A Giant Step to Treat, Prevent, and Cure Tinnitus

What is Tinnitus?

Tinnitus is a private auditory noise that can manifest as buzzing, hissing or other sound in one or both ears that only that person will hear.1Hackenberg, B.; O’Brien, K.; Döge, J.; Lackner, K.J.; Beutel, M.E.; Münzel, T.; Pfeiffer, N.; Schulz, A.; Schmidtmann, I.; Wild, P.S.; et al. Tinnitus Prevalence in the Adult Population—Results from the Gutenberg Health Study. Medicina 2023, 59, 620. https://doi.org/10.3390/medicina59030620 It ranges from a mere irritation to a debilitating condition that causes severe annoyance, distraction, and frustration.2https://www.ata.org/about-tinnitus/why-are-my-ears-ringing/ Hearing loss is a frequent comorbidity.3https://my.clevelandclinic.org/health/diseases/14164-tinnitus While tinnitus (pronounced “ti-nuh-tuhs” or “ti-nahy-tuhs”) is affiliated with 200 health conditions, it’s rarely the primary diagnosis.4https://www.merriam-webster.com/dictionary/tinnitus,5https://www.dictionary.com/browse/tinnitus Those who suffer from tinnitus report problems ranging from reduced quality/quantity of sleep to concentration lapses to exacerbation of medical ailments.6https://www.mayoclinic.org/diseases-conditions/tinnitus/symptoms-causes/syc-20350156 Due to its lack of a definitive cure, its share of research funding, measured against the number of those who are afflicted, is sadly under-appropriated.7McFerran DJ, Stockdale D, Holme R, Large CH, Baguley DM. Why Is There No Cure for Tinnitus? Front Neurosci. 2019 Aug 6;13:802. doi: 10.3389/fnins.2019.00802. PMID: 31447630; PMCID: PMC6691100. Most hospitals and clinics do not have tinnitus listed on the check-off portion of their registration forms; patients need to fill in “Other” to share their condition with health professionals.8https://stanfordhealthcare.org/content/dam/SHC/clinics/family-medicine-associates-san-jose/docs/shc-adult-patient-questionnaire.pdf

Tinnitus’s Financial Drain on Healthcare and Workforce Systems

Tinnitus’s financial impact on healthcare (an estimated $600 to $1,200 per patient per year) is under-attributed.9Trochidis I, Lugo A, Borroni E, Cederroth CR, Cima R, Kikidis D, Langguth B, Schlee W, Gallus S. Systematic Review on Healthcare and Societal Costs of Tinnitus. Int J Environ Res Public Health. 2021 Jun 26;18(13):6881. doi: 10.3390/ijerph18136881. PMID: 34206904; PMCID: PMC8297244.,10Daoud, E., Caimino, C., Akeroyd, M.A. et al. The Utility of Economic Measures to Quantify the Burden of Tinnitus in Affected Individuals: A Scoping Review. PharmacoEconomics Open 6, 21–32 (2022). https://doi.org/10.1007/s41669-021-00273-8 When loss of work productivity is included, those figures are more than three times as high.11Stockdale, D., McFerran, D., Brazier, P. et al. An economic evaluation of the healthcare cost of tinnitus management in the UK. BMC Health Serv Res 17, 577 (2017). https://doi.org/10.1186/s12913-017-2527-2

Here’s a graphic example of its under-acknowledgment. Chronic sleep-deprived sufferers who’ve committed suicide almost always have their cause of death listed as depression or another biopsychosocial risk factor instead of the most likely culprit, tinnitus.12Stockdale, D., McFerran, D., Brazier, P. et al. An economic evaluation of the healthcare cost of tinnitus management in the UK. BMC Health Serv Res 17, 577 (2017). https://doi.org/10.1186/s12913-017-2527-2,13Lewis JE, Stephens SD, McKenna L. Tinnitus and suicide. Clin Otolaryngol Allied Sci. 1994 Feb;19(1):50-4. doi: 10.1111/j.1365-2273.1994.tb01147.x. PMID: 8174302.,14Szibor A, Mäkitie A, Aarnisalo AA. Tinnitus and suicide: An unresolved relation. Audiol Res. 2019 Jun 7;9(1):222. doi: 10.4081/audiores.2019.222. PMID: 31275536; PMCID: PMC6580142.,15Lugo A, Trpchevska N, Liu X, et al. Sex-Specific Association of Tinnitus With Suicide Attempts. JAMA Otolaryngol Head Neck Surg. 2019;145(7):685–687. doi:10.1001/jamaoto.2019.0566

Since nearly half of the estimated 25 million with tinnitus have hearing loss, a higher percentage than non-sufferers, it’s hoped that the stringent Tinnisense™ methodology will additionally help more seniors maintain their hearing acuity.16https://www.verywellhealth.com/tinnitus-in-older-people-2223696,17https://hearinghealthfoundation.org/hearing-loss-tinnitus-statistics

While tinnitus-focused aligners (see Figure 1) and orthodontic aligners are visually indistinguishable, their usage, desired end goals, and digital tooth movement programming are very different.

Tinnisense Aligner to cure Tinnitus. A novel solution for orthodontic patients.

Figure 1.

Tinnitus-Focused Aligner

Tinnitus’s financial impact on healthcare (an estimated $600 to $1,200 per patient per year) is under-attributed.18Trochidis I, Lugo A, Borroni E, Cederroth CR, Cima R, Kikidis D, Langguth B, Schlee W, Gallus S. Systematic Review on Healthcare and Societal Costs of Tinnitus. Int J Environ Res Public Health. 2021 Jun 26;18(13):6881. doi: 10.3390/ijerph18136881. PMID: 34206904; PMCID: PMC8297244.,19Daoud, E., Caimino, C., Akeroyd, M.A. et al. The Utility of Economic Measures to Quantify the Burden of Tinnitus in Affected Individuals: A Scoping Review. PharmacoEconomics Open 6, 21–32 (2022). https://doi.org/10.1007/s41669-021-00273-8 When loss of work productivity is included, those figures are more than three times as high.20Stockdale, D., McFerran, D., Brazier, P. et al. An economic evaluation of the healthcare cost of tinnitus management in the UK. BMC Health Serv Res 17, 577 (2017). https://doi.org/10.1186/s12913-017-2527-2

Here’s a graphic example of its under-acknowledgment. Chronic sleep-deprived sufferers who’ve committed suicide almost always have their cause of death listed as depression or another biopsychosocial risk factor instead of the most likely culprit, tinnitus.21Stockdale, D., McFerran, D., Brazier, P. et al. An economic evaluation of the healthcare cost of tinnitus management in the UK. BMC Health Serv Res 17, 577 (2017). https://doi.org/10.1186/s12913-017-2527-2,22Lewis JE, Stephens SD, McKenna L. Tinnitus and suicide. Clin Otolaryngol Allied Sci. 1994 Feb;19(1):50-4. doi: 10.1111/j.1365-2273.1994.tb01147.x. PMID: 8174302.,23Szibor A, Mäkitie A, Aarnisalo AA. Tinnitus and suicide: An unresolved relation. Audiol Res. 2019 Jun 7;9(1):222. doi: 10.4081/audiores.2019.222. PMID: 31275536; PMCID: PMC6580142.,24Lugo A, Trpchevska N, Liu X, et al. Sex-Specific Association of Tinnitus With Suicide Attempts. JAMA Otolaryngol Head Neck Surg. 2019;145(7):685–687. doi:10.1001/jamaoto.2019.0566

Since nearly half of the estimated 25 million with tinnitus have hearing loss, a higher percentage than non-sufferers, it’s hoped that the stringent Tinnisense™ methodology will additionally help more seniors maintain their hearing acuity.25https://www.verywellhealth.com/tinnitus-in-older-people-2223696,26https://hearinghealthfoundation.org/hearing-loss-tinnitus-statistics

While tinnitus-focused aligners (see Figure 1) and orthodontic aligners are visually indistinguishable, their usage, desired end goals, and digital tooth movement programming are very different.

Tinnisense Aligner to cure Tinnitus. A novel solution for orthodontic patients.

Figure 1.

Tinnitus-Focused Aligner

Tinnitus: A Meteoric Rise (1983-2021)

Population of the United States (1982-2021)

Number of Patients Who Sought Medical Treatment for Tinnitus in US (1983-2021) 

Number of Patients Who Received Care by a US Orthodontist (1982-2016)

Patient Type Period Timeframe US Pop. - Start US Pop. - End US Pop. Increase Patients - Start Pat. - End Pat. Increase Relative Increase
Tinnitus
1983-2021
38 years
234 Million
332 Million
41%
5.4 Million
16 Million
296%
705%
Orthodontist*
1982-2016
34 years
232 Million
323 Million
39%
2.3 Million
5.6 Million
244%*
626%**
Data Point Tinnitus Patient Orthodontist Patient*

Period

1983-2021

1982-2016

Timeframe

38 years

34 years

US Pop. - Start

234 Million

232 Million

US Pop. - End

332 Million

323 Million

Population Increase

41%

39%

Patients - Start

5.4 Million

2.3 Million

Patients - End

16 Million

5.6 Million

Patients - Increase

296%

244%

Relative Increase

705%

626% **

  • Figures from multiple biannual surveys of U.S. board-eligible and board-certified members of the American Association of Orthodontists (AAO).
  • Traditional and aligner orthodontic therapy is also rendered by non-orthodontists; general practitioner dentists, pediatric dentists, periodontists, and prosthodontists. Verifiable and reliable orthodontic treatment figures from those clinicians are unavailable so they could not be included.

Statistical Significance

The p value analysis of the statistical significance of the data confirms that increases in the number of patients who sought medical attention for tinnitus was significantly much greater (more than 99.9% certainty) than US population increase over that 38-year period.27https://www.statsdirect.com/help/basics/p_values.htm A similar statistical significance exists (more than 99.9% certainty) with the number of patients who were treated by orthodontists over that 34-year period.

Raw Data

1983: 5.4 million patients sought treatment for tinnitus (National Institutes of Health).28https://www.gao.gov/assets/hrd-88-50fs.pdf
2021: 16 million sought treatment for tinnitus.29Jarach CM, Lugo A, Scala M, et al. Global Prevalence and Incidence of Tinnitus: A Systematic Review and Meta-analysis. JAMA Neurol. 2022;79(9):888–900. doi:10.1001/jamaneurol.2022.2189
This 296% increase in Americans seeking medical help for tinnitus was 7x times the US population increase (42%) over those 38 years.30https://www.census.gov/newsroom/press-releases/2016/cb16-tps158.html

1982: 2.3 million patients were treated by a US orthodontist for tinnitus.31American Association of Orthodontists: Figures from AAO Patient Census Surveys – Patients in Treatment by AAO Members in the US and Canada
2016: 5.6 million were treated by a US orthodontist.
This 244% increase in Americans being treated by an orthodontist for tinnitus was more than 6x times the US population increase (39%) over those 34 years.32https://www.census.gov/newsroom/press-kits/2018/pop-estimates-national-state.html

Chart

Patients Who Received Dental Care by an Orthodontist (US)

Patients Who Sought Medical Treatment for Tinnitus (US)

Time Span % Patients Increase vs. % US Population Increase
1982 - 2016
+625% in the # of dental patients treated by an orthodontist ***
1983 - 2021
+705% in the # of tinnitus patients who sought medical care

***Over the past couple of decades, a third of the orthodontic procedures have been provided by non-orthodontists. Combining those figures would raise the rate of increase in orthodontic treatments beyond the 8x level, similar to the observed rise in tinnitus.

Researchers need to investigate whether there’s a connection, between an unintended impact from orthodontic treatment and the eerily sharp rise in tinnitus. Is it possible that there has been a direct negative impact? Tinnisense™ Solutions, LLC (Tinnisense) believes that once the successful implementation of its novel approach becomes the standard of care, the astonishing increase in those suffering from tinnitus will be tamed.

Pertinent Questions – Thoughts – Suggestions

  1. Amongst tinnitus sufferers: Is there a measurable difference between those who’ve had orthodontic care and those who haven’t?
  2. Medical questionnaires and health history reviews taken by surgeons (e.g., otolaryngologists – ear, nose, and throat [ENT] head and neck surgeons), physicians (e.g., primary care physicians [PCPs]), and audiologists should be asking if the patient has had in the past or is currently receiving orthodontic therapy. 33https://www.asha.org/public/hearing/hearing-case-history/,34https://docs.google.com/viewer?url=https%3A%2F%2Fwww.omao.noaa.gov%2Fsites%2Fdefault%2Ffiles%2Fdocuments%2FAudiology%2520History%2520Questionnaire.pdf
  3. Medical questionnaires and health history reviews in dental and orthodontic offices and clinics would improve if they asked whether the patient currently or has in the past experienced tinnitus or hearing loss.35https://www.ada.org/en/resources/practice/practice-management/medical-dental-health-history,36https://docs.google.com/viewer?url=https%3A%2F%2Fcase.edu%2Fdental%2Fsites%2Fcase.edu.dental%2Ffiles%2F2018-04%2FCO_history.pdf
  4. When a patient discloses that they have tinnitus:
    1. A Tinnitus Functional Index (TFI) should be completed to establish the baseline of their condition.37https://docs.google.com/viewer?url=https%3A%2F%2Fwww.ncrar.research.va.gov%2FDocuments%2FTFI.pdf
    2. A Tinnitus and Hearing Survey (THS) should be completed to establish whether hearing loss may be contributing to their condition.38https://docs.google.com/viewer?url=https%3A%2F%2Fwww.dcms.uscg.mil%2FPortals%2F10%2FCG-1%2FPSC%2FPSD%2Fdocs%2FVBA-21%2520-%2520Ear%2520conditions%2520DBQ.pdf%3Fver%3D2017-03-28-110116-753
  5. If it’s determined that those who’ve received orthodontics have tinnitus at a greater level than those who’ve never received that care:
    1. Orthodontists and dentists should embrace the tinnitus-focused aligner protocol.
    2. Tinnitus should be a part of informed consent discussions prior to the start of an orthodontic treatment.

Dental-Medical Consequences

It’s not uncommon for patients with chronic malocclusion (bad bite) to experience acute dental and medical consequences.39https://my.clevelandclinic.org/health/diseases/15066-temporomandibular-disorders-tmd-overview Some examples are fractured teeth, excessive grinding, cracked fillings, temporomandibular joint dysfunction (TMD) and tinnitus.40Edvall NK, Gunan E, Genitsaridi E, Lazar A, Mehraei G, Billing M, Tullberg M, Bulla J, Whitton J, Canlon B, Hall DA, Cederroth CR. Impact of Temporomandibular Joint Complaints on Tinnitus-Related Distress. Front Neurosci. 2019 Aug 22;13:879. doi: 10.3389/fnins.2019.00879. PMID: 31548840; PMCID: PMC6736614.

Dentists provide custom mouthguards, and patients can obtain self-moldable over-the-counter (OTC) versions to diminish grinding. Sometimes, this lessens tinnitus episodes, especially for those who experience TMD.41Med Hypotheses. 2019 Sep;130:109280. doi: 10.1016/j.mehy.2019.109280. Epub 2019 Jun 15.,42Keidar E, De Jong R, Kwartowitz G. Tensor Tympani Syndrome. [Updated 2022 May 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519055/

Since being widely introduced in the late 1990’s, orthodontic aligners — a series of clear, flexible removable oral devices to treat misaligned teeth — have seen extraordinary increases in popularity.43Ann Sara George, Anjuna M. Prakash, Perspective Chapter: Orthognathic Surgery with Clear Aligners, Orthognathic Surgery and Dentofacial Deformities [Working Title], 10.5772/intechopen.109183, (2023).,44Tamer İ, Öztaş E, Marşan G. Orthodontic Treatment with Clear Aligners and The Scientific Reality Behind Their Marketing: A Literature Review. Turk J Orthod. 2019 Dec 1;32(4):241-246. doi: 10.5152/TurkJOrthod.2019.18083. PMID: 32110470; PMCID: PMC7018497.

Orthodontic Treatments in United States

Number of Orthodontist Patients (US) 1982-2016

US Population 1982-2016

No Data Found

No Data Found

Raw Data: Orthodontic Treatments in United States

Number of Orthodontist Patients (US) 1982–2016

US Population 1982–2016

Year 1982 1984 1986 1989 1992 1994 1996 2004 2006 2008 2010 2012 2014 2016
Patients (millions)
2.23
2.33
2.42
3.25
3.53
3.72
4.09
5.21
4.84
4.46
4.56
5.58
5.04
5.62
US Population (millions)
232
236
240
247
257
263
270
293
298
304
309
314
318
323
Year 1982 1984 1986 1989 1992 1994 1996
Patients (millions)
2.23
2.33
2.42
3.25
3.53
3.72
4.09
US Population (millions)
232
236
240
247
257
263
270
Year 2004 2006 2008 2010 2012 2014 2016
Patients (millions)
5.21
4.84
4.46
4.56
5.58
5.04
5.62
US Population (millions)
293
298
304
309
314
318
323
Year Patients (millions) US Pop. (millions)
1982
2.23
232
1984
2.33
236
1986
2.42
240
1989
3.25
247
1992
3.53
257
1994
3.72
263
1996
4.09
270
2004
5.21
293
2006
4.84
298
2008
4.46
304
2010
4.56
309
2012
5.58
314
2012
5.58
314
2014
5.04
318
2016
5.62
323

Are Medical and Dental Scopes of Practice Unintentionally Impeding Tinnitus Research?

Currently, tinnitus-focused aligner therapy resides in a “no man’s land” of therapeutic solutions. That’s because this novel tinnitus treatment does not fit neatly within the domain of medicine (ENTs) or dentistry (orthodontists). ENTs receive extensive surgical and non-surgical training, but none of it focuses on tooth health, periodontal health, or occlusion health.45https://www.facs.org/for-medical-professionals/education/programs/so-you-want-to-be-a-surgeon/section-iii-surgical-specialties/otolaryngology-head-and-neck-surgery/#:~:text=An%20otolaryngologist%2Dhead%20and%20neck,of%20the%20head%20and%20neck.,46https://www.ama-assn.org/practice-management/scope-practice/what-scope-practice#:~:text=Scope%20of%20practice%20refers%20to,by%20the%20appropriate%20licensing%20entity. Orthodontists do not receive any training on how to examine, measure, or treat their patients’ auditory capabilities and related conditions.47https://www.op.nysed.gov/title8/regulations-commissioner-education/part-61,48https://aaoinfo.org/resources/orthodontist-vs-dentist/

It’s incumbent upon each healthcare discipline to establish workable treatment parameters to allow this care to reach the many patients who would greatly benefit by having their tinnitus suffering reduced or eliminated.

View of patient mouth - this tinnitus sufferer received excellent tinnitus-focused therapy using Tinnisense aligners.

Figure 2.

This is a view of the lower jaw of an elderly woman who has tinnitus, sleep apnea, and signs of grinding. Lots of periodontal plaque builds up within weeks after every professional prophylaxis.

tinnitus eliminated after successful tinnitus-focused aligner therapy

Figure 3.

Partway through her tinnitus-focused aligner therapy, she no longer needed a CPAP to sleep safely. Her breath no longer had a foul odor, and there was much less plaque accumulating. Those tinnitus episodes have become fewer and milder and no longer interfere with her ability to fall asleep or prematurely awake her from her sleep.

Tinnitus-Focused Aligner Care: A Novel Solution

Tinnisense Solutions, LLC, a health technology startup based in New York City and founded by Elliot Davis, D.D.S., a prolific inventor and general practitioner dentist in Manhattan and the Bronx, utilizes a multi-patented, never previously attempted process to alleviate and prevent tinnitus.

Tinnitus-focused intraoral aligners minimize the deleterious force of teeth on the supporting bone.49https://www.ata.org/about-tinnitus/therapy-and-treatment-options/tmj-treatments/ Lingering reverberations in the maxilla (top jaw) and mandible (lower jaw) from undesirable occlusal (bite) forces are sufficient to initiate or exacerbate tinnitus. As prudent tooth repositioning progresses, bad bite forces are gradually diminished to the point where they become subclinical (barely perceptible or imperceptible).50https://tinnitus.org.uk/understanding-tinnitus/living-with-tinnitus/tinnitus-and-tmj/,51Ralli M, Greco A, Turchetta R, Altissimi G, de Vincentiis M, Cianfrone G. Somatosensory tinnitus: Current evidence and future perspectives. Journal of International Medical Research. 2017;45(3):933-947. doi:10.1177/0300060517707673 Please refer to Figures #2, 3. Programmed movements of teeth within the tinnitus-focused aligner design are distinct from those within orthodontic-focused aligner designs.

Tooth structure weakened by enamel chips, cleaves, and excessive wear of dentin is repaired non-invasively (no dental shot, no drilling) with the patented enamel replacement process.52United States Patent and Trademark Office: US#11,684,455 B2 2023, Jun 27. Enamel replacement, which has never been a part of the braces process, helps to secure a stable result, one more likely to ward off orthodontic relapse and tinnitus. Relapse, which occurs more often than not, is undesirable because as teeth positions worsen and occlusion health gradually declines, it often leads to unwelcomed medical and dental consequences, including tinnitus.53Littlewood SJ, Kandasamy S, Huang G. Retention and relapse in clinical practice. Aust Dent J. 2017 Mar:62 Suppl 1:51-57. Doi: 10.1111/adj.12475.,54Blake M, Bibby K, Retention and stability: A review of the literature, AJODO, Vol 114-3, 1998, 299-306, ISSN 0889-5406, https://doi.org/10.1016/S0889-5406(98)70212-4.,55Singh Y, Munjal S, Singh S, Singh H. Retention and Relapse – A Review Article. J Adv Med Dent Scie Res 2021;9(2):65-68.

There are aspects frequently included in orthodontic treatments that Dr. Davis believes are deleterious: fixed lingual splints (metal glued to the backs of teeth), extractions of healthy teeth (those with no infection nor decay), irreversible removal of healthy enamel (esthetic incisal shaving, bite adjustments and interproximal reduction [IPR]). These likely problematic inclusions are excluded from his multi-patented protocol.56Kartal Y, Kaya B. Fixed Orthodontic Retainers: A Review. Turk J Orthod. 2019 Jun;32(2):110-114. doi: 10.5152/TurkJOrthod.2019.18080. Epub 2019 Jun 1. PMID: 31294414; PMCID: PMC6605884.,57https://decisionsindentistry.com/article/orthodontic-extraction-therapy-a-hard-look-at-the-evidence/,58Zhang Y, Wang X, Wang J, Gao J, Liu X, Jin Z, Ma Y. IPR treatment and attachments design in clear aligner therapy and risk of open gingival embrasures in adults. Prog Orthod. 2023 Jan 9;24(1):1. doi: 10.1186/s40510-022-00452-1. PMID: 36617584; PMCID: PMC9826765.,59Kokich VO, Kokich VG, Kiyak HA. Perceptions of dental professionals and laypersons to altered dental esthetics: asymmetric and symmetric situations. Am J Orthod Dentofacial Orthop. 2006 Aug;130(2):141-51. doi: 10.1016/j.ajodo.2006.04.017. PMID: 16905057.

Other proprietary advances include enhancements aimed at strengthening the supportive bone, creating healthier gums, achieving 3-D tooth parallelism, bringing about asymmetry reduction, promoting enamel/dentin reinforcement, and obviating the need to remove non-infected wisdom teeth.60USPTO: US#11,173,014 B2, 2021, Nov 16.,61USPTO: US#9,861,451 B1, 2018, Jan 9.,62USPTO: US#11,684,454 B2, 2023, Jun 27. Please refer to Figures # 4,5.

alternative to dental implant and wisdom tooth surgery - Tinnisense is a novel approach for orthodontist patients

Figure 4.

This is the view of a middle-aged woman’s lower jaw. Poor occlusion health from badly positioned teeth posed an elevated risk for developing tinnitus.

best option successful replacement of a missing tooth no dental implant surgery

Figure 5.

Her wisdom tooth went from worthless to valuable as it was elegantly and strategically moved forward along with the molar in front of it. She avoided the need for dental implant surgery and the surgical extraction of a wisdom tooth. The likelihood of her developing tinnitus remained reduced years after tinnitus-focused aligner care elevated her periodontal health and occlusion health.

Orthodontic Care vs. Tinnisense Care: Why Does Only One Help with Tinnitus?

 

Topic Orthodontic Care Tinnisense Care
Improvement Goals
Smile, Bite Health.
Gum Health, Tinnitus Health, Bite Health & Smile.
Enamel Replacement
Not a part of the treatment.
Reinforces/replaces missing dentin/enamel.
Extractions of Healthy Teeth
Not uncommon: Teeth are extracted to accommodate the bone.
Never: Bone is modified to accommodate the teeth.
Retention Goal
Keep teeth in their current locations.
Subtle, but valuable tooth movements.
Retention Methodology
Glued splints and/or removable retainers.
Multiple removable retainers gradually guide teeth to their final desired positions.
Topic Orthodontic Care
Improvement Goals

Smile, Bite Health.

Enamel Replacement
Not a part of the treatment.
Extractions of Healthy Teeth
Not uncommon: Teeth are extracted to accommodate the bone.

Retention Goal

Keep teeth in their current locations.
Retention Methodology
Glued splints and/or removable retainers.
Topic Tinnisense Care
Improvement Goals

Gum Health, Tinnitus Health, Bite Health & Smile.

Enamel Replacement
Reinforces/replaces missing dentin/enamel.
Extractions of Healthy Teeth
Never: Bone is modified to accommodate the teeth.

Retention Goal

Subtle, but valuable tooth movements.
Retention Methodology
Multiple removable retainers gradually guide teeth to their final desired positions.
  1. Orthodontic care, from the AAO website (November 2023):
    1. “Orthodontists are specialists who focus on your bite and alignment of your teeth. Their job is to not only make sure that your smile looks great, but your bite feels good and functions properly, too.”63https://aaoinfo.org/resources/orthodontist-vs-dentist/
    2. There is no expectation for an orthodontic treatment to improve one’s tinnitus health status.
  2. Tinnitus-focused aligner care expects the benefits to tinnitus health to start during treatment and continue after treatment has finished.
  3. Orthodontic research and surveys of orthodontists’ retention methods in Australia, Canada, Croatia64Popović Z, Trinajstić Zrinski M, Špalj S. Orthodontist Clinical Experience and Clinical Situation Significantly Influence the Retention Protocol – A Survey From Croatia. Acta Clin Croat. 2020 Mar;59(1):3-9. doi: 10.20471/acc.2020.59.01.01. PMID: 32724269; PMCID: PMC7382889., Hungary, India65Sr R, Singaraju GS, Mandava P, Ganugapanta VR, Bapireddy H, Pilli LN. A Survey of Retention Practices and Protocols Followed Among Orthodontists in India. J Pharm Bioallied Sci. 2021 Jun;13(Suppl 1):S149-S156. doi: 10.4103/jpbs.JPBS_615_20. Epub 2021 Jun 5. PMID: 34447064; PMCID: PMC8375820. , Iraq66Abid MF, Al-Attar AM, Alhuwaizi AF. Retention Protocols and Factors Affecting Retainer Choice among Iraqi Orthodontists. Int J Dent. 2020 Oct 23;2020:8810641. doi: 10.1155/2020/8810641. PMID: 33149739; PMCID: PMC7603596., Lithuania, Netherlands, New Zealand, Poland67Jedliński M, Mazur M, Schmeidl K, Grocholewicz K, Ardan R, Janiszewska-Olszowska J. Orthodontic Retention-Protocols and Materials-A Questionnaire Pilot Study among Polish Practitioners. Materials (Basel). 2022 Jan 16;15(2):666. doi: 10.3390/ma15020666. PMID: 35057382; PMCID: PMC8779968., Norway, Switzerland68Habegger M, Renkema AM, Bronkhorst E, Fudalej PS, Katsaros C. A survey of general dentists regarding orthodontic retention procedures. Eur J Orthod. 2017 Feb;39(1):69-75. doi: 10.1093/ejo/cjw011. Epub 2016 Mar 11. PMID: 26969423.,69Jedliński M, Mazur M, Schmeidl K, Grocholewicz K, Ardan R, Janiszewska-Olszowska J. Orthodontic Retention-Protocols and Materials-A Questionnaire Pilot Study among Polish Practitioners. Materials (Basel). 2022 Jan 16;15(2):666. doi: 10.3390/ma15020666. PMID: 35057382; PMCID: PMC8779968., Turkey70 Küçükönder A, Hatipoğlu Ö. Approaches of Turkish Dentists in Cases of Orthodontic Lingual Retainer Failures. Turk J Orthod. 2020 Sep 28;33(4):239-245. doi: 10.5152/TurkJOrthod.2020.19040. PMID: 33447467; PMCID: PMC7771290.and the United States have shown
    1. Retention procedures are variable and dependent largely on personal preferences. There does not seem to be any consistent … retention methodologies.” (Australia, New Zealand)71Wong PM, Freer TJ. A comprehensive survey of retention procedures in Australia and New Zealand. Aust Orthod J. 2004 Nov;20(2):99-106. PMID: 16429880.
    2. “59% of the orthodontists believed that a practice guideline for retention after orthodontic treatment needs to be developed…” (Netherlands)72Renkema AM, Sips ET, Bronkhorst E, Kuijpers-Jagtman AM. A survey on orthodontic retention procedures in The Netherlands. Eur J Orthod. 2009 Aug;31(4):432-7. doi: 10.1093/ejo/cjn131. Epub 2009 Apr 28. PMID: 19401355.
    3. “There is a need to identify all causative factors of inadvertent tooth movement in relation to bonded retainers and to prevent the onset of unintentionally active retainers.” (Netherlands)73Padmos JAD, Fudalej PS, Renkema AM. Epidemiologic study of orthodontic retention procedures. Am J Orthod Dentofacial Orthop. 2018 Apr;153(4):496-504. doi: 10.1016/j.ajodo.2017.08.013. PMID: 29602341.
    4. “It is difficult to find statistical data about the frequency and the average degree of the relapse, but some … is observable in 70-90% of the cases.” (Hungary)74Kaan M, Madléna M. Retention and relapse. Review of the literature. Fogorvosi Szemle. 2011 Dec;104(4):139-146. PMID: 22308954.
    5. “There is an urgent need … to identify the most effective and safe method for managing the relapse…” (Cochrane Collaboration – multinational)75Yu Y, Sun J, Lai W, Wu T, Koshy S, Shi Z. Interventions for managing relapse of the lower front teeth after orthodontic treatment. Cochrane Database Syst Rev. 2013 Sep 6;(9):CD008734. doi: 10.1002/14651858.CD008734.pub2. PMID: 24014170.
    6. “… there was no evidence … to show that one intervention was superior to another to manage the relapse of the alignment of lower front teeth…, aesthetic assessment by participants and practitioners, treatment time, patient’s discomfort, quality of life, cost-benefit considerations, stability of the correction, and side effects including pain, gingivitis, enamel decalcification, and root resorption.” (Cochrane Collaboration – multinational)
    7. “No retainer is proved to guarantee a perfect stability of dental alignment…” (Poland)76Jedliński M, Grocholewicz K, Mazur M, Janiszewska-Olszowska J. What causes failure of fixed orthodontic retention? – systematic review and meta-analysis of clinical studies. Head Face Med. 2021 Jul 24;17(1):32. doi: 10.1186/s13005-021-00281-3. PMID: 34301280; PMCID: PMC8306281.
    8. “For patients with removable retainers, most orthodontists instruct them to wear their retainers forever… do not instruct patients to have fixed lingual retainers removed at a specific time…indicating lifetime retention.” (United States)77Valiathan M, Hughes E. Results of a survey-based study to identify common retention practices in the United States. Am J Orthod Dentofacial Orthop. 2010 Feb;137(2):170-7; discussion 177. doi: 10.1016/j.ajodo.2008.03.023. PMID: 20152670.
    9. “Evidence-based guidelines are desired for a common retention protocol.” (Lithuania)78Andriekute A, Vasiliauskas A, Sidlauskas A. A survey of protocols and trends in orthodontic retention. Prog Orthod. 2017 Oct 9;18(1):31. doi: 10.1186/s40510-017-0185-x. PMID: 28990138; PMCID: PMC5632597.
    10. “There seems to be a potential dichotomy between orthodontists being uncomfortable about allowing general dental practitioners to manage retention and orthodontists unwilling to provide retention care indefinitely.” (Canada)79Carneiro NCR, Nóbrega MTC, Meade MJ, Flores-Mir C. Retention decisions and protocols among orthodontists practicing in Canada: A cross-sectional survey. Am J Orthod Dentofacial Orthop. 2022 Jul;162(1):51-57. doi: 10.1016/j.ajodo.2021.02.022. Epub 2022 Feb 11. PMID: 35153115.
  4. These professional surveys confirm that, after more than 200 years, orthodontists and dentists worldwide are still waiting for the development of “that reliable method” which will consistently yield a stable and lasting result.
  5. The increasing popularity of orthodontic braces and aligners and the instability that often follows might explain why dentists, PCPs, audiologists and ENTs are seeing many more patients with undesirable dental and medical consequences, including tinnitus.
  6. Tinnisense incorporates a multi-patented protocol for tooth movement and retention that has provided comfort to patients. Its unique methodology seems particularly well-suited for those with periodontal disease, sleep disorders, and tinnitus. Please refer to Figures #6, 7.
patient at high risk for tinnitus - Tinnisense can cure tinnitus for orthodontic patients

Figure 6.

Decades after finishing with braces as a teenager, his occlusion health deteriorated as orthodontic relapse set in. Widespread poor tooth positioning led bad bite forces to be passed through to the bone. That elevated the risks to his sleep health and for developing tinnitus.

tinnitus-focused aligners helped avoid tinnitus - picture of lower face smiling after receiving Tinnisense to cure tinnitus

Figure 7.

Years after his tinnitus-focused aligner therapy concluded, those “new" tooth positions have stayed stable. His occlusion health remains improved - bad bite forces haven’t returned. The likelihood that he will experience tinnitus episodes has remained greatly reduced.

Conclusion

The startling rise in tinnitus suffering shows no signs of abatement. Despite the many millions who suffer from tinnitus, the ailment has received far too little funding and seen scant progress from researchers over the past 50 years. The number of people hampered by tinnitus increased seven times faster than the population grew over the past few decades, an unsustainable pace for any healthcare system.

The possibility that an important connection exists between orthodontic therapy and tinnitus must be explored. If an upgrade to the current method for prudently moving teeth could help stem the surge of tinnitus, it would make sense to incorporate these principles into our care as soon as possible. Medical, dental, and national institutions need to embrace tinnitus-focused aligner care so this remedy can bring relief and ward off suffering to many in the US and around the world.

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