Help ToothDoc!

[scubakat]

Hi ToothDoc,
In an earlier post you said that a tooth squeeze (barodonti-something ) is relatively rare but I think that I have now had it twice...

Here's my profile from yesterday... I spent about 20 minutes going to 57fsw max. We were in a threesome & one buddy ascended for no known reason so the two of us made a controlled ascent (<60fsw/minute). Everything was fine, I felt no pain whatsoever. We found buddy #3 at the surface, regrouped and started our descent. At about 10fsw I start to feel a strong sharp pain in the upper right part of my mouth. I signalled to my buddy that we needed to ascend immediately. My tooth or teeth throbbed & ached mildy for about 45 minutes.

Why would this happen only on a descent immediately after surfacing? I am going to do at least two dives tomorrow to observe what happens with surface interval.

Also is it possible that I am confusing this pain with some kind of sinus squeeze?

And my next question is how do I go about fixing it? How do I explain what I need to my dentist?

Thank you sooo much for your help!

-kate

 

[scubabunny]

I'm not a doctor, but if the pain went away, I'm guessing it was a sinus thing and not a tooth thing. Its happened to me a few times after I thought I was over a cold. Since the sinuses also run under the cheekbones (or somewhere around there) I was told the pain was caused by pressure in those passages.

When its happened to me, it was always on dives where changed depth a few times within the first 30ft. (mainly helping with open water dives). My ears and nose felt clear, but I still had "goop" hidden in my sinuses that didn't like the change in pressure. It also hurt ALOT more if I tried to put my teeth together..but went away after about an hour.

Lets see what the docs have to say.

 

[Katerina754]

Hi Scubacat! I had the very same symptoms at 10 ft but knew it was my tooth and not sinus as I was experiencing some sensitivity to hot and cold in the affected tooth. Unfortunately, Im a midwife so my area expertise wont help you much! You might try seeing a dentist for a check up, point out the tooth you think might be affected and go from there. Goodluck!!!!!

 

[scubakat]

Ok, the last two days I have done multiple dives. On Saturday I was taking a Rescue class and we did a lot of short dives (<3min) to <25fsw. A couple of times during descent I could feel the squeeze coming on. This might sound weird but when I sould equalize it would feel like my tooth (which is actually a crown) was going to pop off. Though the squeeze never progressed to full-on pain this weekend, I was conscious of something being not quite right.

-kate

 

[Laurence Stein DDS]

Dear Scubakat,

Scubadoc forwarded you question to me. I'm a dentist and consultant for DAN and Scubadoc. This reply is for information only and not a diagnosis. Please contact your dentist for an exam as necessary.

From you discription, my first impression is a sinus sqeeze. If the involved teeth are the upper teeth it makes me even more certain.

About once a year I see a patient who calls from the airport with a toothache. By the time they get to the office there is nothing to find. They usually report the pain occurred during descent and approach to landing. This is the same as your descent in the water only the precent change in pressure in water is greater than you would ever experience in an aircraft.

Pain on descent and ascent is more likely with an acutely abscessed tooth. Pain on ascent is associated with a chronically abscessed tooth or other other tooth pathology.

You can have a referred pain to the lower teeth on the same side however, if the lower teeth hurt you then the likelyhood of a sinus sqeeze is diminished and a real tooth sqeeze would be suspected. Usually with a real squeeze, the tooth remains somewhat tender after the pain is gone.

From personal experience, I find that while the initial ascent is easy, if I have to surface and descend again, I have much more trouble equalizing. I suspect the mucous membranes and eustasian tubes become engorged with blood and swell, making equalization more difficult. Once I'm out of the water, and allowed a surface interval, I usually have no problem with descent.

Your dive profile was descent, quickly ascending and then descent again after linking with your third buddy. I suspect your sinuses.

This DOES NOT rule out a dental problem but I would suspect the sinuses first.

If you wish to contact me directly, my address is Steindiver@aol.com

Hope your feeling better.

Laurence Stein DDS