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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes recurrent earache along with toothache?

lets see. I ve had an ache in my right ear off and on for 3 weeks and now constantly. That goes with the fact that a piece of my lower (2nd from the rear of my mouth) molar tooth broke off two weeks ago and now I ve got the tooth pain. I may be suffering from depression as well, but that s not been diagnosed. On top of that I am living with HIV, but my last counts were viral load below detection and my cd4 count was 716. The pain subsides periodically, usually around 5-10 minutes after it starts; going 6-10 hours in between the pain: then nothing, it went away for 3 days. Now, after it flares up; lasting up to a 10-20 minutes it does really go away. my eye discharges fluid and my jaw and temples feel like they want to explode or implode. should I consider this life threatening or is it just a stupid headache?? Keep in mind that I have a sibling who also has HIV and he has been diagnosed with micro or mini-strokes?
Wed, 3 May 2017
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Dentist 's  Response
Hi..
Thanks for the query..

You symptoms of having episodes of severe pain is pointing towards nerve related pain and most probably it is Trigeminal Neuralgia as it is the nerve of face and your symptoms are very much consistent with it..

Although you have a decayed tooth and it might also be painful but this episodic pain is appearing to be due to trigeminal neuralgia only..
Your CD4 counts are considerable as of now you need not to worry about HIV relating to this..

You should consult an Oral Physician and get your broken tooth examined with the help of x ray..

If it is broken vertically then it might need extraction or else Root Canal treatment and capping can save the tooth.

For this episodic pain if it does not subside with treatment of tooth then you should see a Neurophysician as they can advise you MRI scan and if neuralgia is diagnosed he can advise you neurotic painkillers that commonly help with such pain like Carbamazipine [Tegretol] , Oxycarbazipine [Trileptal] and Gabapentin [Neurontin] etc.

For now you can take painkillers like Ibuprofen [Advil] but if pain is severe Tramadol [Ultram] can be taken for relief..

Hope this helps..

Regards.
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