The association between temporomandibular disorders and ear symptoms of otalgia and tinnitus

Speculations concerning a possible association between temporomandibular disorders (TMDs) and ear symptoms of otalgia and tinnitus have been made in the dental and medical literature for a long time. Current understanding of this association is reviewed. An analysis of relevant studies published between 1947 and 1996 shows that a relatively high percentage of TMD patients reported the presence of ear pain and noise. However, a cause-effect relationship has not been established to date. Theories that try to explain the concurrence of TMD symptoms and ear symptoms (particularly tinnitus) by a common underlying cause remain speculative. It has to be taken into consideration that due to their high prevalence,TMDs and ear symptoms in a given patient may be present by chance alone. A methodological weakness of most of the studies available is the fact that control groups were not considered. Owing to the lack of prospective, controlled, and randomized studies, statements regarding the effectiveness of certain dental measures for the treatment of otalgia and tinnitus in TMD patients are not well supported.