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Smokers are at higher risk for refractory periodontitis, complicating management and increasing the likelihood of tooth loss

Other risk factors for acute ear infections include: Attending day care (especially centers with more than 6 children) Changes in altitude or climate Cold climate Exposure to smoke Family history of ear infections Not being breastfed Pacifier use Recent ear infection Recent illness of any type (because illness lowers the body's resistance to infection) Birth defect, leading to deficiency in eustachian tube function Symptoms In infants, often the main sign of an ear infection is acting irritable or crying that cannot be soothed

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