An ear infection can make your teeth hurt, a phenomenon known as referred pain. This occurs when discomfort originates in one area but is felt in another, due to shared sensory pathways. Inflammation within the ear canal or middle ear space irritates these pathways. Determining the true origin of the pain is the first step toward proper treatment.
Understanding Referred Pain
The connection between an infected ear and tooth pain involves the complex network of cranial nerves serving the head and face. The primary driver of this misdirected sensation is the Trigeminal Nerve (Cranial Nerve V), which transmits sensory information. This single nerve provides sensation to the face, teeth, gums, jaw, and parts of the ear.
An infection in the middle ear, such as otitis media, causes inflammation and pressure that irritates the nerve branches supplying the ear. Since these sensory branches travel along the same main pathways as those supplying the teeth and jaw, the brain struggles to accurately pinpoint the source. The resulting signal can be misinterpreted, or “referred,” often to the molars in the upper jaw.
Symptoms That Point to an Ear Infection
To differentiate referred tooth pain from a primary dental problem, look for accompanying symptoms centered on the ear. An ear infection presents with a distinct feeling of pressure or fullness deep within the ear canal, usually caused by fluid buildup behind the eardrum.
Ear pain worsens when lying down or chewing, as these actions change the pressure within the middle ear space. Other signs include muffled hearing, a recent cold or respiratory infection, or a low-grade fever. If the pain is from an outer ear infection (otitis externa or swimmer’s ear), you may also notice itching or fluid drainage. Primary dental pain, in contrast, is usually localized to a single tooth and triggered by hot or cold temperatures or biting down.
Other Common Sources of Jaw and Face Pain
While an ear infection is a common cause of referred tooth pain, other conditions can mimic this discomfort. Sinusitis, or inflammation of the sinuses, causes pain felt in the upper back teeth because their roots are near the maxillary sinuses. This pain intensifies with sudden movements, such as bending over, which shifts fluid and pressure within the sinus cavities.
Temporomandibular Joint (TMJ) Disorder
A frequent cause is a disorder of the Temporomandibular Joint (TMJ), which connects the jawbone to the skull near the ear. Inflammation or misalignment in this joint can cause pain that radiates into the ear canal, jaw muscles, and teeth.
Dental Abscess
A severe dental abscess can also cause referred pain that travels up the jaw and is felt as an earache. The infection creates intense pressure that affects the nerve endings running through the jawbone.
When to Seek Medical Attention
While mild referred pain from a minor infection may resolve on its own, certain warning signs require professional evaluation by a doctor or dentist. If the pain is severe, unmanageable, or persists for more than 48 to 72 hours, seek medical attention to prevent further complications.
Specific red flags include:
- A high fever
- Significant swelling in the face or neck
- Inability to swallow
- Inability to open the mouth fully
A healthcare provider can use specialized tools, like an otoscope, to examine the ear canal and eardrum to confirm an infection. Once the true source of the pain is determined, appropriate treatment can begin promptly.