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Teething or ear infection? How to tell?

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It can be difficult to distinguish between teething and an ear infection, but a doctor should be consulted to examine the ears. Other signs to look for include drooling, response to pressure on the gums, type of nasal mucus, worsening of the condition, and discomfort in the prone position. Both conditions can have shared symptoms such as fever, poor sleep, and mouth pain, so it is important to seek medical attention if there is suspicion of an ear infection.

The best way to tell the difference between teething and an ear infection is to ask a doctor to examine your baby or toddler’s ears. There are a few other signs that suggest one condition or the other, but sometimes babies can have both. An infection indicates the presence of bacteria and without treatment this could cause harm. It always makes sense to consult a doctor, if in doubt. However, parents can look for other signs that differentiate between teething and ear infection such as drooling, response to pressure on the gums, type of nasal mucus, worsening of the disease, and increased discomfort in the prone position.

One of the challenges in trying to tell the difference between teething and an ear infection is that both conditions can be accompanied by a low-grade fever. Usually, the fever with teething does not exceed 100 degrees F (37.78 degrees C), but sometimes an ear infection occurs without fever or a low-grade fever. By itself, this symptom is unreliable in telling the difference between the two.

Some classic teething symptoms can help make this judgment. Teething is usually accompanied by increased salivation, which is uncommon in ear infections. Babies may also respond if the gums are pressed lightly. This can be comforting or provoke an annoyed or pained response. Looking into your baby’s mouth can help determine if any teeth are appearing. The gums may feel swollen or protruding, and there may be evidence of one or more teeth breaking off in the gums.

One test to distinguish between teething and an ear infection is the lie down test. Teething babies tend to feel uncomfortable all day, but babies with an ear infection are often more uncomfortable when they’re lying down. During naps and at night, the pain from ear infections can increase, making it difficult to sleep. Teething babies may also have trouble sleeping, but tend to show constant irritation during the day. This test is not completely reliable.

Another way to evaluate these differences is to consider the nasal discharge. It is rare for a baby who is teething to show many traces of nasal discharge, although he may have a small amount of clear nasal mucus. Ear infections are often more indicated when a child has a classic stuffy nose with yellow or green mucus. Your child’s recent illness also makes an ear infection a more likely diagnosis.

Teething and ear infection can share the following symptoms:
Pulling the ears
High irritation
Fever
Poor sleep
Difficulty eating
Positive response to pain medicine
Mouth pain
Diarrhea
Given these shared symptoms, it simply makes sense to see a doctor if there’s a reasonable suspicion of an ear infection. It is important to protect a child’s hearing through appropriate treatment, if needed.

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