Dental_Pain. _Referred_to_Ear.pptx

Dental_Pain

1. Dental Pain Referred to the Ear Understanding Referred Otalgia in Dental Practice By: [Your Name]

2. Introduction - Ear pain (Otalgia) is a common complaint. - Sometimes, the ear is normal but pain comes from nearby structures. - This is called Referred Pain.

3. Definition Referred Otalgia: Pain felt in the ear although the source lies outside the ear, such as in teeth, TMJ, throat, or neck.

4. Neural Basis - Shared nerve supply between teeth and ear. - Mainly via Trigeminal nerve (CN V). - Also: Vagus (CN X), Great auricular, Glossopharyngeal (CN IX).

5. Mechanism - Sensory fibers from teeth and ear converge in brainstem. - Brain cannot localize exact source → Pain felt in ear.

6. Common Dental Causes 1. Pulpitis 2. Periapical abscess 3. Periodontal infections 4. Impacted wisdom tooth 5. Cracked tooth or trauma

7. Teeth Commonly Involved - Lower molars (especially 3rd molar) - Premolars - Occasionally upper molars (sinus involvement)

8. Clinical Features - Ear pain with normal ear exam. - Pain worsens by chewing. - Sensitivity to temperature. - Pain radiates to temple or jaw.

9. ENT Findings - Normal external/middle ear. - No discharge or redness. - Pain persists despite ear drops → Suspect dental cause.

10. Differential Diagnosis Dental origin: tooth sensitivity, swelling TMJ disorder: clicking, limited opening Throat infection: sore throat, dysphagia True ear disease: discharge, hearing loss, fever

11. Diagnostic Approach - Take dental & medical history. - Oral exam & percussion. - Radiography (OPG). - Refer to dentist if ENT normal.

12. Treatment - Treat underlying dental problem: - Root canal (pulpitis) - Extraction/drainage (abscess) - Analgesics for pain. - ENT + Dentist collaboration.

13. Case Example 32-year-old female, right ear pain, normal ear exam. → OPG: periapical abscess of lower molar. → Root canal performed → Pain resolved.

14. Complications - Unnecessary antibiotics. - Delayed dental care. - Spread of infection to neck spaces.

15. Prevention - Consider dental origin in unexplained ear pain. - Promote ENT-Dental cooperation.

16. Summary - Referred otalgia = ear pain from non-ear source. - Common dental causes: pulpitis, abscess, impacted tooth. - Careful history & dental exam essential.

17. References 1. Zakrzewska JM. Referred Otalgia: A Dental Perspective. 2. Scully C. Oral and Maxillofacial Medicine. 3. Bhatia K. Referred Ear Pain: Clinical Review.