Root Canal Question

[Fouremco]

My wife had a root canal two days ago, to be continued next week. The tooth was packed and a temporary filling put in until the next appointment. Does this pose a problem from a diving perspective? We are scheduled for two dives tomorrow afternoon, and the tooth feels fine.

She isn't certain whether or not there may be air inside the tooth. If there is, presumably it would compress during descent and return to it's pre-dive volume upon ascent. If there are any live nerves remaining, will the increased pressure cause a problem, and if so, is it likely to a sensation of pressure or one of pain. She really doesn't want to pass on the dives, but wants some sense of what she's in for.

I realize that this doesn't have all the information that might help, but any advice would be appreciated.

 

[cardog]

I did two dives to a max depth of 95 fsw three days after a root canal and had zero problems.

 

[Fouremco]

Completed two 85' dives, one on the Henry C. Daryaw (http://www.scubaq.ca/ontarioscubadiving/daryaw.htm) and a drift dive starting at the Lillie Parsons (http://www.scubaq.ca/ontarioscubadiving/daryaw.htm) with no hint of a problem with the tooth. We're both glad that we chose to go for it (with the understanding that we would abort immediately if the tooth became painful) rather than sit it out.

 

[DocVikingo]

Hi Fouremco,

For future reference, here is the position of Dr. Larry Stein, a diving dentist & expert in the field:


"If your root canal is properly done and the tooth is permanently restored, then ideally there will not be an air space or a potential space that compressed gas can accumulate.

That being said, it can't hurt to advise your dentist that you scuba dive.

Frequently, following root canal therapy, but before the final restoration, there is a tiny cotton ball placed in the remaining pulp chamber. It is there to demarkate the chamber and where the root canal has been treated. It is a normal, common practice which normally causes no problem. If you dive however, then this is an air space and can cause problems.

The simple solution is to tell your dentist that you intend to dive before the tooth restoration is completed. All he has to do is fill the pulp chamber with a soft temporary cement to elimate the space that would be created by the cotton.

Other potential air pockets or potential spaces may occur due to accessory canals. These branch off the main canal at right angles and usually go undetected unless some root canal cement is squeezed into them during the root canal filling procedure. Then they become visible on an x-ray.

Extra nerve canals may be present and are difficult but not impossible to find. Upper first molars have a 4th canal in the mesio-buccal root about 30% of the time. If untreated, it may lead to a failure of the root canal over time and is certainly a place that gas may accumulate. Dentists who do root canals know this and usually try to locate these canals...not all can be found.

Poorly treated root canal have the potential to trap an air space or gas can accumulate in any unfilled or unsealed portion of the root canal. Root canals filled "short of the apex" can cause problems.

It doesn't surprise me that your parents have had no pain. Barodontalgia is a very rare phenomenon. Even if there is a space, most people won't suffer any problem.

On the other hand, you don't want to take a chance if you can help it. Gently remind or advise your dentist that you do scuba dive and would he be so kind to eliminate all air spaces. It is a reasonable request IMHO.

Here is a broader discussion of root canals and diving from Dive Medicine Online (http://www.scuba-doc.com/) :
http://www.scuba-doc.com/dendiv.htm#Root_Canal

Finally, it may surprise you to know the leading cause of root canal failure is the FAILURE TO PROPERLY RESTORE THE TOOTH IN A TIMELY MANNER. If saliva is able to penetrate into the tooth under the temporary filling, it will contaminate the chamber and the treated canals. Sometimes the bacteria are able to penetrate to the end of the root around the root canal filling material is as little as a month.

Where possible, you should try to complete your tooth before diving. While it is a small risk, it does exist.

Hope this helped.

Regards,

Laurence Stein DDS"


Regards,

DocVikingo