Can Dental Work Cause Vertigo?

image of twisted hallway

Have you ever stood up too fast and caused yourself to be dizzy?  As a child, do you remember the feeling of spinning fast on a merry-go-round and suddenly stopping, but the world around you continued to spin?

Now, imagine you are standing still, not moving, and the room starts spinning around you.  Although your body is still, you feel you’re losing your balance. Suddenly you feel nauseated because you can’t get the room to stop spinning.  Finally, think of how it would feel if this sensation lasts for several hours.

This is how many people feel with various forms of vertigo.

I recently had a patient for a moderately long dental appointment, probably about 2.5 hours.  When we were finished, the patient said they felt well, thanked us for our service, and left in a stable and ambulatory state.  The next day the patient’s spouse called our office and reported the patient was experiencing dizziness if they tried to get up and walk.  Furthermore, the dizziness was inducing some significant nausea. These symptoms slowly got better throughout the day, and by noon the following day the patient was fine.

This patient had experienced a significant vertigo episode shortly following her dental appointment. They had never experienced vertigo problems like this before. This begs the question: can dental work cause vertigo?  This post will explore the relationship of vertigo and dental visits.

 

What is Vertigo?

 

As described above, vertigo is a sensation of dizziness or lack of balance.  Patients often report they feel the room is spinning, even though they are standing still.  Obviously this can be quite a disconcerting experience!

There are several different types of vertigo, but the one appearing to be most associated with dental work is benign paroxysmal positional vertigo (BPPV).  It is the most common type of vertigo observed in the general population.

Most causes of BPPV are unknown, but some inner ear disorders and trauma to the head have been known to cause it.  Several risk factors have been identified which include bed rest, osteoporosis, migraines, and some vascular factors.

It is believed BPPV is induced by small calcifications in the ear that dislodge and collect in the vestibular canals.  The vestibular canals are the part of the inner ear that affect your sensation of balance from your head position relative to gravity.

Many times, patients with BPPV will experience symptoms on and off for a few days, sometimes even weeks.  The symptoms may disappear for weeks or months, then return again.

 

A Look at the Literature

 

There have been a number of case reports that document the onset of vertigo symptoms following dental visits.  Until 2016, no major population-based studies had been published. This study by Tzu-Pu Chang, et al. explores onset of BPPV in the general population in Taiwan. It pays particular focus to those who had recent dental work.

The study found a correlation between recent dental work and onset of BPPV symptoms.  It took note of patients with BPPV onset within 1 month following dental work and those with BPPV onset within 3 months.  They documented a statistically significant difference between those receiving recent dental work and the control groups.

The study also explored the types of dental procedures performed to explore their relationship to BPPV onset.  However these were reported as very broad fields. For instance, one of the procedures reported was “prosthodontics”.  Prosthodontics is an extremely broad field of dentistry that is further divided into “fixed” and “removable” sub-fields.  Techniques and procedures for fixed prosthodontics are totally different than those of removable prosthodontics.

I didn’t put much stock into this section. The procedures explored were far to broad and non-specific. Instead, I would like to have seen a focus on appointment length and chair position rather than the very broad types of dentistry performed.

 

Can Dental Work Cause Vertigo?

 

Based on the available evidence, it is difficult to conclude that dental work is a direct cause of BPPV.

Onset of BPPV symptoms seemed to correlate with recent dental visits in the Taiwan study.  However, it is still not clear if these patients already had BPPV and dental work merely induced the first onset of symptoms.

I would say it is a possibility that should not be ignored.  Furthermore we still do not know why dental work would cause onset of BPPV symptoms.  I have a few educated guesses on the matter.

First, patients often need to turn their heads left and right during dental procedures to provide the caregiver access to different parts of the mouth.  It is known that turning of the head in this manner can bring about BPPV symptoms.

Another possibility is the length of time the patient is supine (laying on their back) in the chair.  Many patients sleep with multiple pillows at home and do not sleep in a totally supine position. The length of time spent supine while turning the head left and right could also be an inducing factor for BPPV symptoms.

Finally, another possibility could be related to the micro-vibrations experienced with the dental handpiece (or “drill”).  These micro-vibrations could cause calcifications already deposited in the vestibular canals to circulate.  This would send confusing signals to the brain related to balance and head position.

The bottom line I draw from all of this is: It’s difficult to conclude that dental work directly causes BPPV, however the correlation between the two cannot be ignored.

 

Treatment for Benign Paroxysmal Positional Vertigo

 

There are several different ways to treat BPPV.  Several in-office remedies exist that can be performed to alleviate symptoms, or in some cases cure BPPV altogether.  There are also reported home remedies and surgical interventions. This article goes into some detail about the treatments available.

Our recommendation is to discuss treatment options with your physician.  A joint effort by your dentist and PCP can get you to the doctor with the right knowledge and skill set to help.  As is often the case with many conditions, treating BPPV is a team effort!

 

Tell Your Dentist!

 

If you have a history of vertigo of any kind, it is extremely important to notify your dentist and their staff team.  Each patient should be received and treated differently based on their health needs. We strive to create an environment where patients’ individual needs are met so they do not have to be nervous about dental treatment!

There are several things your dentist can do to mitigate the risk of BPPV symptom onset.

I usually recommend shorter visits for patients with a history of vertigo.  We have several patients who come for their routine cleaning appointments and have no problems.  However, those same patients often feel much dizzier after a longer appointment such as a crown prep.  I try to keep their appointments around an hour in length, and ideally no more than 90 minutes.

Modifications

Chair position is also important!  Vertigo patients will often notify us to not lean the chair too far back.  I make it a routine practice to let patients dictate how far back they are willing to lean in the chair.  I want to maximize my ease of access to the mouth in order to work most efficiently, while keeping the patient in a comfortable position.

Finally, we will attempt to minimize turning the patient’s head during procedures.  Certain parts of the mouth are easier to access when the patient is facing toward or away from the dentist.  This keeps the dentist from having to excessively bend his/her back, neck, and shoulders to perform treatment.  While all dentists have their ideal chair position for treatment, it does not work for every patient. I would much rather bend a little awkwardly for one short appointment rather than induce a vertigo episode in my patient that could last for a day or more!

Our chart program has a feature where we can set pop-up alerts for individual patients.  If you tell us you have a history of vertigo, we will set an alert that will pop up on our screen any time we access your chart.  This way, we have constant reminders of your treatment modifications to keep you comfortable!

 

Conclusion

 

I’ve had 2 patients so far in my career that had their very first vertigo episode either in the dental chair or in the 24 hours following an appointment.  In both cases, the patients kept me informed of their condition. We were able to work together to manage the vertigo and keep the patients’ mouths healthy!

I want to give special thanks to one of these patients who inspired this post.  This person kept me informed of their condition and helped find a lot of the background information and research used to write this post.  Due to privacy laws, I can’t credit this person here by name. But, you know who you are, and I want to say thanks!

Based on the available literature, there is clearly some correlation between dental procedures and onset of vertigo symptoms.  However it is still unclear whether dental treatment directly causes the underlying conditions for BPPV.

Dentists and patients alike should be aware of this link.  Patients should be thorough and communicative with their dentist in regards to their health history.  Likewise, dentists should be prepared to observe treatment modifications on behalf of their patients’ comfort.

Have you ever had vertigo symptoms seemingly linked to a dental visit?  What triggers your vertigo, and what helps prevent vertigo episodes? Let us know in the comments.

31 thoughts on “Can Dental Work Cause Vertigo?

  1. Thank you for sharing your research. I am suffering with incidents of Vertigo for the past two years and two recent visits to dentist made me feel nauseous and dizzy. While the dizziness was not intense it was clearly similar to vertigo incident. Initially I attributed it to side effect of local anesthesia but after reading this article I am certain it was vertigo triggered after an very two hours in dentist chair

    1. I was at the dentist the other day and he gave me the third Novocain shot and the room started spinning. My head was pulsating and I was throwing up. I went to the hospital and they saw a small bleed in my brain but it wasn’t currently bleeding so I am not sure if the dentist caused all this or the bleed happened at exactly the same time. It’s near the brain stem I think.

  2. I recently had a minor root canal done. The initial work went well with no problems and the appointment was on a Wednesday. By Sunday I was feeling the effects of vertigo which got worse on Monday then after doing the exercises and being careful not to move too much, went away. Today (two weeks later) I was having the tooth prepped for the temporary crown and got dizzy in the chair. It went away then when my dentist was finished and I was sitting up, I felt dizzy again. I told his assistant and she said it can happen from being in the chair sometimes. I have had vertigo before and felt it was much more than just being in the chair. I had to be careful driving home. After resting I went online to see if there was any information. I found your article and it was very helpful. I really believe that the drilling contributed greatly to the vertigo episode. I think that the possibility of jarring those little calcium deposits in the inner ear is a huge contributing factor. Especially since testing which side was the worst for the “vertigo exercise”, it was the left side and that is the side I am having the dental work on. Molar #15 to be exact.

    1. I went to the dentist 05/2000 for work for two crowns I am getting. I was in the dentist chair for and hour. After I tried getting up, my whole head was spinning. I have an appointment with an ears, nost throat specialist for vertigo of the BPPV. It mainly happens at night or if I sit for awhile in my recliner. I hope he can fix this. I gate shaking my head like a dog with ear problems to make it go away.

    2. I experienced something similar had a root canal on molar #14 everything went well didn’t hurt at all left the dentist office relived and went about my day next morning woke up feeling dizzy and nauseous went away after awhile but I’m afraid this will continue don’t know how long this is going to happen.

  3. I had the most severe vertigo accompanied by nausea yesterday after a dental visit. I feel like the drill is what triggered it. My mouth is small and at one point I think my top teeth were touching the drill and caused my whole head to vibrate. I opened my mouth wider, of course, but after the procedure was done, I could barely walk and I have never been that dizzy before in my life. In fact, I don’t really have issues with dizziness at all.
    I was concerned about the epinephrine in the anesthetic coupled with some un-diagnosed hypertension possibly causing problems. I also worried that I was having a stroke or heart attack because it was so severe. My vitals were better after the procedure than before. I had them check my pulse and blood pressure when I got up feeling dizzy. It was 140’s/ 80’s ( kind of high but not dizzy inducing high or even stroke inducing). My pulse was about 78. It felt regular and I had no actual numbness or one sided weakness, not even any real blurred vision, just this horrible dizziness. So, I just sat in the waiting room for a while and later in my car for an hour before finally driving home ( still dizzy).
    It might also be of note that this was the very back tooth ( bottom right) in very small mouth and she did need to numb it several times as I still felt something at one point. Any chance the anesthetic could actually affect the inner ear or be injected into the inner ear being in such close proximity? My ear feels a little bit full today.
    The actual visit started around 1:15 pm. She took breaks once or twice and seemed like she was very experienced, although it was my first visit with that particular dentist. It was the same facility that I have used for years now. It was a big filling removal and a temporary crown placement, but the visit really wasn’t excessively long. I’ve never had issues with this at a dentist before and I have had longer visits, maybe not long drilling sessions though. The appointment was over by 2:25 pm and the severest of the symptoms lasted until about 7:30 pm
    This morning it’s still there, very slightly, along with a general weak feeling in my extremities, but the weak part could be from just feeling bad, laying around for a whole day and not eating much since yesterday.
    This morning, looking back, I think it does sound more like BPPV triggered by the drill. I plan to make a visit to a medical doctor, today if possible, to follow up. Any chance, if it’s BPPV that it will go away and never return? That was a horrible experience!

    1. I just went through the same thing. And I have had BPPV episodes before so I knew what was happening. They usually go away after 24 hours. But this kept me at home for days. The drilling is what triggered it. I am sure. It took me 3 days of off and on dizziness to make it stop. I treat this with doing the Epley maneuver. Your doctor or a PT can perform thi. My husband helps me with it. Remember that BPPV is usually temporary and can be treated. Learn how to do the Epley.

    2. Yesterday i went for a deep cleaning and later in the day i feel my vertigo coming on. I wome up today in full vertigo. Also when i cant use an electric toothbrush. I get vertigo everytime i try to use it. So the vibration theory sounds about correct.

  4. I had a similar experience being in the medical field for my entire career I was unaware how scarey a vertigi episode can be. I an fearful of going bk and now have a toothache

  5. Currently I am having dental work, this morning I took half a dose of the antibiotic the dentist prescribed. I felt dizzy beyond words and nausea. I have never experienced this in my life until I had this dental work and never took antbiotics like this before and after dental work. I am happy I found this article and when I see the dentist on Tuesday I will make sure I am at an angle that is comfortable in the chair. the dizziness didnt occur until a day later.

  6. I get vertigo as well but need to go back in. I was wondering if having anesthesia or the laughing gas would bypass the vertigo? Anyone know?

    1. Sorry for taking so long to respond! What I do for my patients is try to decrease appointment times and account for chair position. Sometimes is leaning back and turning the head left and right that triggers the vertigo episode. Sedation may help or hurt. Anxiety can contribute to the onset of a vertigo episode, in which case having laughing gas could help. BUT, laughing gas makes some people dizzy which could exacerbate a vertigo episode. Each of my patients that experience vertigo have different triggers, so the dentist should be prepared to have a conversation with each patient and customize their experience accordingly.

  7. After hour in dental chair Which involved drilling to remove an old crown and getting temporary one, I could not stand up for a minute due to extreme dizziness. The rest of the day I fought dizziness as well. I am a 60 year old thin, athletic woman so this was very strange to me. The dentist pointed out that my X-rays in recent years show increased calcifications and he was concerned enough he plans to share them with a specialist. Perhaps as this article indicated the drill caused some of the calcifications to move causing the vertigo. Hopefully tomorrow will be better. Thanks.

  8. Upon getting up from the dental chair after a root canal yesterday, I experienced a very severe vertigo episode (My first). I was unable to stand and my symptoms quickly deteriorated, vomiting, sweating, blood pressure 200, inability to open my eyes or move at all without vomiting. I was ambulanced to the hospital where I remained overnite. After some initial tests, they gave me medicine for the nausea and vertigo which helped tremendously. An MRI and cat scan detected a non related carotid aneurysm, which was lucky to find. I am 70 with history of juvenile rheumatoid Arthritis, osteoporosis, chronic headaches, and did experience severe jaw pain during the dental procedure.

  9. I had a molar removed which required lots of numbing and drilling. Just about two weeks later I had my first ever vertigo attack. It was horrible. I recall have ear and throat pain while I was healing from the surgery. I immediately wondered if my inner ear was traumatized during the surgery which then caused the vertigo.

  10. I just went to the dentist Monday. He used lidocaine. He didn’t even get finished numbing me up when the room started spinning. I believe its when he shot the lidocaine into the cavity connected to my ear that caused my vertigo.
    My ear up to my temple & back was more numb than my jaw. It was crazy scary! Hope to never experience that again.

  11. I have experienced Vertigo on average of once per year since 2013. It only lasted a day each time, with the exception of one time when it lasted 3 days. None of these were associated with the dentist.

    Recently, I had my first, and hopefully last, root canal. First visit was the root canal and the second visit was prep work and two temporary crowns. They were both long appointments without incident. During the third visit for the permanent crowns, the Dentist positioned the chair back and inspected the temporary crowns for about five minutes, then positioned me back up in the normal sitting position. As soon as he sat me up, the room starting spinning and I knew Vertigo had hit me hard. After about twenty seconds, the Vertigo subsided and they sat me back to begin the procedure and I had no further problems. The next morning, I woke up with Vertigo and I have suffered with it daily, for fifteen days straight! I have a doctor’s appointment in two days.

    I have never had extensive dental work before, other than a cleaning, and didn’t know to advise the dentist that I had previously suffered with Vertigo. I learned the hard way. I feel as though the cause of the Vertigo wasn’t the actual dental procedure but was the position of the chair being so far down. I will definitely advise my dentist next time. Cross your fingers this goes away soon because it is aggravating and exhausting!

  12. Both my girlfriend and myself have experienced BPPV soon after having dental treatments. I believe there is a direct correlation between the jaw being jammed open, forcing pressure on the Temporal Mandibular Joint along with the head position to cause the otoconia crystals to become dislodged. Fortunately, there is the Epley maneuver which almost always works.

  13. Had crown prep work yesterday. When she finally finished (it was around 1-1/2 hrs.) I felt so, so dizzy and the room was spinning around. The dental hygienist was kind enough to offer me water to drink, which did help a little. Still, I had difficulty getting up from the chair and the hygienist guided me to a less busy waiting room where she told me to sit and rest for 20-30 minutes or however long it took. I guess I was there around 15 minutes then I inched my way to the reception to get the date of the NEXT (permanent crown) appointment. I was holding on to the counter, the walls, anything I could find to help me stay upright. Next, I walked ever so slowly to my car – I had forgotten to bring my cell phone to call for help (still, my husband probably couldn’t come as he was working at the hospital)….thankfully, it’s a very small town and I drove ever so slowly, using a back road which had less traffic. It was the scariest incident in my life (and trust me, I KNOW scary – having had a heart attack in 1998)…I felt so totally out of control. I thought perhaps they might call and see how I was doing but no-one called.

  14. I just had work done on molar number 14. This is third root canal on this tooth. I was in the chair for between an hour to an hour and a half. My vertigo started the next morning, and seems to be at its worst when I’m laying flat on my back in bed. I’m not looking forward to the next hour and a half in the chair with the endodontist to finish the procedure. I do have artificial jaw joints and history of migraines. The doctor was made aware of this and we did stop for a small resting period three times. I appreciate your article since my endodontist does not recognize that it is a problem.

  15. My 86 yo mother had x-rays and impressions taken on a recent Tuesday afternoon and woke up Friday morning with severe vertigo and vomiting. She was unable to ambulate safely unassisted. After a visit to the ER and a complete work up including CT Scans, the doctors diagnosed BPPV and put her on oral meclizine (Brand name: Bonine). They also gave her a dose of Zofran IV. She left the ER a few hours later and was very weak but no longer dizzy. After a couple of days on meclizine and sleeping in a semi-reclined position instead of flat, she has completely recovered. She has more dental work ahead so we’ll be asking about reducing the angle of recline in the dental chair and will probably have her take the meclizine prophylactically before her appointments. Thank you for your article. It was very helpful!

  16. A week ago, I had 10 teeth pulled to prepare for upper dentures. The appt lasted about 2 hrs and I am 59 yrs old. I am still very dizzy, in a lot of pain, and not eating anything solid. I hate this feeling! No history of vertigo, but do have a pacemaker, RA, and have had 10 back surgeries in 19 years. Have already been to the ER once for dehydration, nausea, and pain. Initially, the pain radiated to my sinuses and ears, but that has resolved. At yesterday’s follow up, I told all this to my dentist and he acted like he had never heard of vertigo after dental work, and the ER treats everyone like drug seekers. Any idea what is going on? I’m scared!!

  17. These are some great vertigo and dentistry that you have discussed here. I really loved it and thank you very much for sharing this with us. You have a great visualization and you have really presented this content in a really good manner.This Papakuradentalworld.co.nz is very useful and its related to what you have actually mentioned here.

  18. I’ve had Vertigo for the past 5 years. It was almost constant for 2 years. I do take meclizine before a dental appointment. Two days ago I had a crown put on and a filling. The appointment was 2 1/2 hours with little breaks in between. I did feel nausea during the procedure. I was a little dizzy when we took breaks. My dentist let’s me know when she is going to move the chair . I pull myself up and down ,to minimize head movement. I was fine when I left and also for the next day. But 3 day post procedure I got vertigo. As I look back it’s a pattern for me after a dental appointment. Cleanings are the same way. Using an electric toothbrush is also a trigger for me. Anyways, I’m so glad my dentist listens to me and we try and figure what works better for me.She adjusts her way of doing things so I am more comfortable. She even calls to see how I’m doing.

  19. My dentist wasn’t able to remove the temporary crown, so she Drilled it off, took so long. In chair two hours. Went back next day to begin temporary crown on different tooth. Had dull headache. Next morning woke at 3am with vertigo so awful I rolled out of bed. Vertigo lasted three days, primary physician gave me meclizine. Took it for 4 days before vertigo subsided. Was told to avoid extensively long dental visits and also avoid electric toothbrush!

  20. Just had an upper wisdom tooth removed. Only about 15 minutes in the chair. The second night after (last night) I experienced vertigo for the first time in my life (57yr old). It was scary. It sounds like BPPV and rotating my had 90° at a time as I found in a video online seemed to help. I still feel a bit uneasy.

  21. I came across this article in my search to see if my vertigo symptoms (that I woke up with this morning) could be related to my dental cleaning yesterday.

    Since I first started having bouts of Vertigo in my 30’s (I’m 48 now) much of the time it involves extreme dizziness when I turn my head to a certain position & I could avoid the symptoms by not putting my head in that position. Most of the time my Vertigo dissipates without having to get the Epley Maneuver.

    But today I woke up with a general feeling of dizziness & nausea. (I have been careful not to turn my head in a way that could induce more extreme Vertigo.) I’m not congested, so I don’t think the cause is related to my sinuses. I do have TMJ so I thought maybe the opening & closing of my jaw yesterday for my dental cleaning may have irritated something. So I decided to put in my bite plate & wear it awhile to see if it helped. No change yet, but it’s only been in a short time, so even if it might help, it’s probably too soon to tell.

    After reading this article, I’m starting to wonder if the position my head is placed in the dental chair has something to do with triggering my symptoms. Maybe it’s the position of my head (i.e. both the angle & turning towards one side for the hygienist) and the opening and closing of my jaw during the procedure? … maybe it’s like a reverse Epley in a way?)

  22. Just got a crown and an implant put in today. I was in the chair for 2.5 hours. I was fine until I got home 10 mins later. I got out of my car and felt dizzy. I then ate dinner and immediately felt worse. The room started spinning and I’m now laying down in bed.

  23. I went to the dentist yesterday to have a crown reattached. The procedure involved drilling, tapping and pressure. I received local anesthetic. The night after I experienced dizziness when getting into bed. When I woke up, I went to the bathroom and the room was spinning. I have never had Vertigo before.

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