Patients frequently present with mysterious pain or other symptoms in the head and jaws, which they do not associate with jaw dysfunction (TMJ-TMD). Recently a woman presented with the primary complaint of ear pain. Thinking she had an ear infection, she sought care from her primary physician and an ENT (ear, nose, and throat physician). Both assured her there was no evidence of infection but they did not have an explanation for the pain and gave no recommendation for treatment. She explained to me that although her jaw joints clicked and popped, she did not experience jaw joint pain or limitation of movement. She had come to see me on recommendation of a friend and was uncertain how a dentist could help her ear pain.
The explanation of the mysterious ear pain is actually well understood. The ear pain was what we call “referred pain” resulting from pinching of a branch of the auriculotemporal nerve as it passes thru the temporomandibular joint on its way to the inner ear. Treatment of the underlying jaw dysfunction resulted in relief of her chronic ear pain.
One of the challenges to effective treatment of chronic head and jaw pain is proper diagnosis of the cause, which is often not immediately apparent.
