Regarding Dr. T. H. Devlin’s March JADA letter to the editor, laying blame for his tinnitus on the turbine handpiece, there may be others responding to it beside myself.
Dentists who have been exposed to temporomandibular joint disorder and related bruxing problems have long known that tinnitus is a common problem among those with overclosure or bruxing, and that the use of mandibular orthopedic repositioning appliances and bite splints to control bruxing may help resolve the problem. Everyone bruxes, some more severely than others, as a reflection of stress; and no one realizes it unless he or she is trained to become aware of it. Besides, bruxing is done even while asleep and usually more heavily.
After over 50 years in practice and still going strong, my hearing loss is noticeable. Forty years of studying and experiences in trying to control and minimize stress have taught me to be aware of my own severe bruxing, which has been under control with the aid of mouth splints and constant reminding to stay loose. For some time, I have not required the use of the splints; headaches or tinnitus have never been problems.
Dentistry can be very stressful, and we are in a unique position to recognize stress. Stress management can be included in helping our patients to stay healthy and to delay and even ignore the aging process.
In the same issue, dental waterlines were discussed in the letter to the editor from Dr. Michale Boothe and response from Dr. Louis DePaola. I have been using the Scope 1:10 dilution in the irrigator. Whether it’s bactericidal or not, it must be more reassuring to the patients as it comes out foaming with a mouthrinse flavor.
