Dear Readers,

Milton S. relates his story to Lifeline about a recent health- related experience. He visited Canada and, while there, experienced a terrible earache and dizziness. It got so bad that he had to seek medical help. He was told that it was an ear infection and congestion and was treated with antibiotics, DPH and Gravol. His condition only marginally improved and, when he returned to Jamaica 10 days later, he visited an ear, nose and throat (ENT) specialist who told him that he had tempero-mandibular joint (TMJ) Dysfunction, but his ears were okay.

When the pain and dizziness persisted, his general practitioner suggested he visit a dentist. The dentist took pictures of his teeth and diagnosed an upper molar tooth abscess on the same side as the terrible earache. At a significant cost, the dentist drained the tooth abscess and the severe ear pain was immediately relieved and dizziness resolved. Milton asks Lifeline how come he had no significant toothache at all, only an earache and dizziness which was cured by dental work. He finds this amazing!

Earache can occur because of several reasons which do not necessarily include an ear problem. One third of individuals who visit ENT doctors complaining of ear pain have no identifiable ear disease. In fact, many complaints of 'ear pain' occur because of tooth decay. The real problem then, is to determine the actual cause of the ear ache. As was very apparent with Milton, until the real cause is determined and appropriate treatment given, the pain will persist.

Although most nerves will send pain signals only to an affected area, sometimes the pain signal is also sent out to other unaffected areas supplied by the same nerve. This is called 'referred' pain. The upper molars and ears share the same nerve source and, therefore, the pain from the sick tooth can occur in the totally healthy ear. When ear pain occurs after a recent dental procedure, chances are that the pain is related to the tooth involved. However, do not rule out the possibility of both ear and tooth being infected at the same time. This also can occur.

Conditions which can cause earache are:

Dental abscesses

Dental caries (rotting teeth)

A broken tooth or other tooth injury

Tooth impaction

Sinusitis

Gingivitis (inflamed gums)

Tempero-mandibular joint (TMJ) syndrome (jaw joint)

As occurred with Milton, pain originating from problems which affect the roots of a tooth can manifest in the mouth but be felt at the jawline and in the ear. Impacted wisdom teeth can also cause ear pain. TMJ disorder resulting in wear and tear in the TMJ cartilage, or even TMJ dislocation, can also result in ear pain, and clenching and grinding the teeth will make both the condition and the pain worse.

For best results, see your family physician first. This medical professional will examine and assess the situation for best specialist referral, if needed.

Write to: LIFELINE, PO BOX 1731, KGN 8

AJM