Balance and the Inner Ear
Vertigo is usually described as feeling “off-balance” or dizzy, like the world is spinning around you. It can also come with symptoms like nausea, headache, or a ringing in the ears.
Vertigo is often attributed to inner ear issues because your inner ear is one of three systems in your body in charge of communicating information to your brain about your body’s balance. Between what your eyes see, what you sense from your muscles and joints (proprioception), and your inner ear detects, the brain can compile and compare information and determine whether or not your body is balanced. If the three inputs don’t match, your brain gets confused and you feel dizzy.
The way the inner ear specifically gauges balance is with a system of canals filled with fluid. Tiny hairs in the canals can tell your brain when the fluid is moving and when the fluid is still, as well as the position of the fluid. The three canals are angled to detect movement of three types: up and down, side to side, and tilting. You feel dizzy after spinning because the fluid is still moving, but the evidence from your other inputs tells the brain you’re not moving. Any type of mismatch between these three systems can similarly lead to dizziness.
TMJ and the Ear
At first glance, it may not seem like TMJ would have any effect on the inner ear. But the temporomandibular joint connects your jaw to the temporal bone, which is where your inner ear systems are located. In addition, two of the tiny bones in your middle ear, the incus, and malleus (anvil and hammer), were jaw bones in our reptilian ancestors, and they retain some connections with jawbones and muscles. By putting pressure on the temporal bone or triggering the connection between tense jaw muscles and tiny structures in the ear, TMJ can disrupt ear systems, which causes a host of ear-related problems.
Most ear-related TMJ symptoms are associated with the middle ear. They include feelings of ear fullness, tinnitus (ringing in the ears), and ear aches. However, TMJ-related vertigo is not uncommon. Estimates of how common it is vary, but some say about half of all people with TMJ experience vertigo.
Your susceptibility to jaw pressure could be due to anatomical variations. We know that for some people, putting pressure on the auditory canal can trigger vertigo. This is called Hennebert’s sign. It’s linked to the Tullio phenomenon, where people get dizziness caused by certain sounds. Both conditions are now known to be related to an anatomical variation in the temporal bone, which exposes the inner ear to pressure and/or vibrations. TMJ-related vertigo might be linked to this or a similar variation in the temporal bone.
Is Your Vertigo Linked to TMJ?
There are many potential causes of vertigo. How do you know if yours is linked to TMJ? Typically, we recommend a three-point test. Suspect that TMJ is linked to your vertigo if you:
- Have eliminated other causes
- Have other TMJ Symptoms
- Experience vertigo with heavy jaw activity
The challenge of eliminating other causes of vertigo is that many are nonspecific. If vertigo is your main symptom, get evaluated for benign paroxysmal positional vertigo (BPPV), which relies on a test your doctor can conduct quickly and easily, though they may order an MRI to be sure. Meniere’s disease is harder to diagnose and may take several tests. Make sure you aren’t taking medications that could cause vertigo and haven’t received a head injury.
If you can’t easily detect another cause for vertigo, check to see if you have other TMJ symptoms. Look for symptoms beyond the ear. These include jaw pain, face pain, headaches, tooth wear, and more. If you have these symptoms, it’s a good bet that TMJ is responsible for your vertigo.
Finally, see if your vertigo tends to flare up during or after periods of heavy jaw activity. This can include doing lots of talking or chewing. Or it could be related to periods of heavy physical strain where you might clench your teeth for greater strength and stability. Don’t forget emotional stress, which might cause you to clench your jaw unconsciously, and on waking in the morning, because you might clench your teeth during sleep (sleep bruxism).
Luckily, treatments for TMJ have been shown to often be effective at reducing or eliminating vertigo. Call (803) 781-9090 or contact Smile Columbia Dentistry online to learn more about TMJ treatments and how they can help.