Is That Ear Infection Really New Teeth?

by Russell A. Faust, PhD, MD

Like Veterinary Medicine

Infants can’t tell us much – not where it hurts, not how it hurts, not whether the treatment is making it better.

Many pediatricians say that diagnosing infants is like veterinary medicine for these reasons.

Ear infections (otitis media) in infants can be a challenging diagnosis. “Veterinary medicine.”

Most Common Diagnosis of Infancy

Let’s look at a common diagnosis of infancy: Otitis. Ear infections.

Parents bring their infants to their docs saying they think junior has an ear infection.

Why do they think there’s an ear infection? Because:

• junior is running a low-grade fever,
• is drooling,
• is banging on their ears or putting their fingers in their ears,
• is grumpy,
• has not been sleeping well (or at all!)

Let’s look at what happens next in 90% of doctor’s offices:

• The doc looks at junior’s ear drums – to be more accurate, attempts to look at junior’s ear drums.
• Junior is understandably fussy. More than usual. Junior is not feeling well. Does not want this weirdo looking in his/her ears!
• The doc is trying to examine the ears while junior is struggling to get out of Mom’s grasp, or while screaming bloody murder as if a leg has just been amputated without anesthesia.
• The doc maybe gets a brief glimpse of an ear drum. Maybe.

Guess what an infant’s eardrum looks like when they are struggling or screaming – right: it’s red or pink.

• As we are trained to do, the doc adds this all up: (1) low-grade fevers; (2) putting fingers in ears, hitting ears; (3) irritable; (4) not sleeping, and (5) red ear drum!!

Diagnosis? Acute Otitis Media – an ear infection.

Treatment? Antibiotics.

Not to malign doctors (I am one, after all), but this infant is teething. The symptom that was overlooked was drooling.

Don’t get me started on what all those unnecessary antibiotics are doing for developing drug-resistant bacteria!! I’ll save that rant for another blog post.

Teething can, and does, cause ALL of these symptoms.

The symptoms that confuse people are the “putting fingers in ears” or “hitting ears” symptoms. A brief review of the neuro-anatomy of the mandible and ear canal clarifies the situation (I know – nobody wants an anatomy lesson. I’ll make it brief).

Why Does Teething Cause Infants to Dig at Their Ears?

The ear canal and middle ear are innervated by several nerves, including some that also innervate the mandible (jaw) where new teeth are erupting.

These sensory nerves do not provide the same sensation that your fingertips provide. They do not provide accurate, pin-point sensation of pain. The pain sensation is vague, deep. It’s called “visceral” pain.

[For the anatomic drawings of how these areas are related, see earlier article on this blog, "Reflux and Otitis": http://wp.me/pR4iB-fZ]

The pain that some infants feel from teething, or from the back of the throat, or back of the nose, can be perceived as deep ear pain.

Just ask anyone who has experienced the pain from a tonsillectomy. Deep ear pain is the #2 complaint after a tonsillectomy!

Teething infants simply feel that something deep in the region of the ear canal or throat is hurting. The most convenient thing to grab is the external ear.

Maybe the infant thinks, “Hey, maybe if I jab my finger down in there this horrible throbbing pain will stop.”

In my practice it is imperative – essential – that I get a good look at the ear drums of these children. Also important to perform “insufflation” with a puff of air to see how easily the ear drum moves.

Yes, that is challenging with a squirming, screaming infant. I’m not always successful.

But if the ear drum moves – and that’s most of the time - there is no fluid in the middle ear.

No fluid in the middle ear means no acute infection.

In those cases, those symptoms must be from something other than an ear infection.

That is worth repeating: Not an ear infection.

MANY of the infants who are sent to me to put “ear tubes in” are merely experiencing teething symptoms.

Most of the time it is teething pain!

So – What To Do About It?

Calming a teething baby is a bit like trying to calm a colicky baby.

Challenging.

See Dr. Greene’s blog post on teething pain for an excellent description of mainstream medicine’s approach to the problem (in Resources, below). I can’t improve on his comments so I won’t bother to repeat them here.

Since there are so few resources for natural options, let’s review some here:

Some Natural Options

Chamomile

Chamomile is soothing, calming. Make an herbal tea with Chamomile:

• steep 1 teaspoon chamomile in 1 cup hot water for 10 minutes
• strain, cool
• 1 ounce every few hours for soothing effect

Topical Treatment

• place 1-2 drops of clove essential oil in 1 tablespoon vegetable oil
• apply to gums with cotton swab every couple hours for soothing effect

Aromatherapy

• Calming, soothing essential oils include lavender, chamomile, and lemon balm
• Place 2-3 drops in a steam vaporizer water for soothing effect

See earlier post on this blog regarding what to look for when buying a humidifier: http://wp.me/pR4iB-2X

Use CAUTION when setting up your steam vaporizer if you have infants or young children – keep it out of reach to prevent burns!

Keep essential oils AWAY from infants and children. They can be toxic if ingested in quantity.

That’s it.

If your little boogorhead is unusually grumpy, digging at their ears, drooling, and running a low-grade fever, consider teething as the cause. Consider trying some natural remedies to make things more comfortable for junior.

You might avoid a set of ear tubes!

These might also help you get some sleep.

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Until next time, remember … you can pick your friends, and you can pick your nose, but you can’t pick your friend’s nose (unless you’re a boogor doctor :~D)

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Resources

From littlestomaks.com, Do Milk Allergies Cause Ear Infections?: http://bit.ly/drUZYK

Dr. Greene’s blog post on teething pain: http://www.drgreene.com/qa/teething-pain

Image Credit: slinky789, on Flickr.com: http://www.flickr.com/photos/slinky789/4382012585/

For the Creative Commons image use guidelines: http://creativecommons.org/licenses/by-nc-nd/2.0/deed.en

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Tags: anatomy, drooling, ear drum, fever, natural, natural remedy, otitis, otitis media, teething, tympanic membrane