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What is Benign Paroxysmal Positional Vertigo (BPPV)?

Benign Paroxysmal Positional Vertigo (BPPV) is one of the most common causes of vertigo – the sudden sensation that you’re spinning or that the inside of your head is spinning.

BPPV causes brief episodes of mild to intense dizziness. It is usually triggered by specific changes in your head’s position.

The signs and symptoms of BPPV may include:
• Dizziness
• A sense that you or your surroundings are spinning or moving (vertigo)
• A loss of balance or unsteadiness
• Nausea
• Vomiting
• The signs & symptoms of BPPV can come & go and commonly last less than one minute. Episodes of BPPV can disappear for some time & then recur.

Activities that bring about the signs & symptoms of BPPV can vary from person to person but are almost always brought on by a change in head position.

Some people also feel out of balance when standing / walking.

Abnormal rhythmic eye movements usually accompany the symptoms of BPPV.

How’s does it happen in relation to Dental / Oral Surgical Treatment?

BPPV can occur after wisdom teeth removal. It can also occur with bone-removal using drills, osteotomes (in effect, bone chisels) & surgical hammers (used to tap dental implants into place) which can transmit percussive forces which can dislodge the otoliths.

The dizziness is generally thought to be due to the crystal part of the otolith organ in the inner ear becoming detached from the otolith organ & drifting away. This can occur when the head is positioned in abnormal positions for a prolonged period of time.

Treatments:

Treatment includes the Epley manœuvre or the Semont manœuvre.

Useful Articles & Websites

Wikipedia

Patient.co.uk. Benign Paroxysmal Positional Vertigo

J Multidisciplinary Care (Decisions in Dentistry)

American Academy of Otolaryngology & Head & Neck Surgery

Vestibular Disorders Association (VEDA)

Meniere’s Society

J Laryngol Otol 2003. Bilateral Benign Paroxysmal Positional Vertigo following a Tooth Implantation

Acta Otorhinolaryngologica Italica 2007. Iatrogenic Benign Paroxysmal Positional Vertigo. Personal Experience in OMF Surgery

Med Oral Patol Oral Cir Bucal 2007. Positional Vertigo afterwards Maxillary Dental Implant Surgery with Bone Regeneration

Eur Arch Otorhinolaryngol 2008. Benign Paroxysmal Positional Vertigo After Dental Surgery

Int J Oral & Maxillofac Implants 2008. Protracted Benign Paroxysmal Positional Vertigo Following Osteotome Sinus Floor Elevation. A Case Report

Int J Otolaryngol 2011. Inner Ear Disease and Benign Paroxysmal Positional Vertigo. A Critical Review of Incidence, Clinical Characteristics & Management

BJOMS 2013. Bilateral Benign Paroxysmal Positional Vertigo. An Unusual Complication of Orthognathic Surgery

J Contemp Dent Pract 2013. Maxillary Sinus Functions. Complications with Lateral Window & Osteotome Sinus Floor Elevation Procedures

Eur Rev Med Pharmacol Sci 2015. Benign Paroxysmal Positional Vertigo (BPPV) – it may occur after Dental Implantology. A Mini Topical Review

JMOS 2016. Benign Paroxysmal Positional Vertigo Following Sinus Floor Elevation in Patient with Antecedents of Vertigo

PLOS ONE 2016. Benign Paroxysmal Positional Vertigo after Dental Procedures – A Population-Based Case-Control Study