by Neil Bauman, Ph.D.
A lady wrote:
I have had tinnitus for the past 4+ yrs. It goes up and down according to stress levels, diet, and so forth. However, I went to the dentist three days ago and I notice that the volume has increased more than usual. I called today and his assistant told me he used Lidocaine as an anesthetic. Could this be the cause of the sound level increase? I do not see Lidocaine in the ototoxic lists I have searched in the Internet. Perhaps this could be a temporary condition and may level out in several more days. Do you have any info on this subject?
Internet lists are not very complete and typically only list the most ototoxic drugs. However, Lidocaine is listed in both the Physicians’ Desk Reference (PDR) (used in the USA) and the Compendium of Pharmaceuticals and Specialties (CPS) (used in Canada) as causing tinnitus. (The CPS also lists Lidocaine as causing hyperacusis.)
It is certainly possible that your tinnitus might have been caused by the Lidocaine. However, Lidocaine may not have been the culprit. Your increased tinnitus could have been caused by the “trauma” of your dental work. For example, dental drills are pretty loud in your ears (and via bone conduction too). Also, your jaw could have been stretched a certain way which could have affected your TMJ, and thus affect your tinnitus. You need to consider these and other possibilities besides the Lidocaine.
In any case, I would expect your tinnitus to drop back to its old level in a few days to a couple of weeks.
Dear Dr. Neil,
I have hyperacusis and tinnitus and am in need of dental work very soon. After reading the above information I am very fearful of going. Could you tell me if Novocaine is also Ototoxic? Are there any safe drugs when it come to dental work?
Thank you for your time and advice.
4 months ago I received 2 injections of lidocaine at the points between the neck and head. I then started having tinnitus in both ears. Is it related to lidocaine?
Hi Avi:
How soon after the Lidocaine injections did the tinnitus appear? If it was within a week or so, I’d say there was a reasonable chance it was the Lidocaine as numbers of people have reported Lidocaine as causing their tinnitus. However, be aware that Lidocaine is also used to stop tinnitus, so it certainly doesn’t cause tinnitus in the majority of people taking it.
If you neck, shoulders, head and/or jaw are “tight”, the tinnitus could be due to overactivated nerves in those areas. This is called somatosensory tinnitus. Getting the bones/vertebra properly aligned and the muscles relaxed can cause this kind of tinnitus to go away.
Cordially,
Neil
Yes, It happened to me too.
The tinnitus began a few days after the injections.
Thank you for the quick response.
As part of the treatment I was also given Prednisone steroids. I received 40 mg per day for 3 days. Tinnitus began a few days later. Can Tinnitus be caused by Prednisone?
Hi Avi:
Prednisone does cause tinnitus in some people, but it’s probably not too common as they use Prednisone so often it treating ear problems.
Cordially,
Neil
I started getting tinnitus in my left ear after my third root canal and three doctors later the best answer I have is a possible diagnosis of vestibular migraines. That diagnosis only fits me partially. I had never heard that lidocaine could be a cause for tinnitus. During my last root canal the lidocaine wasn’t effective the first two times they tried it. Could there be a correlation between the use of lidocaine/my resistance to it and my single sided tinnitus?
Hi Lily:
Lidocaine can cause tinnitus in some people, but it also helps people with tinnitus so it can work both ways. If you are sensitive to lidocaine, then it is possible that the Lidocaine is the culprit in your tinnitus.
However, the tinnitus could be from just the trauma to your dental nerves–especially if the root canals were on upper teeth (which have closer connections to your ears than your lower teeth.
It also could be a result of the sound of the high-speed drill.
And it could be a bit of each, not just one thing.
Cordially,
Neil
Hello,
I had a basic filling done for a cavity 18 days ago and have had consistent unilateral tinnitus on the same side starting two days after ever since. I recently went back to have it “fixed” thinking that was the cause but have had no relief. Could the tinnitus eventually go away on it’s own or is this permanent now? My ENT says it is most likely caused by the dental work. How long would it take to resolve itself?
Hi Robin:
Was the filling done on an upper tooth or lower tooth? And was it a molar or more of a front tooth? It seems mostly problems occur when you have work done on upper molars since those teeth are closer to your inner ears.
There is nothing that says the tinnitus will be permanent. It may be, but I’d expect it to fade away in time. In your case, obviously it is not going to fade away in two weeks since it is more than 3 weeks already. Thus, you could be in for the long haul.
The best thing to do is learn to ignore you tinnitus and focus on the loves of your life. You do this by first understanding that tinnitus is NOT a threat to your well-being. When you do this, you give you limbic system permission to habituate to this sound so that it appears to fade into the background and won’t bother you anymore, even if you do hear it from time to time.
On the other hand, if you worry about your tinnitus you are treating it as a threat to you well-being and thus your limbic system won’t let you ignore it.
If you treat you tinnitus as just another totally unimportant background sound and thus ignore it, you should notice that in a few months, your tinnitus is just a shadow of its former self.
Also, if your tinnitus tries to bother you, especially when you are trying to get to sleep at night, you may find that playing some soft sounds will help you. An excellent choice is to download some water sounds (waves on the beach, rainfall, waterfall sounds, babbling brook, etc) and listen to them as you fall asleep. These sounds not only reduce the contrast between your tinnitus and silence, but they are also naturally soothing and easy to habituate to.
Cordially,
Neil
I got tinnitus after 3 shots of lidocaine for a front tooth. It is permanent. Believe us.
Neil,
I have been receiving lidocaine injections in my neck,back of head and temples every week for the past year to reduce my cervicogenic headaches. My tinnitus has been getting louder over the past month. My doctor says the lidocaine wouldn’t cause that but I’m not so sure. What do you think?
Hi Bea:
Lidocaine is one of those “funny” drugs. For some people, Lidocaine injections through the eardrum can cause tinnitus to temporarily disappear. However, for other people, taking Lidocaine makes their tinnitus worse. The Nurses Drug Handbook, the Physicians’ Desk Reference and the FDA’s database all report that Lidocaine causes tinnitus or makes it worse. So your doctor is wrong.
Unfortunately, you seem to fall into this second class. If you stop taking the Lidocaine, you may find that your tinnitus soon reverts to its old level.
Cordially,
Neil
I have had a procedure in the past I was given lidocaine intervenously I then had dizzy spells and very loud noise in my ears and pain I’m supposed to injected tomorrow with meracain will that affect me I also have anemia they wanna inject my neck and back for a injury I’m allergic to steroids and lot of other medications
Hi Lorraine:
Some of the more common ototoxic side effects of Lidocaine are indeed dizziness, tinnitus and ear pain.
I assume that you mean Mericaine, not Meracain. The generic name is Procaine. If so, as compared to Lidocaine, there are hardly any ototoxic side effects reported. So you have a much better chance of not having the above side effects showing up. But, as always, there is still some risk, although in my opinion it is much lower than for Lidocaine.
Cordially,
Neil
If I were to have a reaction to lidocaine would it be immediately or can it build up over time of repeated injections? I get lidocaine nerve blocks in my neck every 3 weeks.
Hi Joni:
I think tinnitus from Lidocaine can develop rather quickly within a few hours, but could also take considerable time to develop. I don’t have much information on how long it takes for tinnitus to develop after taking Lidocaine so I can’t be very specific.
I don’t think it builds up if the Lidocaine is out of your body before you get the next shot, but this is just a guess. One lady found that each time her dentist gave her Lidocaine, her tinnitus became temporarily worse.
Why do you need nerve blocks in your neck? If you have pinched nerves in your neck, have you tried upper cervical chiropractic to relieve the pressure on them?
Cordially,
Neil
My tinnitus ramped up to an almost untenable level this week after getting prepped for a crown. I’m mortified to think it will remain at this level. I don’t know if they used lidocaine. I’m unsure if I want to have the permanent crown placed. If I do it’ll be without anesthesia. If I would have known the risk I wouldn’t have had it done, FOR SURE. I’m so sad and scared. Should I get a second opinion? When I called the dentist to inquire they first told me it wouldn’t cause tinnitus to flare. When I told her I’d researched it and had tinnitus for 15 years she was much more open.
Hi Lisa:
If your dentist did the prep correctly and the crown is made to fit properly, then I don’t think they need to drill on your live tooth. Basically, the break the temporary crown off and glue the permanent one on. So they shouldn’t be freezing your tooth, thus you won’t get Lidocaine or one of the other “caines”. That’s how I remember it for my crowns.
I’d check with your dentist and see whether you need more freezing. If not, you don’t have to worry. If they are going to use freezing, find out what they used last time that apparently caused your tinnitus.
Find out what other analgesics they alternately use and I can tell you which is the least likely to make your tinnitus worse.
Cordially,
Neil