Temporomandibular joint disorders and tinnitus: a systematic review and meta-analysis

Temporomandibular disorders (TMDs) are a common set of conditions affecting the jaw muscles and joint. Given the anatomical and neurological proximity, a conceptual link between TMDs and tinnitus has been hypothesized, but the strength and consistency of this association remain unclear. To systematically review and quantitatively synthesize evidence on the association between TMDs and tinnitus, specifically by pooling the prevalence of tinnitus in patients with TMDs and the prevalence of TMDs among patients with tinnitus, and by estimating corresponding odds ratios (ORs) in comparative studies. We included single- and double-arm observational studies (cross-sectional, case-control, and cohort) reporting the prevalence or odds of tinnitus in patients with TMDs or vice versa. Case reports, case series, reviews, and meta-analyses were excluded. PubMed, Web of Science, Cochrane Library, and Scopus databases were searched from inception to January 2026. The Newcastle-Ottawa Scale (NOS) was used to assess study quality and risk of bias for all included studies. Pooled prevalence rates with 95% confidence intervals (CIs) were calculated for single-arm studies. Pooled ORs with 95% CIs were calculated for double-arm studies, using random-effects models. Thirty-four observational studies (27 cross-sectional, 5 case-control, and 3 cohort studies) involving 47,349 participants were included. The estimated pooled prevalence of tinnitus in patients with TMDs was 31.8% (95% CI, 24.2–40.5). The pooled prevalence of TMDs among patients with tinnitus was 63.4% (95% CI, 46.5–77.6). In comparative studies, TMD diagnosis was associated with higher odds of tinnitus compared with controls (OR = 3.924; 95% CI, 2.636–5.841). Similarly, the odds of TMD diagnosis were higher in patients with than in those without tinnitus (OR = 4.147; 95% CI, 1.877–9.164). The findings are limited by the observational nature of the included studies, which prevents establishing a temporal sequence or causal link. Furthermore, the high heterogeneity and reliance on self-reported tinnitus in many studies limit the certainty of the evidence. Approximately one-third of the cross-sectional studies were rated as fair or poor. This meta-analysis indicates a consistent association between temporomandibular disorders and tinnitus. Pooled prevalence estimates and odds ratios indicate frequent co-occurrence of the two conditions in observational studies, although causality cannot be inferred. PROSPERO (CRD42024616120).