DISCUSSION
As a diver descends into the
water, the ambient pressure
increases by one atmosphere
every 33 feet. This pressure
change affects body cavities
such as the ears and sinuses
by creating unequal pressures
between the body cavity and
the ambient environment.
This is relieved by equalizing
the pressure. When a tooth is
damaged, restored defectively
or has a loose crown, an
opening may allow air to enter
into the space and become
trapped during a dive with no
means of being equalized. The
diver may experience tooth pain
during descent, when pockets
of air that exist under defective
fillings are compressed, or
during ascent as the trapped air
expands and may crack teeth or
loosen or expel fillings.
In this case, the diver had
tooth pain on ascent due
to defective fillings, which
subsequent dental diagnostics
confirmed. The unusual aspect
of this case was that a total
of five teeth appeared to have
been affected on the same dive,
two of which were confirmed
to have lost fillings during the
dive. Barodontalgia generally
originates with poor oral health,
neglected dental maintenance
and/or ineffective dental
treatments. Of the 347 total
cases of barotrauma reported
in the 2008 edition of the
DAN Annual Diving Report,
two cases were categorized
as barodontalgia. Although
considered a rare occurrence,
barodontalgia should not
be dismissed; it can lead to
potential safety risks such as
rapid ascents and impaired
judgment during a dive due to
severe pain.
This case, in which as many
as five teeth were affected by
barodontalgia during the same
dive, is extreme. However, it
serves as a reminder that being
fit to dive is holistic and includes
dental health. It is not necessary
to seek a dentist specifically
trained in dive medicine for
dental checkups; rather it is
important to routinely visit a
dentist that provides quality
care so you can be confident
your dental health is maintained.
The FDI World Dental
Federation advises that divers
have regular dental checkups,
refrain from diving (or flying in
nonpressurized cabins) within
24 hours of any dental treatment
that requires anesthetic and wait
seven days after an oral surgical
procedure before returning to
diving.
Fillings are prone to
deterioration over time.
Semiannual dental exams allow
the dentist to inspect existing
fillings for damage and to detect
and treat tooth decay in a timely
manner. By maintaining good
oral health, divers can avoid
barodontalgia and smile easily
after diving.
AD
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“By maintaining good oral health, divers can avoid
barodontalgia and smile easily after diving.”
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