I have vivid memories of my last earache. My fiancé (and current wife/partner/great Mom to my kids) and I had retreated to the hill country for a few days so that I could study for my national
dental board exams. It was summertime and we headed to a hunting lease in Junction for a quiet July 4th holiday. At some point, we took a study break and went swimming in a big stock cistern that we had sanitized with a few gallons of bleach. A few hours later, my ear started to throb. A few more hours and I was miserable.

Luckily, Junction had an emergency room and a doc on call. I rolled in at 8:00 am on Independence Day for an exam, a painful poke in the ear, and the prescriptions that followed. My next
problem was that we had to bother the pharmacist to come in and dispense the prescriptions. After a long rest of the day, the Vicodin and antibiotics began to work and I returned to my studies. A few weeks later, our trip paid off and I passed my first round of boards.

So why does an earache hurt so much? Also, what makes a toothache so painful? The answer to both questions has to do with our bodies’ response to damage or infection…inflammation.

Our body’s reaction to injury almost always involves the process of inflammation. To make a long story short, damaged tissue swells as a side effect of being repaired. The growth of an infection can also cause fluid or pus to build up in damaged areas of our bodies. Now take all these cells coming to save the day, add in some fluid and a few colonies of bacteria and things start to get crowded. On top of all that, lock these conditions into a tight space (the inside of a tooth or ear canal) and things can get painful…fast. I remember that earache vividly.

The intense, throbbing pain of a toothache has much to do with swelling in an enclosed space.  Eventually, this swelling will burst into more space and be relieved. This stops the pain short term, but sets up an even greater infection, commonly called an abscess. If left untreated, an abscess can spread even further and cause systemic (full body) health problems. Oral antibiotics often work short term, but the abscess will always return until the source (the infected tooth) is treated. A toothache is a suggestion to get something done.

A bad toothache causes pain that is not easily forgotten. Just one more reason to brush and floss daily.

Also, be careful where you swim.

Until next time, keep smiling.

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