Q: Each time I chew, I get a sharp pain in my left ear. What causes this and what I can do to alleviate it?

A: There are two common sources of ear pain when you chew.

The first comes from a problem with the ear canal. If the ear canal is swollen and tender from an infection, chewing will put pressure on this tender tissue and cause pain. The pain can be very intense.

The other common source of ear pain is inflammation in the jaw joint. Chewing puts pressure on the joint and produces the pain, which feels like an earache.

Treating an ear canal infection starts with antibiotic eardrops. Sometimes oral antibiotics are necessary if the infection is severe. Keeping water out of the ear also helps recovery.

If the pain is from an inflamed jaw joint, the standard treatment is to apply heat to the area with a heating pad or hot water bottle. You may also need to eat soft foods and take an anti-inflammatory medicine like ibuprofen. If the symptoms continue, you may need to visit a dentist for a mouth guard. In severe cases, further treatment by a temporomandibular joint specialist is necessary.

David Vernick, M.D., is assistant clinical professor of otology and laryngology at Harvard Medical School and interim chief of the Division of Otology and Laryngology at Beth Israel Deaconess Medical Center.

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