Infection after dive.........

[DESIGNERDIVER]

Hi ,
I am new to diving and i searched the threads and do not see anything that applies to what I am experiencing

I was certified last week first day first 2 dives were un eventful...went great
2nd day 1st dive wonderful..........
2nd dive 2nd day at 30' about 20minutes into the dive I get a piercing pain in my right ear..........i ascended a little and within about 10-20 sec;s pain went away

days after diving ear felt sore with a mild ache that came and went. 3 days later i dove again to about 60'. had no trouble equalizing and no pain.

now 3 days after that I have again that dull ache in my ear...........but worse i have a 3 tooth crown in the upper right side of my mouth wich now hurts! and the gum seems to be becoming infected. ( i have a dentist appt later today to have it checked)
anyone have anything similar happen to them.........dont know if it is sinus related or tooth or what..........

 

[doctormike]

Hi ,
I am new to diving and i searched the threads and do not see anything that applies to what I am experiencing

I was certified last week first day first 2 dives were un eventful...went great
2nd day 1st dive wonderful..........
2nd dive 2nd day at 30' about 20minutes into the dive I get a piercing pain in my right ear..........i ascended a little and within about 10-20 sec;s pain went away

days after diving ear felt sore with a mild ache that came and went. 3 days later i dove again to about 60'. had no trouble equalizing and no pain.

now 3 days after that I have again that dull ache in my ear...........but worse i have a 3 tooth crown in the upper right side of my mouth wich now hurts! and the gum seems to be becoming infected. ( i have a dentist appt later today to have it checked)
anyone have anything similar happen to them.........dont know if it is sinus related or tooth or what..........

Hi, and welcome to diving!

The ear symptoms certainly suggest barotrauma, possibly due to incomplete equalization. This can leave you with middle ear fluid (OME) middle ear infection (AOM) or worse, so if it persists, it would be a good idea to see an ENT doctor.

You can get tooth pain from barotrauma as well, but it is not usually related to similar problems in the ear. There can be a connection between tooth pain and sinus pain. This can be either real due to a fistula from the tooth socket into the sinus, or referred pain (sinusitis causing pain in the upper teeth).

If you haven't seen this video or gone over this material, you might want to take a look:

Edmond Kay's video lecture

Edmond Kay's discussion of barotrauma

Feel free to keep us posted!

Happy New Year,

Mike

 

[Laurence Stein DDS]

Hi Designerdiver,

I would agree with Doctormike. Most likely, the ear pain and the tooth pain are two separate problems. There are however, ways for ear or sinus problems to manifest as a seemingly unrelated tooth problem.

You description of you ear problem is typically a barotrauma of the middle ear that was relieved by ascent. Most likely your descent was too fast for your ability to clear your ears. Although you eliminated the cause by ascending a little, this resulted in a mild injury... possibly stretching the ear drum (tympanic membrane), making it sore for a few days. You could also have fluid in the middle ear so have an ENT check. Had there been fluid, I doubt that you would have been able to successfully clear your ears on subsequent days.

You tooth is a separate matter and may be unrelated to your dive but if left unattended, may have serious dive consequences.

I'm assuming that you meant to say tooth #3. This is the upper right first molar. Since it has a cap, most likely the tooth had previous fillings and/or fractures and at some point your dentist determined that it could no longer be filled again. Each restoration in the past and any additional injuries represent trauma to the nerve within the tooth. At some point, some teeth will become devitalized (nerve death) and may start to hurt. You may need to be evaluated for a root canal treatment.

If the capped tooth has already had root canal therapy, the success is not 100% and re-treatment may be necessary.

This has to be evaluated by your dentist.

Another possibility is a maxillary sinus problem. If your sinus is congested, it is possible to get both ear pain and tooth pain. It is also possible that any inflammation in the sinus can press your teeth into tighter contact and this results in occlusal interferences that may stimulate or increase bruxism. The more you clench (brux) the more sore a tooth may get in a vicious cycle.

Finally, there is one more way an ear injury can be related to tooth pain. Even without a sinus problem, a middle ear problem may exist. The external and middle ear rests right next to the tempero-mandibular joint. If there is some inflammation or infection in the ear, it is then possible to put pressure on this joint. The pressure can then displace the position of the jaw slightly and that can lead to occlusal interferences as in the previous paragraph.

Have your dentist check your bite before any treatment for a devitalized nerve is started AND check with the ENT. If a bite adjustment solves the tooth problem and any x-rays of the tooth is negative, then the bite rather and a dead or dying nerve is most likely the problem with the tooth.

In 1993 I wrote an article for DAN called the Rarest Barotrauma. A PDF file for this article is on the Scubadoc website and can be found at: http://scuba-doc.com/RarestBT.html In the article I describe a condition called Barodontalgia, its causes, signs and symptoms. While it is very rare, a capped tooth that may be suspect is a recipe for a dive problem.


I hope this information helps.

Regards,


Laurence Stein, DDS

 

[DESIGNERDIVER]

thank you both for taking the time to respond.................went to the dentist yesterday and it isnt related to the ear pain. I have an infection in my gums due to bone loss. thats a whole other story (not good). as far as my ear I will call the ent today and make an appt as my ear still aches...............slightly but still does
thanks again

 

[solarmat]

Dear Designerdiver: I was diving last week in San Andres Island (Colombian Caribbean), very nice, warm water and lots of coral. I rented the gear and checked out that operator didn´t wash too much regulators. First day went to a wall at 100 ft, no problem to equalize, second day couldn´t dive due to ear pain and some discomfort in right frontal sinus, just put 2 drops of Auralyt in each ear and got better quickly. Then dove almost normally, only the last of the 7 days had slight caugh. Didn´t felt earpain during the flights. Once back in my country (Uruguay) at 30ºF, a strong sinusitis and some bronchitis started after 2 days, high fever, lot of green mucus, some pain in frontal and maxilar sinus. My main question is: can it be caused for self infection? several years ago my doc made me a TAC to check for an obstruction in my right maxilar sinus, caused by nose fracture during childbirth.
4 days ago started to have a pill of Amoxicilin 750mg each 12hs, but it seems to have no effect, only a mucus color reducing, should I change the antibiotic or keep on having it more days unti mucus dissapear?
What do you recommend for getting ready before future diving trips?
Thank you

 

[solarmat]

Hi: I was diving last week in San Andres Island (Colombian Caribbean), very nice, warm water and lots of coral, that´s the good part.... I rented all the gear and checked out that operator didn´t wash too much regulators, just a fast rinse with freshwater. First day went to a wall at 100 ft, no problem to equalize, second day couldn´t dive due to ear pain and some discomfort in right frontal sinus, just put 2 drops of Auralyt in each ear and got better quickly. Then dove almost normally, only the last of the 7 days had slight caugh. Didn´t felt earpain during the flights. Once back in my country (Uruguay) at 30ºF, a strong sinusitis and some bronchitis started after 2 days, high fever, lot of green mucus, some pain in frontal and maxilar sinus. My main question is: can it be caused by self infection? several years ago my doc made me a TAC to check for an obstruction in my right maxilar sinus, caused by nose fracture during childbirth, so I have a reduced communication between sinus and nose.
4 days ago started to have a pill of Amoxicilin 750mg each 12hs, but it seems to have little effect, fevers goes down and mucus color is reducing but very slowly, should I change the antibiotic or keep on having it more days unti mucus dissapear?
What do you recommend for getting ready before future diving trips?
Thank you