Several years ago, I came down with an ear infection. The pain was so excruciating that I could barely tolerate the doctor gently placing the otoscope into my ear to check it out.
I remember thinking, No wonder my kids lose their poor, little minds when they have an ear infection!
I had so many ear infections as a baby that I started getting complications from the antibiotics that I took to get rid of them. I must have passed down a proclivity for ear infections because both of my daughters got them regularly. The number of hours I spent cuddling and soothing my daughters while they suffered from ear infections is far too many to count.
During their first few years, it felt like we were often in the doctor’s office, hearing that ever-so-familiar, “Yep, this one’s infected.” Once they started teething at around 6 months, it was sometimes difficult to know whether they were hurting because they had a new tooth coming in or if it was, in fact, just another ear infection.
My ear infection as an adult was uncommon and I’ve only had that one, thank goodness! Babies and toddlers are far more susceptible to ear infections and some people think that teething can be a culprit.
But is teething really one of the causes of ear infections or is that just a myth? Let’s dive in.
Can Babies Get Ear Infections from Teething?
The pain associated with a tooth that is cutting through the gums can radiate to the ears and be very painful. In addition, the excessive drooling that comes with teething can irritate the eustachian tubes which can then bother the inner ear.
Some babies who have these symptoms from teething may pull or tug on their ear, which is also a symptom of an ear infection. While the pain in their ear is very real and the symptoms can overlap, teething does not cause an actual ear infection.
Why Parents Often Mistake Teething for Ear Infections
Acute otitis media (AOM) also known as an infection of the middle ear is the second most common diagnosis in emergency rooms. In fact, the American Academy of Pediatrics (AAP) says that most children will have an ear infection by the time they’re three years old.
The ear has three parts, the outer ear, middle ear, and inner ear. There is a narrow tube called the eustachian tube that connects the middle ear with the back of the nose. When a child has a cold, upper respiratory or throat infection, or allergy, the mucus can enter the eustachian tubes, causing a buildup of fluid in the middle ear.
In babies, the eustachian tubes are more narrow and horizontal, making buildup and infection easier. Add to that their still-developing immune systems, and it’s easy to see why babies and toddlers have such a high risk of ear infections.
When your little one is tugging at their ear, you might be tempted to assume it’s an ear infection. And it’s a good guess considering how common they are in childhood, but like most things in parenting, it’s not quite that simple. The time when children are most vulnerable to ear infections also happens to be prime time for teething.
Nerves from the back teeth are closely connected to the ear, likely tiny tree branches reaching toward the ear canal. As your baby’s teeth come in and ignite those nerves, it can feel as though the pain is coming from the ear. Because the timing and symptoms of both teething and ear infections overlap, it’s important to know some of the key differences.
How to Tell if Your Baby Is Teething or Has an Ear Infection
As baby teeth push their way toward the surface of the gums, it can be painful, causing a myriad of symptoms. The first teeth typically make an appearance around 6 months and most children have a full set of baby teeth by the time they’re 3. There are many signs and symptoms to tell you when your baby is teething.
Symptoms of teething:
- Excessive drooling
- More fussiness than usual
- Increased chewing, biting, or sucking (aka, putting everything in their mouths!)
- Redness, irritation, or a rash due to extra saliva on your baby’s chin or cheeks
- Red, swollen, or bulging gums
- Changes in appetite
- Teething blister or eruption cyst (buildup of fluid on the gum that usually goes away without treatment)
- Rubbing cheeks or the side of their face, tugging on ears
Although teething happens beneath the surface, there are usually some visual cues in the child’s mouth that a tooth is ready to erupt. With an ear infection, there’s no way to see inside the ear with the naked eye, but there are some symptoms that can help.
Symptoms of ear infections:
- Ear pain and discomfort that worsens when lying down
- Tugging or pulling at an ear
- Trouble sleeping
- Crying more than usual; increased fussiness
- Loss of or reduced appetite
- Fever of 100° (38° C) or higher
- Hearing loss; trouble hearing and responding to sounds
- Loss of balance
- Fluid draining from the ear
Ear infections are often associated with an illness of some kind, but they can occur when your child appears healthy, making things even more confusing. I once took my youngest in for her yearly checkup and she was promptly diagnosed with a double ear infection. Needless to say, I was wracked with mom guilt and admiration for my daughter’s toughness.
Since ear infections occur more frequently with a cold or upper respiratory infection, that can be one of the biggest differentiators between them and teething. Since the Eustachian tubes of infants and young children are so soft and still developing, they can have a harder time staying open and dry. Allergies, post-nasal drip, adenoid issues, and viral infections can all interfere with the health of your child’s ear.
While a teething baby and a baby suffering from an ear infection can have similar symptoms, there are some differences that can help you know when to call your pediatrician. Namely, if your child has a fever, you notice fluid draining from their ear, or you notice hearing loss, it’s a good idea to contact the doctor.
When your baby has an ear infection, it can be agony for both your child and you. Anytime your little one is sick, it’s more important than ever that they’re getting enough fluids. Offer more opportunities to eat, whether nursing or bottle feeding.
If you notice repeated ear infections, you might ask your pediatrician if a tympanostomy tube is an option for your child. Tympanostomy tubes are tiny ear tubes that are inserted into the eardrum to allow for proper drainage and prevent buildup.
How to Soothe a Teething Baby’s Ear
When the likely culprit of your baby’s ear pain is teething, there are a few things that you can do to relieve the discomfort. Some of the same remedies for teething can also help relieve ear pain associated with it.
1. Warm compress
Try holding a hot water bottle (or warm water bottle in this case) or a warm, damp towel against the side that’s bothering your little one.
2. Hair dryer
Yep, you read that right… a hair dryer! After bathtime, briefly blowing warm air (set on low) toward your baby’s ears can be helpful in two ways.
First, the warm air can be soothing for an aching eardrum. Second, it can help to dry out the ear canal. Pooled water in the outer ear can lead to germs and bacteria growth which can cause otitis externa, commonly known as swimmer’s ear.
3. Gum massage
With a clean finger, gently rub your baby’s gums. The pressure can provide some temporary relief.
4. Teething toys
Plastic and rubber toys that are safe for your baby to chew on can soothe swollen gums.
5. Cold helps
While warmth can soothe an achy ear, you can use cold to soothe swollen gums. Cold helps with inflammation and pain. A cold or frozen wet washcloth or teething ring can work wonders.
6. Pain medication
When the home remedies aren’t doing the trick, ask your pediatrician for some safe pain relief options. These may include acetaminophen like Tylenol or ibuprofen such as Motrin.
If you choose an oral teething gel, be sure that it’s free of benzocaine, like Dr. Talbot’s.