My Aching Ear

My Ear Hurts! What Does This Mean?


ear-pain2“My ear hurts but I have gone to the doctor several times begging for an antibiotic and he keeps telling me that my ear looks fine!”
This is more common than you may think.  Many of my patients have complained about this.  They present with severe ear pain and pressure, some eye pain or pressure, pain around the temple area, and sometimes sensitive upper teeth.  How could this not be an infection of some sort….right?  Well the truth is, you may be suffering from temporal tendonitis.

What is Temporal Tendonitis?

Temporal tendonitis is a craniofacial pain disorder which results in the inflammation of the temporal tendon which connects the temporalis muscle on the side of the head to the mandible, or lower jaw, on the coronoid process.

temporal-tendon
Temporalis Muscle attaches to the lower jaw (mandible) on the Coronoid Process by the Temporal Tendon

After our examination, I usually discover signs of occlusal wear on a patient’s teeth, possible arthritis occurring in a patients joint, or a history of clenching.  All of these, and other predisposed conditions, can contribute to temporal tendon inflammation.

If a patient has an irritated temporal tendon prior to a dental procedure (or any of the other reasons listed above), it is more likely that they will develop a tendonitis after the procedure is completed (or after taxing the tendon through normal function: yawning, eating, etc).

What Causes Temporal Tendonitis?

You may develop temporal tendonitis from:

  • Trauma to the side of your face/head
  • Being opened really wide for a long period of time for a dental procedure
  • Yawning really wide
  • Eating very hard foods
  • Loss of vertical dimension of occlusion (the distance between your nose and chin is shorter than it was when you were younger – you are becoming over-closed)
  • Chronic parafunction (your bite is off and your teeth do not come together appropriately)
  • Hypertrophy of the coronoid process (your coronoid process, a part of your lower jaw, becomes larger than it once was)

Temporal Tendonitis Symptoms

If you have one or more of the causes of temporal tendonitis listed above and experience one or more of these symptoms, it’s time to give us a call:

  • TMJ pain
  • Eye pain
  • Ear pain and pressure or congestion
  • Limitation in opening the mouth
  • Pain/pressure behind the eye
  • Temporal head pain that can radiate to the forehead
  • Pain and/or swelling in the cheek
  • Sensitivity of the teeth, particularly the upper maxillary teeth

How Do You Treat Temporal Tendonitis?

Treatment of temporal tendonitis can involve multiple processes such as:

  • Anti-inflammatories like ibuprofen
  • Muscle relaxants
  • A soft diet
  • Splints/orthotics
  • Physical therapy
  • Biofeedback if clenching related
  • Injection therapy with a long lasting local anesthetic and a steroid, sarapin, or prolotherapy

Temporal tendonitis is harder to treat through medication alone.  We have several ways that we treat this condition successfully in our practice every day.  Proper diagnosing is crucial and allows us to create your ideal treatment plan.

If you believe that you may be suffering from Temporal Tendonitis, we can help you! Call us today for an evaluation and treatment and be done with that ear pain once and for all!

Dr. Tracy Davidian

Fellow of the American Academy of Craniofacial Pain

Fellow of the Las Vegas Institute of Neuromuscular Dentistry

919-366-PAIN (7246)

How can a Dental Appliance help my Migraines go Away?

One of the first questions patients ask me when they are at my office for their New Patient or Consult appointment is: “How can a Dental Appliance help my Headaches/Migraines go Away?”  The simplest way to explain this is by having them imagine a Bucket.  We each have our own Buckets that are filled with our daily intakes.  For example, if you drink coffee every morning….that cup will go into your daily bucket.  If  you drink a glass of wine every night….it to will go into your bucket.  Other things that get poured into our individual daily buckets are: stress, lack of sleep, food allergies, allergies in general, monthly hormonal changes, temporomandibular joint or facial muscle issues, etc…  What happens when your bucket gets full of daily intake?  For a lot of my patients, they develop headaches or migraines.  These headaches/migraines can be debilitating for a lot of my patients.  It, in fact, is what brought them to my office in the first place.  So back to the question: How can a Dental Appliance Help My Headaches/Migraines go Away?…..   It has been proven that by repositioning the lower jaw in a down and more forward position, that the muscles of the face begin to relax.  They are no longer constricted and in spasm; thereby, reducing headaches/migraines.  Now how does this relate to the bucket?  It is a wonderful thing for my patients, and for others that suffer from headaches/migraines, that by repositioning and relaxing the muscles of the face…. a huge portion of the bucket is emptied.  This is Fantastic!  My patients have fewer, if any, headaches/migraines with this treatment.  And, I’m referring to my Many patients who have had debilitating, in the corner, lights off Migraines for many years…….they are now gone or Greatly Reduced.  Will you ever have another headache/migraine with this treatment?  Well sadly, the answer is probably yes.  Occasionally.  However, you are Always in Control of what You put into Your Daily Bucket.  If you are filling it with EVERY Trigger you have, then chances are you will get a headache….  The power is still in Your Hands.  But isn’t it Fabulous to know that You are In Control?  An Occlusal Appliance will Help to Give you that Control….and in turn, help to Give you Your Life Back.  Call Now……Physiologic Aesthetics is Where the Pain Ends and Your New Life Begins!   919-366-PAIN