Short answer: Yes, a toothache can radiate to the ear. Because the teeth, the jaw and the area around the ear receive sensation from the same nerve (the trigeminal nerve), pain coming especially from the lower and upper molars can be felt in the ear, the temple or the head. This is called referred pain. Deep cavities, inflammation of the tooth nerve, abscesses, wisdom tooth inflammation and jaw joint problems are the most common causes. Telling them apart requires an examination.
Does your ear hurt, yet the ear examination shows nothing wrong? Or has an ache that started as a toothache gradually spread to your ear and temple? This is a very common situation, and it brings the same question to many people's minds: can a toothache cause ear pain? The answer is yes; because of the nerve connections of the mouth, jaw and ear region, pain originating in a tooth can be felt in the ear. In this article we look at why this happens, which teeth can cause ear pain, how to tell it apart from an ear infection, the role of wisdom teeth and the jaw joint, and the treatment options.
Why does tooth pain radiate to the ear?
Tooth pain radiates to the ear because the teeth, the jawbones, the jaw joint and the area around the ear largely receive sensation from the same nerve, the trigeminal nerve, which is the fifth cranial nerve. The brain cannot always pinpoint exactly where pain signals arriving along the same nerve pathway come from. As a result, inflammation in a tooth may be felt in the ear, the temple or another part of the face. This is known as "referred pain."
The branch of the trigeminal nerve that goes to the lower jaw is linked with fibers supplying sensation to both the lower teeth and the area in front of the ear and the jaw joint. That is why pain from the lower molars in particular is often felt in the ear. Pain from the upper molars, on the other hand, can spread to the temple, around the eye or to the sinus area.
Referred pain can sometimes be so pronounced that a person does not notice any problem with the tooth and complains only of ear pain. For this reason, an examination of the teeth and jaw should also be part of the evaluation of unexplained ear pain.
Which teeth cause ear pain?
The teeth that most often cause ear pain are the lower and upper molars at the back of the mouth and the wisdom teeth. Pain from the front teeth radiates to the ear less often.
The main dental problems that can cause pain radiating to the ear are:
- Deep cavity: When decay approaches the tooth nerve, pain may appear that is triggered by hot, cold or sweet foods and over time starts on its own.
- Inflammation of the tooth nerve (pulpitis): It can cause throbbing, spreading pain that tends to get worse at night. The person may not be able to point exactly to the tooth the pain is coming from.
- Tooth abscess: An infection at the root tip; it may come with pain when biting, swelling and sometimes fever.
- Cracked tooth: It can cause sudden, sharp pain when chewing; it is sometimes difficult to diagnose.
- Gum and root surface problems: Advanced gum disease and gum abscesses can also cause spreading pain.
How can it be told apart from an ear infection?
Accompanying symptoms can offer clues when distinguishing tooth-related pain from an ear infection; however, the definitive distinction is made by examination. Ear-related pain is more often accompanied by a feeling of fullness in the ear, reduced hearing, ear discharge and fever. Pain that increases when the outer ear is touched or pulled may also suggest inflammation of the outer ear canal.
Signs that may point to tooth-related pain include:
- Pain that starts or worsens with hot, cold or sweet foods,
- Pain that becomes more noticeable when chewing and biting,
- Tenderness when a tooth is lightly tapped or pressed,
- Swelling, a bump or a bad taste in the gum area,
- Pain that gets worse at night and when lying down,
- A normal ear examination.
Sinusitis can also cause pain in the upper molars and be mistaken for a toothache; in that case there is usually tenderness in more than one tooth, a feeling of pressure that increases when bending forward, and nasal congestion. In addition, pain spreading to the jaw and ear region can, in rare cases, come from the heart; jaw pain that appears together with chest pain, shortness of breath or sweating requires going to the emergency room without delay.
How do wisdom teeth and the jaw joint affect ear pain?
Because they sit close to the ear, wisdom teeth and the jaw joint are among the most common dental sources of ear pain.
Wisdom tooth
When the gum around a partially erupted wisdom tooth becomes inflamed (pericoronitis), the pain often spreads to the ear, the throat and the side of the face. This may be accompanied by limited mouth opening, pain when swallowing, a bad taste and swelling in the cheek. An impacted wisdom tooth pressing on the tooth in front of it or developing decay can cause similar complaints.
Jaw joint
The jaw joint (temporomandibular joint) sits just in front of the ear. Inflammation in this joint, problems with the disc inside the joint or excessive tension in the jaw muscles can feel like ear pain. Jaw joint pain commonly comes with the following signs:
- Pain in front of the ear that increases with chewing and speaking,
- A clicking sound or grinding sensation when opening and closing the mouth,
- Limited mouth opening or the jaw getting stuck,
- Jaw and temple pain that is more noticeable in the morning (especially with teeth clenching and grinding),
- A feeling of fullness or ringing in the ear.
Bite problems, a clenching habit and stress are among the factors that can make jaw joint complaints worse.
How is it treated?
Treating tooth pain that radiates to the ear depends on correctly identifying the source of the pain; once the cause is treated, the ear pain usually goes away as well. The dentist identifies the source of the pain through a clinical examination, simple tests on the teeth and X-rays.
- Cavity: The decay is removed and a filling is placed.
- Tooth nerve inflammation or abscess: Root canal treatment is often performed to save the tooth; if the tooth cannot be saved, extraction may be necessary.
- Wisdom tooth inflammation: The area is cleaned and medication is given if needed; in recurring cases, extraction of the tooth is considered.
- Cracked tooth: Depending on the depth of the crack, a crown, root canal treatment or extraction is considered.
- Jaw joint problems: Jaw rest, a soft diet, warm compresses, a night guard, physical therapy and, if necessary, treatments addressing the bite can be planned.
If you use a pain reliever until you can see a dentist, follow the advice of your doctor or pharmacist and do not place the medication directly on the gum; this can burn the tissue. Pain relievers ease the pain temporarily but do not remove the cause. Symptoms such as rapidly increasing swelling in the face or neck, high fever, or difficulty swallowing or breathing require going to an emergency facility without waiting. For other questions about toothache, you can visit our frequently asked questions page.
When should you see a dentist in Ankara for tooth pain spreading to the ear?
If your ear pain started together with a toothache, gets worse when chewing or with hot and cold, or if you were told that the ear examination found no problem, a dental examination helps clarify the source of the pain. At our polyclinic in Oran, Çankaya, next to Panora Mall, your teeth, wisdom teeth and jaw joint are evaluated together; if an ear-related problem is suspected, you are referred to the appropriate specialist.
Frequently asked questions
Which toothaches radiate to the ear?
Pain radiating to the ear most often comes from the lower and upper molars and the wisdom teeth. Deep cavities, inflammation of the tooth nerve, abscesses and inflammation around a partially erupted wisdom tooth are among the main causes of this kind of pain.
How can I tell whether it is ear pain or tooth pain?
Pain that increases with hot, cold or chewing and becomes more noticeable when a tooth is touched may be tooth-related. Ear discharge, hearing loss, fullness in the ear and fever suggest an ear infection. A definitive distinction requires an examination.
Can the jaw joint cause ear pain?
Yes. Because the jaw joint sits just in front of the ear, pain from the joint and the surrounding muscles can feel like ear pain. Pain that increases with chewing, sounds from the jaw and limited mouth opening may point to this condition.
What should I do when a toothache radiates to my ear?
It is advisable to see a dentist as soon as possible to identify the source of the pain. Pain relievers can bring temporary relief but do not treat the cause. If there is facial swelling, fever or difficulty swallowing, go to an emergency facility without waiting.
