Meeting a New Dentist — What Should I Ask for Regarding My Tinnitus?

[JohnJohnJohn]

Hi all,

My regular dentist found I have a cavity but is quite off-hand about my tinnitus.

I am meeting a new one who seems quite nice and had heard about this problem, what should I be looking out for or asking for? For example, are there quieter drills - e.g., electric vs air-powered?

I also have the option of air-abrasion, do you have any thoughts on that? He said he could maybe use air-abrasion as well as breaking up the tooth manually, maybe that would be good?

So basically, what makes a good dentist for a patient with tinnitus?

Thanks guys!

Triple Johns

 

[Starthrower]

So basically, what makes a good dentist for a patient with tinnitus?

Good question @JohnJohnJohn. I am going through the same search. My previous dentist retired early.

I am going with my gut instinct right now. If the dentist does not get the deer in the headlights look when I mention tinnitus...

 

[kmohoruk]

I would say look for a dentist who is flexiable. Are they willing to do the ol'10 seconds of drilling and then take a 5 second break?

Do they listen to your concerns, and don't just brush them off?

I haven't personally noticed a big difference between electric vs air drills, but that may be something to ask if you're concerned. I believe the dentist I go to uses air, but it doesn't seem to bother my H or T when I've had cavities worked on.

 

[JimChicago]

Hi all,

So basically, what makes a good dentist for a patient with tinnitus?

Thanks guys!

Triple Johns

Some thoughts for your consideration:

• For me, I haven't been able to form an opinion on the effectiveness of water laser because I can not find a dentist in my metro-Chicago area of 10 million people who uses water laser on adults for hard tissue (cavities) and definitely not for existing filling extraction.

Cleaning:

• Avoid the hypersonic scaling and only allow manual scaling (scraping).
• I prefer polishing using the traditional contact approach with the rotating tool that is low pitch and that uses short bursts to polish.
  
• I do not like the newer air-blast polishing (for various reasons that might have anything to do with T -- I can't remember why I don't like it)

Drilling (cavities and crowns):

• Ask the dentist you are considering to run the drill he uses next to your ear as a test.
• Regarding air drill vs. electric, I can't remember what my new dentist uses.
  • But if you think about it, it is not the electric motor that makes the noise, it is the rotating parts and drill bit contact on your tooth.
  • It may be that dentists with older equipment have electric drills. IIRC the newer electric drills are measurably quieter.
• Find a dentist who is willing to do it in short bursts... I forgot the drilling and resting intervals, but if you search this TT.com forum you can find threads that specify the preferred intervals for drilling and resting.
  • Be prepared for >90% of the dentists to not want to do this. Dentists are not trained to perform drilling this way (i.e., it does not seem a natural dentistry approach to them) and it is not economical for them (takes longer).

• Find a dentist who will allow you to wear hearing protection (e.g., earplugs and/or ear muffs). You need to research on your own what to use as each come in different levels of hearing protection.

• Find a nice way to inquire whether the drill bit is new. (It might not be possible to find a nice way to inquire without coming across as challenging/questioning the dentist).

And even if you are successful on all that above, be prepared that you still have a good degree of residual risk when drilling (especially prolonged drilling) is done.
Why? You can't intercept/block the drilling vibration that radiates through your jaw/skull to the trigeminal nerve and also to your inner ear hairs (IIRC they are in the cochlear).

Hope this helps
Jim

 

[JohnJohnJohn]

Wow! Thanks so much for all the information everybody! I have read up and it seems 5 seconds on and 10 seconds off is the way to go.

What are your thoughts on the headphones vs earplugs? I've been told to avoid them due to an occlusion effect which will make the treatment louder in my ears when wearing them!

Also I have found the following quote to suggest that a local anesthetic may weaken the connections between nerves and protect our ears, does anyone know anything about this?

Maybe try a local anesthetic as it will weaken the connections between nerves. In addition to this, dental procedures can be avoided by good hygiene, so speak to your dentist

https://www.tinnitustalk.com/thread...nnitus-—-questions-and-experiences.826/page-2

 

[Bill Bauer]

What you should be looking for is the doctor being willing to take those 10 second breaks. Some dentists will tell you that they would do it and to not worry, and then would just do their thing the way they normally do it - with no breaks. You might want to offer to pay extra for the extra time due to those pauses. If the dentist accepts, make sure to remind him or her about it, as they might forget about it when it is time to do your procedure.

It is also my understanding that laser can be used for everything - it just takes longer. You might want to offer to pay for the extra time and get the doctor perform the entire procedure using a laser.

 

[Starthrower]

What are your thoughts on the headphones vs earplugs? I've been told to avoid them due to an occlusion effect which will make the treatment louder in my ears when wearing them!

That was my personal experience @JohnJohnJohn. I even tried music via bose headset while having a crown that was damaged drilled off.

In my case the dentist prescribed a few valium to take (one) just before a big procedure. This helped keep me calm.

My dentist would have to pick me up off the floor a few times. And a few times I would bolt out the door. I have since gotten much better with this.

 

[JohnJohnJohn]

@Starthrower Did you find that even with noise cancelling headphones the drilling was louder than without protection? Wow

@Bill Bauer I didnt know everything could be done with lasers! Are there any serious concerns to laser treatment? Believe it or not the only laser treatment in my entire country is located a twenty minute walk from my front door, we'll be having a consult next week, but because I've had many fillings with my current dentist (8 and 2 root canals!) and had no problems I'm scared of switching over to the laser and then suddenly having a spike or worse, the ultrasonic cleaning style damage!

What are your thoughts?

 

[Bill Bauer]

@Bill Bauer I didnt know everything could be done with lasers!

Most dentists don't own lasers. Of those that do, most refuse to use a laser for an hour and a half for a procedure that would take 30 minutes using a regular drill. Instead of explaining that they are not interested in spending a whole extra hour, they say that a laser can't be used for major cavities (so according to them, it can be used only to treat minor cavities). But one person on this forum wrote that she was able to find a more reasonable dentist in London. He took the time to fix a major cavity using a laser. I imagine what she paid had reflected the extra time.

Are there any serious concerns to laser treatment?

Lasers are less powerful, so they are slower. If you wear some hearing protection, you won't need to worry about your T spiking as a result of the noise.

 

[Bill Bauer]

then suddenly having a spike or worse, the ultrasonic cleaning style damage!

I've had a minor cavity treated with a laser. The noise is very reasonable. The only problem is that (according to my dentist) the filling had to be shaped using a regular drill.
https://www.tinnitustalk.com/threads/dentist-laser-vs-ordinary.2791/#post-272983

 

[JohnJohnJohn]

Super informative Bill, thank you! I asked somewhere else but I usually find you very informed, what about the ototoxicity of the injection used when teeth are drilled? Should we be worried?

 

[Bill Bauer]

I asked somewhere else but I usually find you very informed, what about the ototoxicity of the injection used when teeth are drilled? Should we be worried?

I've had two dental procedures done (one was a root canal), and I ended up being ok. Having said that, for all we know, it is possible that the people who report spikes after dental procedures get them as a result of the injections and not as a result of the noise...

This reminds me - on several occasions, @Greg Sacramento had suggested that keeping one's mouth unnaturally wide open or having one's neck at an unnatural angle for a long time might have a role in causing T. So make sure to ask them to place a rolled up towel (I brought my own with me to the dentist's office) under your neck, and make sure to close your mouth once in a while.