[31F] Experiencing severe dental and ear pain with associated symptoms

Patient Description

A 31-year-old female presents with a constellation of symptoms including severe tooth pain described as sharp, throbbing, and excruciating, particularly in relation to a previous root canal with a cap that recently fell off. The patient also reports a sharp, stabbing, and throbbing ear pain with associated ringing, which has been persistent for over a month and is on the same side as the dental pain. Additionally, she experiences neck pain with a sore and tender sensation, stiffness, and a feeling of a lump, rated 8 to 10 in severity. The patient has noticed facial puffiness around the chin, eye pain with constant tearing, and blurry vision in the right eye, alongside a new floating black spot in the other eye. Symptoms are exacerbated in the evening around 7 to 8 pm. The patient also mentions fatigue, stomach pain, and occasional nausea. She has a history of fibromyalgia and arthritis diagnosed in 2022 and is allergic to neomycin. No current medications are being taken. The patient has had past dental infections and complications requiring treatment.

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Arora's Assessment

What might be happening

Based on the information you provided, the following conditions might be considered:

  • Dental Abscess: This is an infection at the base of a tooth, and it can cause severe, persistent, throbbing pain that can radiate to the ear and neck. Other symptoms can include sensitivity to hot and cold, fever, and a tender, swollen lump on your gum.

    • Treatment typically involves draining the abscess and getting rid of the infection, which can be done through root canal treatment, tooth extraction, or antibiotics.
  • Temporomandibular Joint Disorders (TMJ): These are problems affecting the 'chewing' muscles and the joints between the lower jaw and the base of the skull. It's been known to cause pain in the ear, face, jaw, and neck.

    • Treatment can range from non-invasive therapies and self-care to surgery.
  • Trigeminal Neuralgia: This condition affects the trigeminal nerve (one of the most widely distributed nerves in the head), and can cause extreme, sudden burning or shock-like facial pain that lasts anywhere from a few seconds to as long as 2 minutes per episode.

    • Treatment options include medications, injections, and in some cases, surgery.
  • Sinusitis: This is an inflammation or swelling of the tissue lining the sinuses, and can result in symptoms such as facial pain or pressure, nasal stuffiness, nasal discharge, loss of smell, and congestion or cough.

    • Treatment usually involves self-care measures, managing symptoms, and in some cases, antibiotics.

What you can do

  1. Seek immediate medical attention: Given the severity and duration of your symptoms, it's important to see a healthcare provider as soon as possible for a proper diagnosis and treatment.

  2. Over-the-counter pain relief: Non-prescription pain relievers can provide temporary relief for your pain. However, they should not be used as a long-term solution, and you should see a healthcare provider for a proper diagnosis and treatment.

  3. Warm compresses: Applying a warm compress to the painful area may help reduce pain and inflammation.

What you should look out for

  • If your symptoms worsen or don't improve, seek immediate medical attention.
  • If you develop a fever, this could be a sign of an infection and you should seek medical attention immediately.
  • If you experience difficulty breathing or swallowing, seek immediate medical attention.

Please remember that while I strive to provide accurate information, I'm not a doctor and this advice should not replace a consultation with a healthcare provider.

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10 mo ago

People Also Ask


What are the common symptoms of a dental abscess?

Common symptoms of a dental abscess include severe, persistent, throbbing pain in the affected tooth or surrounding area, sensitivity to hot and cold, fever, swelling in the face or cheek, and a tender, swollen lump on the gum.


How can temporomandibular joint disorders (TMJ) affect other areas of the body?

Temporomandibular joint disorders (TMJ) can cause pain in the ear, face, jaw, and neck. They may also lead to headaches, difficulty chewing, and a clicking or popping sound when opening or closing the mouth.


What are the treatment options for trigeminal neuralgia?

Treatment options for trigeminal neuralgia include medications such as anticonvulsants and muscle relaxants, injections to block nerve pain, and in some cases, surgical procedures to relieve pressure on the trigeminal nerve.


How can sinusitis lead to facial pain and pressure?

Sinusitis can lead to facial pain and pressure due to the inflammation or swelling of the tissue lining the sinuses. This can cause congestion, nasal stuffiness, and a feeling of fullness or pressure in the face, particularly around the eyes and forehead.


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