Occupational health

Occupational Health - Meliva

Middle Ear Infection in Children and Infants 

Kõrva-nina-kurguarst Jalgpalli

Kõrva-nina-kurguarsti vastuvõtt (Tallinn)

Kõrva-nina-kurguarst Tartu (Turu tn)

Kõrva-nina-kurguarsti vastuvõtt (Tartu)

Kõrva-nina-kurguarst Ülemiste Tervisemaja

Kõrva-nina-kurguarst Rävala

Middle ear infection (otitis media) is one of the most common illnesses in childhood. According to WHO, 80% of children under the age of five have experienced at least one episode of ear infection. 
Initial home treatment includes pain relievers and numbing ear drops, which can help ease symptoms. However, if the ear pain does not improve within 48 hours or the child has a high fever (38.5 °C or higher), it is recommended to consult a doctor. Good hand hygiene and vaccination help prevent ear infections.  

Symptoms and Recognition of Middle Ear Infection 

Otitis media can be difficult to recognize in children, as symptoms such as nighttime restlessness or crying may also be signs of a common cold. Ear pain does not always mean there is an infection — it may be caused by eustachian tube dysfunction or throat inflammation. The diagnosis must be made by a doctor; it should not be made at home. 

Symptoms vary depending on the child’s age and the type of infection. The most common symptoms include: 

Ear pain – one of the most frequent symptoms, which may be throbbing or sharp and often worsens when lying down. 

Nighttime restlessness and waking – especially in young children, ear pain may disrupt sleep. 

Fever – inflammation may raise body temperature. 

Decreased hearing – temporary hearing loss may occur in the affected ear. 

Ear discharge – if the eardrum has perforated, clear or purulent fluid may drain from the ear. 

Irritability and fussiness – the child may be more irritable than usual. 

Runny nose and cough – otitis media often develops as a complication of an upper respiratory viral infection. 

Loss of appetite and vomiting – in small children, ear pain may affect appetite and cause nausea. 

If you suspect a middle ear infection, it is important to seek medical attention so that the child receives an accurate diagnosis and treatment if needed.  

Most middle ear infections do not require antibiotics and often resolve on their own. In the past, antibiotics were routinely prescribed for all ear infections, which has led to significant overuse of antibiotics for otitis media today. 

The key is to relieve the child’s symptoms. Pain relief should involve oral analgesics (paracetamol and/or ibuprofen) and, if needed, numbing lidocaine-based ear drops. 

Treatment focuses on symptom management: pain relievers, adequate fluid intake, and nasal drops or saline spray if required. These will not speed up recovery but may make the child feel better. 

If the child’s condition does not improve or a high fever develops, medical evaluation is necessary. Only a doctor can diagnose otitis media with certainty and decide whether antibiotics are needed.  

Paracetamol or ibuprofen to relieve pain and reduce fever. 

Numbing ear drops for rapid pain relief. 

Used primarily when the infection is bacterial. 

Antibiotics are started immediately if: 

There is ear discharge (pus) regardless of age. 

The child is under 6 months old and otitis media is suspected. 

The child is under 2 years old and has a bilateral middle ear infection. 

Antibiotics are not always started right away — „watchful waiting” for a few days may be appropriate, especially in older children. If significant pain does not improve, antibiotics may be considered. Antibiotics are also considered when the child has a high fever (over 38.5 °C). 

Ventilation tubes (ear tubes) may be inserted to improve middle ear ventilation and reduce recurrences. 

Adenoids may be removed if they are a source of chronic inflammation. 

A common procedure performed in children under general anesthesia. 

A small incision is made in the eardrum, fluid is removed, and a ventilation tube is inserted. 

The child can go home the same day and follow-up visits are scheduled to monitor healing.

The main goal is to reduce viral upper respiratory infections. 

Ear pain often appears at night and usually does not require immediate medical attention — a doctor’s visit the next morning is typically sufficient. 
For longer-lasting symptoms, a medical assessment is recommended to rule out complications, such as otitis media with effusion, in which thick fluid accumulates in the middle ear and hearing decreases. 

Ear examination may feel uncomfortable for a child, but it is harmless and painless. The doctor will determine whether further treatment is needed or if symptomatic care is sufficient. 

Ear, nose and throat (ENT) specialist as Otorhinolaryngologist

An ear, nose and throat (ENT) specialist — also known as an otorhinolaryngologist — diagnoses and treats disorders of the ear, nose and throat in both adults and children. 

Ear, nose and throat problems can be uncomfortable and interfere with daily life. For acute illnesses, initial care is usually provided by a family doctor or general practitioner (for example, acute ear infections, runny nose or sore throat). However, if symptoms are persistent or do not respond to treatment, it is important to consult an ENT specialist. 

If you are concerned about an infant’s or child’s ear infection, you can read more about it here. 

Common reasons to see an ENT specialist include: 

Ear or throat pain that recurs or does not resolve within 2 weeks 

Persistent nasal congestion or a runny nose 

Recurrent ear infections or rhinosinusitis 

Lumps or nodules in the face or neck area 

We also offer the following procedures: 

Adenoid and tonsil removal (adenotonsillectomy) 

Tympanic membrane paracentesis with aspiration 

Tympanic membrane ventilation tube insertion (middle ear drainage) 

Ear irrigation (please book a nurse’s appointment for irrigation only) 

Tongue-tie release under local or general anesthesia 

Vocal cord examination with fiberoptic endoscopy 

Our specialists are here to help you find the best possible solution to your concern. 

Ülemiste Tervisemaja kliinik

Jalgpalli kliinik

Kvartali kliinik

Rävala kliinik

Autotransplantation

Autotransplantation of teeth (ATT) is a procedure that surgically moves a tooth from one position to another in the same oral cavity. This method is used to remove a hopeless, deeply caries tooth with its complication and replacing it with a healthy, nonfunctional tooth. Also, it is indicated to manage injury in the esthetic zone, tooth development disorders, congenitally missing or impacted tooth, especially canines. Treatment of impacted canines usually requires an interdisciplinary approach if the impacted tooth cannot be moved with orthodontic treatment. Treatment options include beside orthodontical alignment of the tooth also surgical exposure and autotransplantation of impacted tooth e.g. when the tooth has unfavorable position and it leads to prolonged treatment duration.   Surgical treatment techniques and orthodontical considerations depend on the location of the impacted canine in the dental arch.

Autotransplantation is the most biological and natural way to restore the dentition both aesthetically and functionally in young patients during their growth period. With this method, a patient own tooth is used, which can induce bone formation and the growth of maxillo-facial structures around the transplanted tooth.

M.Tsukiboshi  Autotransplantation of Teeth  2024

In what cases can autotransplantation be performed?

Studies have shown that 70–90% of all dental injuries occur before the age of 19 years, with a peak between ages 8–12 years. If the space left by a lost tooth remains empty after trauma, bone and the surrounding tissues begin to collapse over the years, making implantation in adulthood more complex and expensive.

A suitable donor tooth is identified through the cooperation of several specialists. We consider the age of the patient, jaw development, and the stage of root formation. If necessary, space is created or later closed using orthodontic treatment. Autotransplantation is suitable for children aged 10–15 years, and in the case of wisdom teeth, for young people aged 16–18 years.

When a tooth is moved from one place to another, its blood supply is interrupted. The restoration of blood supply in the new location depends largely on the stage of root development, the condition of the surrounding tissues, the root anatomy, the position of the tooth in the jaw, and many other factors. Assessing and treatment planning requires careful evaluation of the patient, including clinical and radiologic findings and follow-up X-rays.

ATT is technique-sensitive and requires multiple steps and appointments. The highest number of complications occur with impacted canines due to their difficult position and fully developed roots. It is necessary to measure and assess the donor tooth and the recipient site as well as the root shape and the stage of root development. If the root tip of the donor tooth is still open, the ingrowth of new blood vessels through the root apex is possible. In all cases the treatment outcomes may be difficult to predict.

Follow-up visits at treating physician are required monthly at first, and less frequently after 6–9 months, to prevent transplantation-related complications, which may result in the eventual loss of the tooth. The main complications are tooth resorption and it is categorized in three groups:

Replacement resorption or ankylosis-related resorption – aggressive ingrowth of bone cells through the root surface. The root is resorbed and replaced by bone.

Inflammatory root surface resorption – an inflammatory lesion on the root surface. Larger ones that do not respond to root canal treatment may eventually require tooth extraction due to progressive root damage.

Small, well-defined lesions may heal on their own (surface resorption).

Why is root canal treatment done after ATT?

Root canal treatment is performed on a tooth that does not respond to vitality tests or if nerve necrosis is suspected due to disruption of blood supply. The pulp may become infected, and bacteria can migrate through tiny channels to the root surface, causing inflammation. To prevent this, root canal treatment is case-specific and done by endodontist, usually under a microscope control. If the tooth needs reshaping, this is done by the dentist or prosthodontist.

Because tooth roots are located below the gum inside the bone, they are not visible to the eye. We must monitor the processes occurring in the bone and tooth. X-rays are taken to check for changes of the root surface, the width of the root canal, the periodontal space, and whether the roots are continuing to develop or development have stopped. The tooth is monitored closely for 1.5–2 years, and after that once a year.

Are there alternatives to this procedure?

For children, this is the only way to restore the dentition using their own tooth, because implants cannot be placed while growth is ongoing. Even if complications arise and the transplanted tooth is eventually lost, it serves the child throughout the growth period and postpones implant placement until growth has finished. Other options are evaluated individually by the patient’s dentist based on the dentition and age.

The success of autotransplantation depends on the different factors, e.g. patient age, stage of root development, root anatomy, tooth position.

A treatment plan (incl necessary additional examinations) is agreed before the operation. A preoparative x-ray study is needed at treating clinic.

The patient cooperation, good oral hygiene, and adherence to instructions are essential.

After transplantation, swelling, limited mouth opening, pain, and difficulty eating may occur for 4–5 days. A soft and cool diet is recommended.

Intensive physical activity (active training programs) should be avoided for 1–2 weeks.

Please schedule follow-up appointments in advance with the reception according to agreed treatment plan

Kaarli

Dental autotransplantation is the most biologically natural method to restore dentition in children and adolescents using their own tooth in cases of deep caries, trauma, or impacted teeth. Dr. Dagmar Marandi explains who is suitable for the procedure, how it is performed, possible risks, aftercare, and why early treatment is important for jaw development.

Autotransplantation in Children and Adolescents – Dr. Dagmar Marandi | Meliva Kaarli Clinic

Mental health

Meliva's mental health specialistis are offering advice and support to all who seek help with mental health care, psychological treatment and prevention of mental health problems.

Meliva's mental health professionals have a wide range of expertise. We employ occupational and organisational psychologists, clinical psychologists, counselling psychologists, psychologists specialised in couples and family therapy and psychotherapy, mental health nurses, psychiatrists, supervisors, coaches, crisis counsellors, and a creative arts therapist.

The comprehensive range of services offered by each of these professionals enables the mental health professional to refer the client to a colleague if necessary.

Supporting mental health in the workplace

Many of our services are aimed at the business client, i.e. the employer, for whom we offer a logical package. Since the mental health of employees is crucial for creating value, it is more sustainable and economical to systematically maintain the employees’ mental health. The services include counselling, training, and work environment mapping.

The most important thing for the employer and the employee is the availability of an occupational and organisational psychologist. Our people in this field are highly trained professionals who focus their daily work on issues related to the work environment.

Occupational and organisational psychology is an applied science that studies the interactions between the employee and the workplace at individual, group and organisational levels, with the aim of increasing productivity and supporting the (mental) health and working life quality of employees.

In the current working environment, mental activities play a major part and the changing environment requires employees to adapt to new situations and conditions. This creates tension.

Naturally, various factors affect the mental health of employees and the working conditions and psychosocial working environment have a significant impact on their health, as they spend a large proportion of their days at work.

Appointments with an occupational and organisational psychologist are an excellent opportunity for employees and often also act as a preventive measure, as the problem can often be resolved or alleviated without the need for more serious intervention, such as a clinical psychologist or even a psychiatrist.

Booking an appointment for a mental health service

Our mental health specialists are located in Tallinn (Rävala, Jalgpalli, Ülemiste health centre), Tartu (Kvartali and Annelinnas clinics) and we also offer digital appointments. On September 15, 2025, Katriito Mental Health Clinic joined Meliva.

Do you have difficulty concentrating and setting goals?

Are you experiencing burnout due to accumulated stress?

Do you feel anxious or moody and not interested in anything?

Are you in the middle of stressful life events or troubled relationships?

Is there a question on your mind for which you cannot seem to find an answer?

If you answered 'yes' to any of the above questions, we recommend you see a mental health nurse for some self-help techniques. If necessary, we will refer you to an appropriate specialist. Use our online booking system to book either a face-to-face or remote appointment.

If you do not find a suitable service or specialist in the booking system, please call +372 6051500.

We have launched a Mental Health Line to make getting help as easy as possible for you. 

When you call, you can speak with a mental health assistant who will help assess your situation, recommend a suitable specialist, and assist with booking an appointment. If a suitable time is not available, you can be added to a waiting list upon request. 

To connect with the Mental Health Line, call 6051500 and select option number 3. 

Appointments with Estonian Health Insurance Fund (Tervisekassa)

Appointments with mental health specialists are now available at our clinics with funding from the Estonian Health Insurance Fund (Tervisekassa). 

To register for services with a referral from the Health Insurance Fund, please call +372 605 1500 or book an appointment in the national digital registry. 

Annelinna kliinik

Exercise test

The exercise test is a cardiovascular test which enables assessment of exercise tolerance and helps reveal health problems which might go unnoticed during a regular ECG conducted in a resting state.

The exercise test allows to diagnose possible cardiovascular disorders and is also used to evaluate treatment outcomes.

Before the exercise test, we ask you to sign a consent form on the conducting of the exercise test (the form is available in the physician's office or at reception).

We ask you to bring athletic and comfortable clothing and shoes to the exercise test. There is a showering option after the exercise test (bring a towel and shower products).

We recommend bringing an apple, yoghurt, or something sweet to get your energy up before the exercise test.

We recommend not working out one day before the test and avoiding major exercise.

The exercise test will be performed with persons weighing up to 140 kg.

Aesthetic procedures

Aesthetic medicine combines beauty and treatment. All our doctors and specialists have received medical education and have completed the relevant training.

The price of the first consultation is 58 euros. If the procedure is performed during the same visit, the consultation fee will be deducted from the cost of the procedure.

Vaccination

The vaccination against the flu for 2024-2025 is still ongoing. FLu vaccine costs 13€, we also offer free vaccines for high-risk groups.

The Meliva medical centre administers vaccines that are part of the immunisation schedule and other vaccines recorded with the Estonian Agency of Medicines to adults and children.

We ask you to bring your vaccination card when coming in for vaccination. If you do not have the card, we can issue one. Keep the vaccination card, as you may need it when travelling to another country or going abroad for work or studies.

Please contact the desired clinic or our customer service at the Meliva Digital Clinic to book an appointment for vaccination. You can book an appointment for a seasonal vaccine in the online booking system.

Men's health

Meliva offers men a wide range of blood tests to assess their current state of health, the risk of developing a cardiovascular disease (cholesterol) and the risk or presence of diabetes (glycated haemoglobin).

Together with Meliva's highly valued specialists, a man can find out whether alcohol or medications have had damaging effects on the liver or testosterone levels. We recommend monitoring uric acid levels to reduce the risk of kidney and heart diseases. We are also a partner when it comes to testing for prostate cancer (PSA).

Recreational athletes package is designed for physically active people, i.e. recreational athletes, and people who simply want to check their health even though not actively involved in sports, as well as for those who are yet planning to take up recreational sports.

A health audit is a comprehensive health check-up that provides an overview of a person's health, as well as guidance from doctors on how to look after one's health.

Test panels are groups of blood tests used to identify the causes of various health problems. The blood tests give an overview of the body's current state, creating opportunities for prevention and early detection of diseases.

Surgery

At Meliva, we offer fast access to care, taking into account your individual needs and wishes. Minor surgical procedures and surgeries are performed in our clinics. More complex day surgeries are performed in cooperation with our good partners Ülemiste Surgery Clinic and Fertilitas. The surgeries, however, are performed by Meliva's surgeons only.

If you need surgery, contact Meliva's customer service or book an appointment with a specialist in one of our clinics. Every surgical procedure must be preceded by a consultation with a surgeon at Meliva, so that he or she can thoroughly address your health concerns and decide which treatment is best for you.

You can get information about the details of procedures and surgery from our specialists. The prices of the most common surgical procedures can be found in our price list. We cooperate with all major private health insurance providers in Estonia.

At Meliva, we perform surgical procedures in the following specialties:

Bones, muscles and joints

Musculoskeletal disorders are very common and are often caused by repetitive motions and sustained awkward postures. In today's world, sedentary behaviours (e.g. prolonged sitting, lack of physical activity) pose health risks to many workers, including drivers and IT and office workers. The sedentary nature of work leads to chronic joint pain and reduced work capacity.

Meliva employs specialists who can help maintain the health and functioning of your bones, muscles and joints. Our team includes orthopaedists, hand surgeons, physiotherapists, sports medicine physicians, and massage therapists.

Patients with bone, muscle and joint problems are welcome to see an orthopaedist for treatment and disease prevention.

The main reasons for consulting an orthopaedist include:

Bone and joint problems such as shoulder, knee, hip or ankle pain, joint wear and tear and injuries

Back pain that is not responding to physical therapy or pain medications

Planning surgical treatment for bone, muscle and joint problems

A hand surgeon can be consulted for all problems related to the nerves, muscles, tendons and joints of the hand.

In Tallinn, you can make an appointment with orthopaedists Dr Dmitri Kulak, Dr Raul Parik, Dr Ingmar Kurg, Dr Raoul-Oliver Kuklane and hand surgeons Dr Kristo Kask, Dr Villem Teder and Dr Marian Zopp. In Tartu, you can visit Dr Mati Merila, an orthopaedist who specialises in hand surgery.

In Meliva's Jalgpalli clinic, Dr Mart Pais, an orthopaedist and pediatric surgeon, welcomes patients of all ages.

You do not need a referral for a paid appointment.

Health panels

Health panels are fast and comprehensive medical assessments used to ascertain your current health status. Our selection includes various panels for checking your health status and we have also thought of people who lead an active lifestyle.

Health panels allow for the early detection and prevention of the most common health issues. For example, we know that cardiovascular diseases are the leading cause of death in the world and the risk of contracting a cardiovascular disease increases as you age. Contributing factors include low mobility, smoking, excessive consumption of alcohol, being overweight, not eating enough fruits and vegetables, and excessive salt consumption.

The health audit focuses on the early prevention of various disorders, including cardiovascular diseases, and the evaluation of the function of organ systems.

We have created a health panel exclusively for health-conscious athletes. This panel is designed for individuals who lead an active lifestyle and those who want to monitor their health but are not actively involved in fitness or plan to start a fitness routine.

Together with the ‘Friends For Life Day’ initiative, the month of November of every year is focused on men’s health. The ‘Friends For Life Day’ invites men to a health check-up to give them the best possible overview of their most important indicators.

Our customer service is happy to help you with any questions regarding the health panels (choice of panel, booking, and payment).

Endocrinologist

Endokrinoloog Tartu (Riia tn)

Endokrinoloog Jalgpalli

Endokrinoloogi vastuvõtt (Tallinn)

Endokrinoloog Rävala

An endocrinologist is a physician who specialises in the prevention, diagnosis, and treatment of hormonal disorders. The physician will often refer patients to have blood tests and other examinations (e.g. ultrasound) done to gain a clearer understanding of the symptoms.

The most common reasons for referring to an endocrinologist are:

diagnosis and treatment of thyroid disorders;

suspicion or treatment of other endocrine system disorders.

If you have diabetes, we ask you to have an overview of the medicinal products you have taken and the reason why you stopped administering them when coming to an appointment. Also be sure to bring your blood glucose monitor or results of the blood sugar monitoring that you have otherwise obtained at home.

Heart health

Heart health is the key factor in ensuring good health and living a full life. You need to consciously take care of your heart health to ensure that it is strong and in good shape. Cardiovascular disorders are the leading cause of death in the world and the risk of contracting a cardiovascular disorder increases as you age. Contributing factors include low mobility, smoking, excessive consumption of alcohol, being overweight, not eating enough fruits and vegetables, and excessive salt consumption.

Our large selection of specialist physicians and advanced medical technology supports the prevention and early detection of cardiovascular disorders. We conduct all examinations and analyses required for ensuring heart health and also provide training courses on heart health topics.

Kvartali kliinik Riia tänav

Women's health

The prevention and early detection of diseases contribute to increasing the number of healthy life years. When it comes to women's health, both doctors and screening play an important role, allowing for proactive monitoring and timely intervention if necessary.

Women of all ages are welcome to see a gynaecologist at Meliva. In the Tartu office, both paid appointments and appointments reimbursed by the Estonian Health Insurance Fund are available with short waiting times.

You can also get initial advice on issues related to women's health via a remote consultation at the Digital Clinic.

Through remote consultations in the Digital Clinic, we can provide advice on a range of important women's health issues. We also offer advice on sexual health issues, such as sexually transmitted infections and contraception. In the Digital Clinic, general practitioners and family doctors can advise women on urinary tract infections and renew prescriptions.

For a more convenient use of the Digital Clinic, patients can use the mobile app, available in both the App Store and Google Play. You do not need to book an appointment to chat with a doctor in the Digital Clinic. Just log in and start the conversation.

Neurologist

Neuroloog Jalgpalli

Neuroloogi vastuvõtt (Tallinn)

Neuroloog Tartu (Riia tn)

Neuroloogi vastuvõtt (Tartu)

Neuroloog Ülemiste Tervisemaja

Neuroloog Rävala

A neurologist is a physician specialised in diagnosing, preventing, and treating nervous system disorders. If necessary, the neurologist will refer you to additional examinations to clarify the source of your symptoms, the most common being Magnetic Resonance Imaging (MRI), electroneuromyography (ENMG), electroencephalography (EEG), and various blood tests.

The most common reasons for referring to a neurologist are:

headaches with various reasons (tension headache, migraine);

stroke prevention and post-stroke consultation;

memory disorders, including suspected dementia;

Children’s health

Meliva conducts regular medical examinations for children to ensure their proper health and development. Our paediatricians, family physicians, nurses, and specialist physicians work together to achieve this. We support parents through both face-to-face and remote appointments.

We help monitor the various stages of a child’s development, their growth, weight, hearing, vision, and speech, and support you in shaping healthy habits. We also consult the family on preventing infectious diseases and administer all vaccines that are part of the state immunisation schedule.

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