When the ear hurts but the ear is fine: the link between the jaw joint and ear pain
The jaw joint sits right in front of the ear canal, so when there is a problem with the jaw joint or chewing muscles, it can feel as if the ear hurts. In Korea, Seoul National University Hospital's medical information explains that some patients with temporomandibular disorder (TMD) complain of pain in front of and inside the ear, tinnitus and dizziness. However, diseases of the ear itself produce the same symptoms, so it is important to have both an ear exam and a jaw exam to sort out the cause.
Key facts
| Pain sites in TMD | Jaw, ear, head, face (source: KDCA National Health Information Portal) |
|---|---|
| Ear symptoms in TMD | Pain in front of and inside the ear, and tinnitus and dizziness in some patients (source: Seoul National University Hospital) |
| Tinnitus and the jaw joint | A jaw joint problem is one cause of sounds produced inside the body (objective tinnitus) (source: KDCA National Health Information Portal) |
| Conditions linked to tinnitus | Noise exposure, hearing loss, otitis media, chronic sinusitis, jaw joint problems, depression, stress (source: KDCA National Health Information Portal) |
| Basic tinnitus exam | The eardrum exam is the most basic and essential test (source: KDCA National Health Information Portal) |
Why does the ear hurt when the problem is the jaw?
In the jaw joint, the rounded head of the lower jawbone sits in a hollow of the skull in front of the ear, so it is very close to the ear. So when the jaw joint becomes inflamed or strained, the pain can feel as if it is in front of or inside the ear.
In Korea, the National Health Information Portal lists the jaw, ear, head and face together as pain sites of TMD. Seoul National University Hospital's medical information explains that when chewing food or yawning, pain is felt in the lower jawbone in front of both ears and in the chewing muscles. If ear pain changes with mouth movement, that is a clue to suspect the jaw joint.
How do I tell ear pain from the jaw apart from an ear disease?
If ear pain gets worse when chewing, yawning or opening the mouth wide, hurts when you press in front of the ear, and comes with jaw sounds, a jaw joint cause can be considered. Conversely, if pus or fluid comes out of the ear, you have a fever, or you suddenly cannot hear well, the possibility of an ear disease must be checked first, so an ENT visit comes first.
It is hard to separate the two completely by symptoms alone. Use the signals below as a reference, but if ear pain continues, confirm with an exam.
- Signs pointing to the jaw: worse when chewing, tenderness in front of the ear, jaw sounds, jaw stiffness in the morning
- Signs pointing to the ear: ear discharge, fever, a sudden drop in hearing, itching and swelling inside the ear
Is the jaw joint also related to tinnitus?
The tinnitus information on the National Health Information Portal explains that tinnitus is associated with noise exposure, hearing loss, otitis media, chronic sinusitis, jaw joint problems, depression, stress and more. It also lists jaw joint problems, along with vascular abnormalities and muscle spasms, as causes of objective tinnitus, that is, sounds inside the body that other people can also hear.
That said, tinnitus cannot be blamed on the jaw joint alone. Tinnitus can come from many causes such as hearing loss and ear disease, so when tinnitus appears, the safer order is to check hearing and the ear first, and to add a dental exam when jaw symptoms are also present.
If tinnitus gets louder or quieter when you open your mouth or clench your teeth, be sure to tell the clinician at the exam. Whether ear symptoms change with jaw movement is an important reference for judging the relationship between the jaw joint and tinnitus.
What tests are done to find the cause of ear pain?
At an ENT clinic, the eardrum is examined and a hearing test is done. The National Health Information Portal describes the eardrum exam as the most basic and essential test for diagnosing tinnitus, and pure-tone and speech audiometry as the basic tests for assessing hearing. The same material also introduces tympanometry, otoacoustic emission testing and tinnitus testing, and which further tests are needed depends on the results of the ear exam.
If the ear is normal but the pain continues, the jaw joint is checked at the dentist. The dentist looks at the range of mouth opening, tenderness of the jaw joint and chewing muscles, and joint sounds, and if needed looks at the state of the joint with imaging. Looking at the results from both departments together makes it easier to narrow down where the ear pain comes from.
How is ear pain caused by the jaw managed?
Once the jaw joint is confirmed as the cause, the principles of TMD treatment are followed. Habit correction, exercise therapy, physical therapy and an occlusal splint worn at night are the basics, and when the pain is severe, medicine is used briefly after the exam.
In daily life, cut back on actions that strain the joint in front of the ear. Chewing tough food on only one side, suddenly opening the mouth wide, and cradling a phone between ear and shoulder for long calls can all make jaw-related ear pain worse. If calls are long, using earphones or a speaker is one option.
If the jaw joint was the cause, watching whether the ear pain decreases along with the jaw symptoms helps in judging the course. If only the ear pain remains unchanged even after jaw treatment, check the ear causes again.
Common myths and facts
Myth: If the ear hurts, it is always an ear disease.
The National Health Information Portal includes the ear among the pain sites of TMD. Pain in front of the ear that gets worse when chewing or yawning can come from the jaw joint.
Myth: If the ear pain is from the jaw, there is no need for an ear exam.
The National Health Information Portal describes the eardrum exam as the most basic and essential test for diagnosing tinnitus. Ear disease must be checked first for the jaw joint cause to be judged accurately.
Frequently asked questions
The ENT said my ear is fine but it keeps hurting. What should I do?
If the ear exam is normal but the area in front of the ear hurts every time you chew or yawn, it is now time to look at the jaw joint. Showing the ENT test results when the dentist examines the jaw joint and chewing muscles helps with the diagnosis.
Can TMD make me dizzy?
Seoul National University Hospital's medical information explains that some TMD patients complain of tinnitus or dizziness. However, dizziness can also come from the inner ear or brain disease, so if the dizziness is severe or began suddenly, have it checked first in the relevant department. Writing down whether the dizziness began at the same time as the jaw pain will help at the exam.
Only one ear hurts and I hear a sound. Could it be the jaw joint?
A problem can occur in only one jaw joint, so pain in front of one ear can come from the jaw. However, the National Health Information Portal explains that for pulsatile tinnitus heard on only one side, if the basic tests are normal, a CT is helpful for checking, so for one-sided ear symptoms it is better to start with an ear exam.
Should I go to the dentist or the ENT first?
If you have ear discharge, fever or hearing loss, go to the ENT first. If you have no such symptoms and the front of the ear hurts when chewing and the jaw makes sounds, it is fine to start at the dentist, and if needed the two departments refer to each other and see you together. Whichever you visit first, bring the test results you received to your next visit.
Does tinnitus caused by the jaw joint get better with treatment?
When tinnitus is related to a jaw joint problem, watch whether the tinnitus changes along with jaw joint treatment. The National Health Information Portal introduces medication, tinnitus retraining therapy and hearing aids as tinnitus treatments, so also discuss whether ENT treatment is needed separately from jaw treatment. If tinnitus began suddenly or you feel your hearing has dropped, get an ear exam promptly.