Severe Toothache and Ear Pain: Causes and Relief Strategies - Dentistry

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Pain in the lower right teeth/gums and ear pain?


Hello, doctor.
I have a question.
I am currently undergoing traditional braces treatment, and it has been about one to two weeks since my last adjustment.
In the past, the adjustments (including this one) haven't been very painful, just a bit uncomfortable.
However, for the past two days, I have been experiencing severe throbbing pain on the lower right side, radiating to my ear.
I have taken pain relievers, but they haven't helped, and it is affecting my sleep quality.
I have tried to schedule an appointment with my dentist, but the earliest I can see them is on Saturday.
Currently, both ice and heat applications have been ineffective, and I have increased my water intake and maintained oral hygiene.
Could you please advise what this issue might be and how I can alleviate the discomfort? Thank you, doctor.

judy, 10~19 year old female. Ask Date: 2023/07/04

Dr. Lin Jiayong reply Dentistry


Hello: If you are experiencing severe headaches and neither medication nor hot/cold compresses are effective, it is advisable to rule out any issues beyond ill-fitting dentures.
It is recommended to go directly to the dental or oral surgery department of a medical center in your area for evaluation and treatment (they typically accept walk-in patients).

Reply Date: 2023/07/04

More Info


Severe toothache accompanied by ear pain can be quite distressing and may indicate several underlying issues. Given your situation, where you are undergoing traditional braces treatment and experiencing intense pain radiating to your ear, there are a few potential causes and relief strategies to consider.


Potential Causes
1. Dental Issues: The most common cause of tooth pain that radiates to the ear is a dental issue, such as an abscessed tooth, tooth decay, or gum disease. The pain from these conditions can often be referred to the ear due to the close proximity of the nerves involved.

2. Wisdom Teeth: If your pain is localized to the lower right side, it could be related to your wisdom teeth. Impacted wisdom teeth can cause significant pain and may lead to inflammation that affects nearby structures, including the ear.

3. Temporomandibular Joint (TMJ) Disorders: TMJ disorders can cause pain in the jaw that radiates to the ear. This can be exacerbated by the pressure and adjustments from braces, leading to muscle tension and joint dysfunction.

4. Nerve Pain: Conditions such as trigeminal neuralgia can cause severe, sharp pain in the face and jaw, which may also be felt in the ear.

5. Sinus Issues: Sometimes, sinus infections can cause referred pain to the teeth and ears, especially if there is pressure in the sinus cavities.


Relief Strategies
While waiting for your dental appointment, here are some strategies you can try to alleviate your discomfort:
1. Pain Management: Since over-the-counter pain medications have not been effective, you might consider alternating between acetaminophen and ibuprofen (if you have no contraindications to these medications). This can sometimes provide better pain relief than using one alone.

2. Cold and Warm Compresses: Although you mentioned that ice and heat have not helped, it might be worth trying again. Apply a cold compress to the outside of your cheek for 15-20 minutes to reduce inflammation, followed by a warm compress to relax the muscles.

3. Soft Diet: Stick to a soft diet to minimize chewing and pressure on the affected area. Foods like yogurt, smoothies, and mashed potatoes can be easier to consume without exacerbating the pain.

4. Hydration and Oral Hygiene: Continue to stay hydrated and maintain good oral hygiene. Rinse your mouth with warm salt water to help reduce inflammation and keep the area clean.

5. Avoiding Aggravating Factors: Try to avoid hard or chewy foods, and refrain from clenching or grinding your teeth, which can worsen TMJ symptoms.

6. Relaxation Techniques: Stress can exacerbate pain perception, so consider practicing relaxation techniques such as deep breathing, meditation, or gentle yoga to help manage your discomfort.


When to Seek Immediate Care
If your pain worsens, you develop a fever, or you notice swelling in your face or jaw, it is crucial to seek immediate dental care. These could be signs of a more serious infection that requires prompt treatment.

In conclusion, while waiting for your dental appointment, managing your pain with the strategies mentioned above may provide some relief. However, it is essential to follow up with your dentist as soon as possible to address the underlying cause of your tooth and ear pain. Your dental health is vital, and timely intervention can prevent further complications.

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