Today a seven year-old came to the clinic complaining of ear pain. On examination I saw fluid behind his right ear but it did not seem infected. I reassured the mother that it would get better without treatment.
As I was finishing my evaluation, I took one last look in his mouth. Near the back on the right side, I saw a small bump resembling a pimple that I had not seen before. Immediately I knew the true diagnosis. The child had a tooth abscess that was beginning to blossom and the pain was being referred to his ear.
As a chief at UCSF, I spent a few hours a week in a pediatric dental clinic to improve my skills relating to illnesses of the teeth and gums. If I had not had the opportunity to work with dentists at UCSF during that year, I have no doubt that I would have missed this diagnosis.