Barodontalgia-or "OWOWOWOWOWOW! My teeth hurt on descent!"

[stillbubbling]

Has anyone suffered from this?

I had it for the first time yesterday - couldn't descend past 7m. And be assured it bloody hurts! It felt like one of my left back upper molars was having a needle rammed through it. Afterwards it turned into a throbbing in/around my cheekbone, behind the left eye, and into the teeth (alternatively that might now be the result of self prescribing several large single malts last night to take my mind off it....)

I've done some reading around it, and it looks like it is one of two things-either a damaged tooth, or the maxillary sinus playing up. It certainly felt tooth related at the time, but the pain in the cheekbone is pointing to sinuses, and in fairness it was the first dive after a cold.

So I was wondering if there is anyone out there with any experience of this? How do you tell? Do I see the dentist or doc first? Or just try again in a few weeks having popped a Sudafed and see what happens?

TIA

[SouthCoastDiver]

G'day

I spent a few hundred dollars at the dentist a year ago convinced that the tooth pain I experienced when diving was a problem that could be fixed with a filling / extraction etc.

After a couple of visits where I was prodded, poked, had teeth cleaned and x-rayed, the official diagnosis was it was "probably" a sinus problem.

Since then I take antihistamines a couple of days before I'm due to dive and have slowed my descent rate a little and it seems to have fixed the problem.

It may be worth trying this low-cost, low-risk "cure" to see how it goes?

SCD

[SoggyBottoms]

chap I know had two teeth literally explode on ascents
some kind of air gap under filling
he asked dentist to pack harder and was good to go afterwards

[Tim Digger]

Difficult to tell upper molar pain from sinus. If you have no filings/previous dental probs in that area, then strongly suspect maxillary sinus. Any cold /con? Wait it out. Hay fever allergy type congestion possible. If no better next time and no previous dental probs then medical/ent consult.
Tim Digger

[stillbubbling]

Thanks for the thoughts, guys.

I have had a cold recently, and it was the first dive since it cleared up. Plus I'm up to date on dentist checkups, and there are no issues in that area-only an old filling (which I suppose might have cracked since the last checkup).

I shall take the 'wait a bit, pop a Sudafed and try again' approach and see if it recurs.

[ChristianG]

Thanks for the thoughts, guys.

I have had a cold recently, and it was the first dive since it cleared up. Plus I'm up to date on dentist checkups, and there are no issues in that area-only an old filling (which I suppose might have cracked since the last checkup).

I shall take the 'wait a bit, pop a Sudafed and try again' approach and see if it recurs.
I'd go very easy on that Sudafed bit. Given that you might already have a problem a reverse squeeze would certainly not endear me if I were you. As for an old filling that "might have cracked" that would allow any pain to be alleviated rather than occur. It's commonly when you have a new filling, with a cavity in it which is sealed over by amalgam that pain of that type occurs. For that very reason (other than, but of course, that he's a much better diver than I'll ever be leave alone photographer than I'll also ever be) my dentist is a SCUBA diver. This (http://www.australia-downunder-productions.com) is he (and Becca his long-time partner). I commend to you, in particular, the AE2 section of that website.

[dixi]

chap I know had two teeth literally explode on ascents
some kind of air gap under filling
he asked dentist to pack harder and was good to go afterwards

how is this possible? my understanding is that if there is an air gap which is reacting to the ambient pressure then there must be a connection to the mouth, therefore while pain on decent is perfectly likely the "exploding tooth" on ascent seems most likely to be an urban myth, much ore likely there was a fracture present before the dive and the increased pressure caused it to propagate, this is unliekly to have been prevented by packing afilling harder.

[nickb]

I suffer a bit of tooth pain on a quick descent with more than about 45% helium in my dil

[stillbubbling]

how is this possible? my understanding is that if there is an air gap which is reacting to the ambient pressure then there must be a connection to the mouth, therefore while pain on decent is perfectly likely the "exploding tooth" on ascent seems most likely to be an urban myth, much ore likely there was a fracture present before the dive and the increased pressure caused it to propagate, this is unliekly to have been prevented by packing afilling harder.

Entirely possible. It's dependent on how fast the compromised tooth can get rid of expanding gas. In the same way as 'normal' decompression, if there is a slow bleed of pressurised gas into the tooth through (say) cracked enamel, it will evenually equalise. Now, taking the pressure off on ascent it has to either escape (not necessarily fast enough if the crack is tiny/hairline), or expand (putting pressure onto the sensitive dentine) or something's gonna go bang....

Or that's the way it was explained to me by a diving dentist years ago. Mostly these incidents blow away a chunk of tooth enamel, apparently (which still bloody hurts!)

[deepunderground]

I have had this on a number of occasions and have put it down to dodgy sinuses...

Worst case of all was on the 2nd dive of a 12 day trip to truk lagoon !

Luckily it cleared up by the 2nd day...

The strange part about the pain in truk which I hadn't experienced before was the fact that the initial decent was fine it was after I had yo-yoed in and out of various holds and hatches that I was unable to re descend to a greater depth than what I currently was at...

I have quite a few fillings in various areas of my teeth but 99% of the time I'm fine, I get caught out once maybe twice a year with the feeling of great pain on descent, I can only describe it as someone having hold of my nerve in a pair of pliers and sqeezing on descent.

Usually once I've had this then I give it a rest for a day and try again the next and its usually fine



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[Gareth]

Those symptoms sound same as when I had cold that included sinus congestion. Sharp pain in back tooth on descent, then back on boat sharp pain in cheek/below eye socket, same side. After an hour the sinus pain would go. Had a couple of days off diving, but still took another two weeks to clear fully, when diving.
Touch your toes if your still blocked you'll feel it in the sinuses!!

[Squidge]

I dived a few weeks ago with blocked sinuses and the descent was purgatorial. I thought my tubes were clear (I had hayfever but could breathe through my nose) but there was obviously still some gunk in there. God, it hurt - teeth, ears, face, the lot. The ascent wasn't very comfortable either. I usually like the slight popping and tinkling noises you get on the way back up, but this was more of a creaking and groaning behind my cheekbones, and there was a little bit of blood in my mask when I took it off.

[dixi]

Entirely possible. It's dependent on how fast the compromised tooth can get rid of expanding gas. In the same way as 'normal' decompression, if there is a slow bleed of pressurised gas into the tooth through (say) cracked enamel, it will evenually equalise. Now, taking the pressure off on ascent it has to either escape (not necessarily fast enough if the crack is tiny/hairline), or expand (putting pressure onto the sensitive dentine) or something's gonna go bang....

Or that's the way it was explained to me by a diving dentist years ago. Mostly these incidents blow away a chunk of tooth enamel, apparently (which still bloody hurts!)

fair enough, suppose my understanding of tooth anatomy and structure is limited enough (BDS), not doubting tooth pain on decent, not sure how much is likely on ascent but teeth exploding is just BS

[stillbubbling]

Ok, finally got diving again after my tooth squeeze. I can confirm that it was maxillary sinus. Everything happy and no hurty teeth. A trip to the dentist found absolutely nothing either.

So breathing a sigh of relief!

[aqua0]

I can personally assure you that it's entirely possible!
I did a 'staff dive' at Roatan Banks about 6yrs ago and on the ascent I felt a bit of a twinge in my lower right molar. Nothing too exciting, just a small ache and then an almost un-noticeable pop. Turns out that pop was 1/4 of my molar exploding off!
On the bright side, it turns out that cotton wool soaked in oil of cloves makes a bloody effective 'battlefield repair' and allowed me to carry on working for another 6wks until the contract ended.



how is this possible? my understanding is that if there is an air gap which is reacting to the ambient pressure then there must be a connection to the mouth, therefore while pain on decent is perfectly likely the "exploding tooth" on ascent seems most likely to be an urban myth, much ore likely there was a fracture present before the dive and the increased pressure caused it to propagate, this is unliekly to have been prevented by packing afilling harder.

[Hotreferee]

My ears feel blocked for last two weeks and sinus pain.Have been using sweet almond for the ears one has stopped aching though one still feels blocked and sinus same tried to decongestant for couple of days sinus feels a little better.Thought about trying swim ear ? If that sounds right.

[Tim Digger]

My ears feel blocked for last two weeks and sinus pain.Have been using sweet almond for the ears one has stopped aching though one still feels blocked and sinus same tried to decongestant for couple of days sinus feels a little better.Thought about trying swim ear ? If that sounds right.

Your problem is congestion and eustatian tube blockage. Swim ear will do nothing but probably not harmful. You need to be able to equalise on land before you dive.
Tim Digger