ears have been hurting for a few days.

There are still new attachments to be placed on my teeth next month and these will have to be removed at the very end of the treatment. I will try then to use earplugs but not blocking the ear, not "properly inserted" but half inserted only to dim noise... see how it goes. I will update this post then.

The thing I learnt during the first removal of attachments using a drill and not using earplugs are that my ears were more or less bearing the noise and the vibration etc but in the end they got hurt. So this is in part a matter of time of exposure. I should have been wiser and broke up the removal process in two sessions. Also, the dental drill makes different sounds at different frequencies depending on the angle the dentist is using, and some frequencies are easier to tolerate than others...

I noticed my ears were hurt because the dentist is talking while removing the attachments and suddenly I hear hear voice sort of drop, and like I cannot understand her that well... and that's the clear symptom that something went wrong.

The other classical symptoms of something going wrong is - oddly - for two or three days after the dentist, my hearing felt "enhanced" but "unbalanced". This probably means recruitment kicking in, this is "angry" hair cells, over-stimulated hair cells playing up. After 48 hours I started getting a massive headache and in a week or so my hearing was more or less stable, but felt a bit muffled... so pretty bad experience overall.

Best is double protection - earplugs and earmuffs - don't ever expose yourself to noise which is possibly bad.

Best wishes.

 

[Juan]

Best is double protection - earplugs and earmuffs - don't ever expose yourself to noise which is possibly bad.

Best wishes.

I did not use hearing protection because, properly inserted, makes the sound even worse through bone conduction.

 

[Juan]

@Juan, I am sorry that you had to go through this.

I have an appointment for implant. I have already done the first part in the summer when I did not have ear issues, and now what's left only is putting a crown. However I am still scared as my hyperacusis got severe and I am homebound for almost a month now.

How do you think it's best to handle my situation? I must go as the implant might not survive for long without a crown.

Hi Freerunner,

Sorry, I missed your post before.

It's hard to deal with the dentist. I have had another session recently to remove Invisalign attachments.

This time I have been exposed to an ultrasonic cleaner that makes a higher pitched sound than the tool they used at the beginning of February.

This time I have worn earplugs half - inserted, instead of fully inserted to reduce occlusion and bone conduction. The sound of the ultrasonic cleaner is a true ear killer... just horrible. With the earplugs the very high-pitched sound is reduced, but there is still bone conduction. The sound of the ultrasonic cleaner is loud and very high...

I regret having started this Invisalign treatment. I hope to be able to finish it though. There is still another year to go. I hope there are two or three sessions to remove attachments at the end of the treatment... I know this will be painful.

I feel the 2 sessions I have had in February, to remove attachments, have damaged my hearing. After the first session (without earplugs and using a tool that makes more vibration but a lower pitched sound) I had a massive headache. I resorted to Deflazacort for a few days, but still I feel my hearing was damaged, and I lost a chunk of hearing...

This week's session, with earplugs, was not much better. I am not taking corticoids now, as the last time Deflazacort did not work, only cleared my headache. Now I have just muffled hearing, very muffled, a bit of pain, but not very bad, mild headache (not as bad as last time)...

I had spent many years avoiding the dentist and I deeply regret to have gone back to the dentist. I am doing the Invisalign treatment to keep my teeth healthy and aligned in the long run, but not for aesthetic reasons. A relative of mine lost a tooth because they were misaligned in a way similar to my teeth...

But I feel I could have postponed visiting the dentists for another good 5 years...

So if you absolutely have to go to the dentist, as it seems, this is a matter of trial and error:

- Tell the dentist you will need to stop frequently and you will raise your hand if the noise has to stop.
- Wear earplugs and see if you feel better with them half-inserted or without them.
- If you need a longer rest because you do not feel well, try to book two sessions instead of one if that can be beneficial in terms of noise...

It is important to have breaks if there is loud noise. Ears take it better...

Keep us posted about how your experience was! There are not many post about the dentist and this is an important topic, as many of us will have to go through dental procedures sooner or later.

Good luck!