Page 6 - GP Spring 2025

Pre-existing dental conditions (follow-up):
Primary teeth present: #D,G
6
Mobility: tooth #D, Cl 0.5 – Cl 1 (unchanged)
Teeth transposed: #6/#D
Overjet: 12mm / (5-6mm after active therapy)
Pre-existing dental conditions (follow-up):
Overbite: 5mm / (1-2mm after active therapy)
Duration of Active Therapy: 5.5 years
Missing teeth: #7, 10, 17, 32
Duration of Passive Therapy: 5+ years, ongoing
Primary teeth present: #D,G
Mobility: tooth #D, Cl 0.5 – Cl 1 (unchanged)
Pre-existing medical condition:
Teeth transposed: #6/#D
Tinnitus: neither disclosed nor discussed before care was started.
Note - prior to 2022, if a patient wanted to point out they had tinnitus, they
Overjet: 12mm / (5-6mm after active therapy)
would have selected “list any other disease, syndrome or condition not listed”
Overbite: 5mm / (1-2mm after active therapy)
and write in “tinnitus.” It was six years later, during the nighttime retainer
Duration of Active Therapy: 5.5 years
phase, when she first disclosed the decades spent suQering with severe
Duration of Passive Therapy: 5+ years, ongoing
chronic tinnitus.
Radiographs: Figure #7 – full mouth series Figure #8 – panoramic
Pre-existing medical condition:
Tinnitus: neither disclosed nor discussed before care was started.
Note - prior to 2022, if a patient wanted to point out they had tinnitus, they
would have selected “list any other disease, syndrome or condition not listed”
and write in “tinnitus.” It was six years later, during the nighttime retainer
phase, when she first disclosed the decades spent suQering with severe
chronic tinnitus.
Radiographs: Figure #7 – full mouth series Figure #8 – panoramic Missing teeth: #7, 10, 17, 32 6
Figure 7. Full mouth series of radiographs. Figure 8. Panoramic radiograph.
Discussion: 6
If not brought to my attention by patients, I would not have conceived that aligners could relieve and exacerbate tinnitus. If it had been,
I didn’t remember the concept of a dentistry-tinnitus connection being broached in dental school, at the hospital, during post-graduate
courses or in professional journals.
Non-tinnitus exclusive websites (e.g., Reddit) have support groups where dentistry-tinnitus and orthodontics-tinnitus are topics of posts. 8-11
Across all groups, not one tinnitus sufferer noted experiencing relief while wearing traditional braces or orthodontic aligners. Every post
described how they acquired tinnitus or had existing tinnitus worsen after a filling or crown was placed, or when wearing aligners, braces or
retainers. However, as with most areas for online expression, user gripes and harsh stories tend to outnumber unincentivized compliments
and good news.
Searches in July 2023 using the Discovery System (American Dental Association) and Google Scholar for “tinnitus dentistry orthodontics”

yielded dozens of scientific articles. All, with one exception for orthodontics, concentrated on TMD. 9
Over 30+ year periods, those who received care from board certified and board eligible orthodontists (American Association of Orthodon-
6
tists [AAO]) or sought treatment for tinnitus with primary care physicians [PCPs] and ENTs grew at rates that far exceeded the rate at which
the US population increased (more than six times). 10-12
Treatment Time Frames Population Population Total # Total # of Patients %
Provided by Studied (US): Actual (US): % of Patient Patient Visits: Increase:
Healthcare (AAO, NIH) Increase Increase Visits: Actual % vs.
Clinicians Increase Increase Population %
Increase
Orthodontics 1982 - 2016 232 323 39% 2.3 5.6 244%* 626%**
35 years million million
Tinnitus 1983 – 2021 234 332 41% 5.4 16 296% 722%
39 years million million

Figure 9: There is no universally accepted explanation for the very large increase in patients who sought tinnitus care (1983-2021). Two
explanations for the large increase in orthodontist visits are: more demand for care by adults and the introduction and wide acceptance of
aligners.

* Figures from biannual, triennial and quadrennial surveys of U.S. board-eligible and board-certified members of the AAO. ** Traditional
and aligner orthodontics are also rendered by non-orthodontists; general practitioner dentists, pediatric dentists, periodontists and prostho-
dontists. When estimates of aligner treatments provided by non-orthodontists are included, the percentage increase vs. the US population
percentage increase over the same period (1982-2016) jumps by about a third, from 626% to 833%.

The p-value analysis of the data confirmed that the increases in the number of patients who sought medical attention for tinnitus and
received care from an orthodontist were both statistically highly significant (more than 99.9% certainty) when compared with the U.S.
population increase over those 35+ year periods. 11
It is not uncommon for disparate entities to have comparable growth patterns. That is why statistical similarities alone are insufficient to
confirm dependent or cause and effect relationships.
Because changes to tooth shapes and movements of teeth can involve changes to muscles, joints, soft tissues, sinuses, bones and “things
happen” when portions of human anatomy are repositioned, the speculation that it could affect tinnitus is plausible.

www.nysagd.org l Spring 2025 l GP 6