Impact of Acoustic Trauma (Ultrasonic Dental Cleaning) After Drug (Finasteride) Induced Tinnitus

[Outlaw]

Hi everyone,

I suffered from tinnitus and slight hyperacusis after taking Finasteride in December. The first 3 months it was a siren in my ears, with hyperacusis.

I have been following a strict protocol to get better (from all the symptoms caused by the pill), and I gradually got better over the span of 9 months. The tinnitus was a quiet hum and hiss in my left ear. I had no trouble sleeping, and at the best times, I could hear it in quiet rooms without it bothering me.

The problem is, I went to have ultrasonic dental cleaning on Thursday, and ever since I have debilitating tinnitus and hyperacusis, to the point that I consider suicide.

It took me all my strength to beat the medication induced tinnitus, and now it's back to square 1 (arguably louder) with increased hyperacusis.

My question is, did the dental cleaning create permanent damage, or did it just exacerbate my medication induced tinnitus (meaning there is still a chance it could go away)?

Before going to the dentist, I had slight tinnitus and slight hyperacusis. Going to play bowling or the metro would bring slight discomfort but that's it.

The procedure lasted like 8 minutes.

Is it possible it's a temporary spike?

Please help, I desperately need it.

 

[ALS]

Very likely it's a temporary spike, though temporary spikes can sometimes take months, at worst, to go down. I doubt the dentist did any real damage, but I'm not an expert.

First thing you should do is sort out the panic. See a good therapist as soon as possible. Maybe look into medication, if you're really at the brink. Take a deep breath.

 

[Manex]

Yes, it's possible it's totally a temporary spike. But, more importantly, for sure it will not be what it is now over time.

I started with audio damage and it was made worse by medication. Opposite of you. But basically once your ears are damaged, they are more likely to be damaged. But what I can tell you for sure after 26 years of having tinnitus is that even when it has gotten worse permanently, it has always reduced a lot from the initial onset.

So put suicide out of your head... There will be a time in the future where it's not the only thing you're thinking about. If this just happened like a day ago, you could talk to an ENT about taking steroids to reduce the inflammation which might help. But you'd need to do that quickly.

 

[Maximilien]

Hi Outlaw! How we meet again.

Our stories just keep being oddly similar, I just physically harmed my ear last week and created an annoying new sound that I hope will go away.

Honestly if your tinnitus and hyperacusis are from ETD, like me, it probably will go away once you recover, really. I know this is one of your biggest struggle right now but you have all the reasons to be hopeful.

Maybe the procedure shook your auditory system bringing a spike but there are chances that it'll subside since your tinnitus is likely not inner ear damage.

You'll be fixed in weeks to months so don't even think about suicide for now please, manage your stress and focus on healing.

 

[Outlaw]

Thank you very much for the replies guys.

It's been really hard to take because I've also been battling the post-drug syndrome for the last 9 months, and tinnitus was among the last 5 remaining symptoms. Last week it was at its lowest, and now its roaring with hyperacusis.

Correct me if I'm wrong, but I do not think that Finasteride caused ear damage. Studies show that it causes tinnitus by lowering GABA. Aside from that route, I was also theorizing that it stemmed from Eustachian Tube Dysfunction or TMJ, since I have crackling ears, crunching jaw, and I can lower the hyperacusis from a sound by yawning.

Since the cause appears to be physical/neurological rather than ear damage, it is reasonable to assume that my ears were not weakened per se, and that the procedure's impact should subside?

 

[Tau]

But basically once your ears are damaged, they are more likely to be damaged.

Does this sensitivity ever subside, in your experience? At the moment I get ear pressure from simply walking down a busy street and my tinnitus sounds keep increasing in number and volume.

Re: dental cleaning: is the ultrasonic cleaner that loud?

 

[Outlaw]

I don't know if you meant to ask the question but yeah, the tool is fairly loud, but the worst is the vibration through your ear on the tooth.

Just had a TMJ massage with a specialist and he said that he doesn't think the cleaning did irreversible damage. He thinks that it had more to do with the stress under which my jaw was at during the procedure. I had to keep my jaw open and I constantly wanted to close it, so my body interpreted it to stay clenched afterward, causing increased tinnitus and hyperacusis.

He said I had a lot of neck and facial tension, and that when he released the tension, it affected the way I breathe through my diaphram.

Makes sense but I'm still afraid their was acoustic damage.

 

[K.A.]

Does this sensitivity ever subside, in your experience? At the moment I get ear pressure from simply walking down a busy street and my tinnitus sounds keep increasing in number and volume.

Re: dental cleaning: is the ultrasonic cleaner that loud?

https://www.todaysrdh.com/deafening...on-hearing-loss-plagues-dental-professionals/

Noisy Environment
Noise levels can be measured with a sound level meter (SLM). If this device is not available, smartphone apps that measure noise levels can be used as a supplement. In fact, NIOSH even developed an app of its own to help promote hearing health.

Dental equipment that can create NIHL include:

• Low-speed handpiece – 70 to 74 dB
• High volume suction – 86 to 89 dB
• Ultrasonic cleaner – 91 dB
• Lathe trimmer – 61 to 96 dB
• Magnetostrictive ultrasonic scaler – 84 to 98 dB
• High-speed handpiece – 88 to 103 dB
• Piezoelectric ultrasonic scaler – 107db

I don't know if this is measure at the head of the dentist or is likely what the patient experiences, also probably not taken into account bone conduction...

Anyhow, the ultrasonic scalers are loud, and if assuming 107 dB at the tip of the scaler we are talking about levels where more than 2-4 minutes is considered a risky exposure - at least near the daily exposure limit. Though a dentist should be able to finish the job within this time, I guess you could argue that it would be better to not clean all teeth at the same session or demand manual cleaning in the future;

http://dangerousdecibels.org/education/information-center/decibel-exposure-time-guidelines/

 

[Outlaw]

https://www.todaysrdh.com/deafening...on-hearing-loss-plagues-dental-professionals/

Noisy Environment
Noise levels can be measured with a sound level meter (SLM). If this device is not available, smartphone apps that measure noise levels can be used as a supplement. In fact, NIOSH even developed an app of its own to help promote hearing health.

Dental equipment that can create NIHL include:

• Low-speed handpiece – 70 to 74 dB
• High volume suction – 86 to 89 dB
• Ultrasonic cleaner – 91 dB
• Lathe trimmer – 61 to 96 dB
• Magnetostrictive ultrasonic scaler – 84 to 98 dB
• High-speed handpiece – 88 to 103 dB
• Piezoelectric ultrasonic scaler – 107db

I don't know if this is measure at the head of the dentist or is likely what the patient experiences, also probably not taken into account bone conduction...

Anyhow, the ultrasonic scalers are loud, and if assuming 107 dB at the tip of the scaler we are talking about levels where more than 2-4 minutes is considered a risky exposure - at least near the daily exposure limit. Though a dentist should be able to finish the job within this time, I guess you could argue that it would be better to not clean all teeth at the same session or demand manual cleaning in the future;

http://dangerousdecibels.org/education/information-center/decibel-exposure-time-guidelines/

Hey man thanks for the numbers, appreciate it, those levels are no joke.

Of course I am never doing ultrasonic cleaning in my life. The question is if one 8 minute cleaning session is enough to inflict a permanent spike to a medication tinnitus. I'm petrified.

 

[Maximilien]

In theory Finasteride could indirectly cause ear damage from oxidative stress and the many things (god knows what) it can mess with in the body.

However, I think that for a majority of people it's either through the neuromodulating effect this drug have or by causing TMJ, ETD etc.

Like for you most likely.

High or low estrogen can cause TMJ. High estrogen has been linked to ETD.

 

[K.A.]

In theory Finasteride could indirectly cause ear damage from oxidative stress and the many things (god knows what) it can mess with in the body.

Is there evidence of this medication causing free radical oxidants, or are you more thinking in the line that "anything" might cause it under certain circumstances?

 

[K.A.]

Hey man thanks for the numbers, appreciate it, those levels are no joke.

Of course I am never doing ultrasonic cleaning in my life. The question is if one 8 minute cleaning session is enough to inflict a permanent spike to a medication tinnitus. I'm petrified.

After having been reading on this forum for years, in addition to own experiences, my impression is that spikes in a number of circumstances does not necessarily come from actual additional ear/cochlear damage, but rather that the brains "filtering system" have been damaged from before and from that is more easily affected temporary or more permanent. So what damages the filter? Difficult to answer, but what does not improve it is certainly anxiety and depression. Maybe that would explain why a number of people improves after some months, cause the hearing certainly does not regenerate on its own during this period of time.

This is all just some wild theories I stick to, I just try to make sense of it all...

107 dB is significant, though not a ridiculously enormous exposure when talking about 8 minutes - regarding actual hearing cell death. But maybe it is more than enough to get the filtering quite out of balance for a period of time. People (who do not get scared and do not think about tinnitus basically all the time) do these things all the time, with none or unnoticeable effects. The science says actual hearing damage will be less significant if you already have hearing loss - for a given exposure. My point is that you should be able to recover from this, physically (regarding hearing). But I think the trick is to be able to also recover mentally (getting the filters to settle back). How to be sure to do it is the 1 million dollar question.

 

[Sean]

Does this sensitivity ever subside, in your experience? At the moment I get ear pressure from simply walking down a busy street and my tinnitus sounds keep increasing in number and volume.

Re: dental cleaning: is the ultrasonic cleaner that loud?

I believe you will be okay in 2-3 months. I know easy for me to say.

 

[Forever hopeful]

Hi everyone,

I suffered from tinnitus and slight hyperacusis after taking Finasteride in December. The first 3 months it was a siren in my ears, with hyperacusis.

I have been following a strict protocol to get better (from all the symptoms caused by the pill), and I gradually got better over the span of 9 months. The tinnitus was a quiet hum and hiss in my left ear. I had no trouble sleeping, and at the best times, I could hear it in quiet rooms without it bothering me.

The problem is, I went to have ultrasonic dental cleaning on Thursday, and ever since I have debilitating tinnitus and hyperacusis, to the point that I consider suicide.

It took me all my strength to beat the medication induced tinnitus, and now it's back to square 1 (arguably louder) with increased hyperacusis.

My question is, did the dental cleaning create permanent damage, or did it just exacerbate my medication induced tinnitus (meaning there is still a chance it could go away)?

Before going to the dentist, I had slight tinnitus and slight hyperacusis. Going to play bowling or the metro would bring slight discomfort but that's it.

The procedure lasted like 8 minutes.

Is it possible it's a temporary spike?

Please help, I desperately need it.

I am so sorry to hear this is happening to you. I personally ask them to clean my teeth the old fashion way. It is quite possible that it is a temporary spike. There's also still a very good chance that medication induced tinnitus will go away. Unless you took something that is truly ototoxic and experienced hearing loss as a result.

Are you 100% sure that Finasteride caused your tinnitus? I was just prescribed it for hair loss and both my dermatologist and I searched and searched and did not see it listed as a side effect.

 

[Outlaw]

I am so sorry to hear this is happening to you. I personally ask them to clean my teeth the old fashion way. It is quite possible that it is a temporary spike. There's also still a very good chance that medication induced tinnitus will go away. Unless you took something that is truly ototoxic and experienced hearing loss as a result.

Are you 100% sure that Finasteride caused your tinnitus? I was just prescribed it for hair loss and both my dermatologist and I searched and searched and did not see it listed as a side effect.

100% sure. It was the first symptom that appeared. Look it up, Finasteride causes tinnitus by lowering GABA levels. I would strongly advise you to never take this drug, because there is a 2% chance that it will make your life a rotting hell from which it will take years to get out of. My life has been seriously altered by this drug. I nearly killed myself, and it took me 9 months of strict health regimen to recover my life. I only had slight tinnitus, slight hyperacusis and low libido left. But honestly it's your body, just want you to know the potential risks.

This damn dentist made the 2 first symptoms considerably worst and now I have trouble leaving my house sound wise. I hope it's a temporary spike.

 

[Maximilien]

@K.A., tbh this is deductive thinking. Since we have little data, we can only guess for now so I probably shouldn't have bring that up on this thread anyway.

PFS can mimic a lot of different medical conditions and it affects everyone differently.

 

[Maximilien]

100% sure. It was the first symptom that appeared. Look it up, Finasteride causes tinnitus by lowering GABA levels. I would strongly advise you to never take this drug, because there is a 2% chance that it will make your life a rotting hell from which it will take years to get out of. My life has been seriously altered by this drug. I nearly killed myself, and it took me 9 months of strict health regimen to recover my life. I only had slight tinnitus, slight hyperacusis and low libido left. But honestly it's your body, just want you to know the potential risks.

This damn dentist made the 2 first symptoms considerably worst and now I have trouble leaving my house sound wise. I hope it's a temporary spike.

I can only understand what you're going through :/ I don't know if you saw my thread here. I was doing pretty well and I foolishly harmed my ear 10 days ago: it caused sound distortion, pain, and increased tinnitus.

Thankfully I don't really have pain anymore and today the distortion is nearly gone and tinnitus has decreased. But I'm still anxious and angry towards me.

Only time will tell if my dumb mistake will resolve itself.

 

[Manex]

Does this sensitivity ever subside, in your experience? At the moment I get ear pressure from simply walking down a busy street and my tinnitus sounds keep increasing in number and volume.

Re: dental cleaning: is the ultrasonic cleaner that loud?

Tinnitus severity almost always goes down from the initial onset overtime. As for fullness or pressure, I'm not sure.

As for the dental cleaning - it's pretty loud in high ranges which are the most sensitive so it's a bad idea. I even have to wear earplugs when I'm at my dental office because others are getting sonic cleaning in other rooms. It's super high pitched.

 

[Outlaw]

Wanted to come back and say that 2 weeks after that, my tinnitus returned to baseline. I even had a few mornings were it was really low, and then it picked up again. My hyperacusis got slowly better. I could cook, talk, and go outside freely. Only limitations were music volume, couldn't shower without earplugs and couldn't record music yet.

Then for no reason my hyperacusis got real bad 10 days ago. Since my tinnitus and hyperacusis were Finasteride induced, I think it has to do with a fluctuation of the condition, rather than acoustic trauma (which I haven't had another of).

2 days ago I listened to a neuromodulation video on YouTube. I had been listening to that video during the summer and it used to soothe my tinnitus. I made the mistake of listening 2 hours for 2 days straight, and now my tinnitus is mad. I have multiple tones repeating the video's melody, and it's reactive. Video was fine predentist, but postdentist with bigger hyperacusis, it was a bad idea.

This taught me that a lot of people forget their threads when they get better. The majority of this forum is people currently suffering, which doesn't give a good idea of the situation

Cheers.

 

[Wrfortiscue]

Tinnitus severity almost always goes down from the initial onset overtime. As for fullness or pressure, I'm not sure.

As for the dental cleaning - it's pretty loud in high ranges which are the most sensitive so it's a bad idea. I even have to wear earplugs when I'm at my dental office because others are getting sonic cleaning in other rooms. It's super high pitched.

So what do we do for cleaning and dental work?

 

[Stacken77]

So what do we do for cleaning and dental work?

I haven't been to the dentist yet with this condition, but I dread that day which is inevitable. From reading this forum, I think I'd use earmuffs(reduced occlusion effect), and insist on having as many things done manually.

My main problem is hardened plaque, and it can be removed completely by hand. It hurts, but can be done. If I don't have this regularly removed, I'll most likely lose my teeth they say.

 

[Wrfortiscue]

I haven't been to the dentist yet with this condition, but I dread that day which is inevitable. From reading this forum, I think I'd use earmuffs(reduced occlusion effect), and insist on having as many things done manually.

My main problem is hardened plaque, and it can be removed completely by hand. It hurts, but can be done. If I don't have this regularly removed, I'll most likely lose my teeth they say.

Damn the dentist sounds like an MRI event... 50/50 permanent worsening, yikes.

 

[Stacken77]

Damn the dentist sounds like an MRI event... 50/50 permanent worsening, yikes.

Yeah, the big problem is the bone conduction, as sound travels through the upper and lower jaw directly to the ears. Because of that, I can imagine drilling being very loud. Ultra-sonic tools seem to be especially dangerous if I'm not mistaken.

 

[Wrfortiscue]

Yeah, the big problem is the bone conduction, as sound travels through the upper and lower jaw directly to the ears. Because of that, I can imagine drilling being very loud. Ultra-sonic tools seem to be especially dangerous if I'm not mistaken.

What the hell do we do then... die? Lol.

 

[Outlaw]

Manual cleaning is all good. Sonic cleaning was a bad idea on my part, given that I already had tinnitus and mild hyperacusis, but tinnitus got back to baseline and hyperacusis was slowly recovering.

Don't listen to maniacs on this forum that keep repeating their life is over. There's like 500 active members here, with 35k total members. Here we only see the people currently suffering and the worst cases.

The majority gets better.

 

[Stacken77]

What the hell do we do then... die? Lol.

We let the teeth fall out so we only can eat soup...

No, but as mentioned, we can request to have things done manually. There has been numerous discussions on the forum that has dealt with this, and I think the general consensus is that e.g. drilling should be done in a 5 second, 10 second (pause) pattern. As that takes more time, the procedures may have to be split into two appointments. There has also been some talk about tools using laser instead for some procedures which is much quieter. So I think we'll be fine, but it is a scary thing nonetheless. I'd load up on some agressive doses of NAC and Magnesium, but I'm highly doubtful it helps when one has very reactive/sound sensitive tinnitus.

Stacken

 

[Wrfortiscue]

We let the teeth fall out so we only can eat soup...

No, but as mentioned, we can request to have things done manually. There has been numerous discussions on the forum that has dealt with this, and I think the general consensus is that e.g. drilling should be done in a 5 second, 10 second (pause) pattern. As that takes more time, the procedures may have to be split into two appointments. There has also been some talk about tools using laser instead for some procedures which is much quieter. So I think we'll be fine, but it is a scary thing nonetheless. I'd load up on some agressive doses of NAC and Magnesium, but I'm highly doubtful it helps when one has very reactive/sound sensitive tinnitus.

Stacken

I agree about the NAC that it does nothing if you are severe. Seems it's just a crapshoot... however, having an abscessed tooth or whatever and not treating it will eventually kill you anyways, if not the pain will be worse than any tinnitus if left untreated.

 

[Stacken77]

having an abscessed tooth or whatever and not treating it will eventually kill you anyways

A situation like that sounds tough. I mean, I guess the only choice we have in that case is to treat the tooth, but dang... maybe severely worsening tinnitus or die... decisions, decisions...

 

[Exit]

I haven't been to the dentist yet with this condition, but I dread that day which is inevitable. From reading this forum, I think I'd use earmuffs(reduced occlusion effect), and insist on having as many things done manually.

My main problem is hardened plaque, and it can be removed completely by hand. It hurts, but can be done. If I don't have this regularly removed, I'll most likely lose my teeth they say.

Doesn't hurt much but could be noisy... I got 2 new tones this summer in my good ear around a fun fortnight with dentist trip and a very loud drilling behind my bedroom and a hospital fire alarm...

Please kill me, I'm so depressed...

 

[Wrfortiscue]

Doesn't hurt much but could be noisy... I got 2 new tones this summer in my good ear around a fun fortnight with dentist trip and a very loud drilling behind my bedroom and a hospital fire alarm...

Please kill me, I'm so depressed...

Don't die... you have just had a setback. Be positive man, it can help believe me.

I have 4 tones, squealing intrusive one, loud jet engine, distortion and reactive again. I'm managing to have some good periods and brain ignoring the sounds by just being positive.

I'm just messed up mentally, and on the depressed days the tinnitus feels catastrophic. Controlling anxiety is key for sure I promise.

When I blew my ear years ago and had screaming ridiculous tinnitus I was just annoyed but slept fairly well. I had no anxiety then and habituated in like a month. I eventually had no ill will with it. Acceptance is real...

I know people will shit on my post but I'll do anything in my power to make it through until a treatment comes, but maybe it doesn't.

My tinnitus is pretty damn bad, not as bad as yours or others but it's bad. I'm going to keep trying and hope you can heal. If you care 0% about the sounds and never get rid of them, then it doesn't matter because you care 0% about them.