Hi dotyj,
I'm the defacto team dentist. I'm also the dental consultant for Scubadoc and DAN.
Normal gums and teeth are not affected by diving. Simple.
Now the exceptions. Approximately 75% of adult Americans have some degree of gum disease and goodness knows how many of us have filled or restored teeth.
Diving can affect any part of the mouth that creates a "potential" space. That is an area that can capture gases as they diffuse in and out of the tissues or areas into which compressed air can be blown. Think of them as a collapsed balloon. No air, no space, only the potential to form a space.
Dead nerves, incomplete root canal fillings, unfinished root canal therapy, fractured teeth, new surgical sites, recently placed implants all have the potential to trap gases and become problems.
Old silver fillings often have small fractures within the material and may leak around the edges. In addition, silver fillings corrode as they age and expand within the tooth. The number of fractured teeth increase with older silver fillings. Unfortunately, many of these fractures are not visible on x-ray or clinically. Sometimes shining a very bright light on a tooth will make a fracture visible.
Tooth colored fillings, while pretty, are not without problems. They wear faster than silver, they shrink when set and can create stresses within teeth making them sensitive. Their placement is very technique sensitive.
There is no ideal fillling material. Some of the best materials are ugly and some of the prettiest don't seal as well or are not as strong.
Recurrent cold sores on the lips or the palate can be a problem if you are in the sun a lot or the regulator irritates the affected tissue. There are some effective medications for them.
Periodontal disease usually is not a problem unless the teeth are loose or there is active infection. Strict hygiene reduces the occurance of the disease. Periodontal pockets are, on occasion, a potential space into which air from the regulator can be blown--this is so rare that it does not exist to my knowledge, in the literature.
A good dental check-up with a full series and periodontal probing is ideal before diving. Failing fillings should be replaced. If the fillings are too big, then caps are appropriate and if necessary so is root canal therapy. A root canal is NOT necessary before every cap. However, most teeth with root canals, should have caps place on them to strenghten the tooth.
Uneruped wisdom teeth are potential problems and you should check with your dentist. If you need them extracted, allow enough time for the jaw bone to heal before putting a regulator into your mouth.
Some people suffer from TMJ joint dysfunction. This can cause pain on longer dives as you clench on your regulator. Changing mouthpieces can sometimes help this.
Scubadoc had a great site for diving/medical questions:
http://www.scuba-doc.com/
If you have any specific questions let me know.
Safe diving,
Larry Stein
:doctor:
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