?Reverse Squeeze in Molar

[Mel.B]

Hi,

I went diving over the weekend for the first time in two months and upon surfacing after each dive (5 dives in three days) I developed this incredible ache in my bottom left molar which subsided after about 5 - 10min. Am I right in assuming this is a reverse squeeze and that I have a hole in my tooth where some air is getting trapped. I'm going to ring the dentist today to make an appointment to see him, but I'm not sure how long I will have to wait for an appointment. If i can put up with pain after surfacing, am I ok to keep diving until it's fixed?

Thanks!
Mel

 

[Laurence Stein DDS]

Hi Mel. B,

Yes, you maybe having a tooth squeeze or barodontalgia but most likely, there will be no hole in your tooth.

Despite reports to the contrary, there is rarely a direct communication between the inside of the tooth and the mouth. In fact, when experimental fillings were placed defectivly, there was rarely a problem.

In my experience, there is most often an UNDERLYING dental problem...usually a nerve that is devitalized or at least in poor health. Then pressure changes seem to affect it. It can occur on descent or ascent...most times it seems to be during ascent.

It wouldn't surprise me to hear that you needed a root canal and/or there was a deep cavity or fracture in a tooth. This can lead to pulp pathology and then barodontalgia.

It is not a good idea to keep diving. Sometimes the pain is nearly unbearable and may persist for some time. Putting it off is just that...putting it off. See the dentist and have it checked out. Keep in mind that the dentist may not find the same signs or symptoms you experienced during the dive...have him look extra close.

Let me know what happens.

Feel better.


Laurence Stein, DDS
:doctor:

Disclaimer
(No representations are made that in any way offer a diagnosis, treatment or cure for any illness or condition, either discussed or implied. Answers to questions are offered as information only and should always be used in conjunction with advice from your personal diving physician/dentist. I take no responsibility for any conceivable consequence, which might be related to any visit to this site.)

 

[Bob3]

When I was diving commercially, we weren't allowed to get root canals because the risk of an air bubble may cause mischief. (I can't vouch for its validity though)
I have had a temporary crown pop loose on ascent.
As far as I know, the biggest problem you'll have is pain.

 

[Mel.B]

Thanks for that info...it sounds painful - both to my mouth and hip pocket!

I've managed to get in to see the dentist this coming weekend so I'll definately report back on how it goes.

Thanks again,

Mel

 

[dtdiver]

could this be referred pain from the sinuses or even the inner ear???

my son dove as he was just recovering from the flu, he was still congested and everything. (yes.. not a good idea)

he developed a tooth squeeze that prevented him from descending. he couldn't equalize to rule that out as a cause.
i can't imagine what it would have been like ascending!

that was two years ago and he has had no dental problems or caries in the meantime and no further problems with equalizing or tooth squeeze.

i know otitis externa can cause jaw pain (personal experience), is there a referral pattern for the inner ear to the teeth??

dt

 

[Laurence Stein DDS]

Hi Dtdiver,

The post above in not likely a sinus squeeze. That diver reports pain in the lower jaw. While a referred pain is possible, usually, if you can localize the pain, then it is from that area.

Lower jaw pain CAN refer to the ear and ear infections, TMJ, etc., must be ruled out.

The most likely cause of a barodontalgia is the maxillary sinus. When the sinus is involved, the pain may refer to the UPPER teeth, cheek, under the eye. There is usually no referral to the ear.

I have never seen a case of referred pain from the inner ear to the jaws. This doesn't mean it hasn't happened...but it would surprise me if it did.

Alas...there are things even a ToothDoc doesn't know!...sigh...

Regards,

Larry Stein
:doctor:

 

[Mel.B]

Hi,

Well I've just had an eventful trip to the dentist. On visual examination she couldn't see any hole so an x-ray was done which revealed a large deep hole on the side surface of my molar. I was told if I had left it a few more weeks that a root canal would definately be needed :wacko: and in fact may still be needed, but she can't predict it. The fact that I hadn't had any pain up until diving she sees as a positive sign. She also said that a root canal may not be too successful as it's below the gum

Thanks again - I'm glad I got it seen to straight away and that I went diving last weekend to discover the problem!

Mel