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Eric

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Hi Dr. Nagler,

It's now about a year and a half that I've been experiencing intrusive tinnitus and, occasionally, periods of decreased sound tolerance. Over the last six months I've made a fair amount of progress—meaning that there has been a gradual reduction in the amount of time I find myself reacting negatively to my tinnitus, as well as a general decrease in the emotional intensity of my negative reactions.

In any case, I saw my dentist for a routine cleaning yesterday and left the office feeling more agitated and anxious than I've felt for some time. The issues are two:

1) The dentist used an ultrasonic scaler, which now and again caused a relatively loud, high frequency whine that made me wince and ask her to stop. Though the sound did not cause any appreciable change in my tinnitus, I can't shake the idea that I allowed damage to be done and that I am now some degree closer to a major setback.

2) The dentist found problems that will have to be fixed over the coming months, and fixing them will require drilling or tooth-shaping. Since there is no way to shield the inner ear from sound waves originating in the mouth, I'm feeling quite anxious about it all.

So, besides avoiding prolonged drilling (using the "5 seconds on/10 seconds off" approach, which I've already discussed with my dentist) is there anything else that can be done to minimize risk?

Thank you.


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Eric
Dr. Nagler

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Originally Posted by Eric
It's now about a year and a half that I've been experiencing intrusive tinnitus and, occasionally, periods of decreased sound tolerance. Over the last six months I've made a fair amount of progress—meaning that there has been a gradual reduction in the amount of time I find myself reacting negatively to my tinnitus, as well as a general decrease in the emotional intensity of my negative reactions.

In any case, I saw my dentist for a routine cleaning yesterday and left the office feeling more agitated and anxious than I've felt for some time. The issues are two:

1) The dentist used an ultrasonic scaler, which now and again caused a relatively loud, high frequency whine that made me wince and ask her to stop. Though the sound did not cause any appreciable change in my tinnitus, I can't shake the idea that I allowed damage to be done and that I am now some degree closer to a major setback.

Eric, I think it's best to consider "increase in tinnitus volume" and "damage" separately. There are a number of factors that can cause a temporary increase in tinnitus volume without causing actual damage. These factors vary from person to person - but they can include stress, fatigue, certain foods, changes in barometric pressure, and the like. The type of noise exposure you describe above is another example. Whether or not the high frequency whining sound aggravated your tinnitus, it was almost certainly not of an intensity and duration to cause any actual auditory damage.

Quote:
2) The dentist found problems that will have to be fixed over the coming months, and fixing them will require drilling or tooth-shaping. Since there is no way to shield the inner ear from sound waves originating in the mouth, I'm feeling quite anxious about it all.

I clearly understand your anxiety. What I want you to understand is that your anxiety is based on emotion rather than reality. Sure, you might experience a temporary exacerbation of your tinnitus, but - again - it takes a lot of sound over a lot of time to cause actual damage.

Quote:
So, besides avoiding prolonged drilling (using the "5 seconds on/10 seconds off" approach, which I've already discussed with my dentist) is there anything else that can be done to minimize risk?

The risk of auditory damage is far far greater to your dentist and to her chair assistant than to you - because they are exposed to drilling day after day after day. So if you are talking about minimizing the risk of damage, give your dentist and chair assistant earplugs to use themselves! If you are talking about minimizing the risk of an exacerbation of your own tinnitus during your own visit to the dentist, you really can't do much better than the five seconds on ten seconds off approach you noted above. And if you do happen to experience an increase in the intensity of your tinnitus, rest assured that things will settle back down in time.

Hope this helps!

Stephen M. Nagler, M.D.
Atlanta Tinnitus Consultants, LLC

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Dr. Nagler's Tinnitus Corner is provided for education and information only. It is not intended for the purpose of providing medical care and should in no way substitute for appropriate in-person consultations with qualified healthcare professionals. By using this site, participants agree to hold Dr. Nagler and Atlanta Tinnitus Consultants, LLC harmless with respect to any loss, injury, claim, liability, or damage arising from following the postings herein.