Temporary Filling

[Jacky Boy]

Hi, I know there have been lots of threads about whether or not its safe to dive with a tempory filling, but none really cover exactly my issue.
So if someone could help I'd greatly appreciate it. I'm going on holiday next week, I had planned to scuba dive. I havnt been diving in a while, or to the dentist in a while so I thought make sure my filling was ok to go diving. Turns out the cavity had grown and the filling needed replacing. So I went back this afternoon for a replacement filling, but even after injecting me many times with 2 different anesthetics, the pain whilst drilling was still too great to continue. She concluded that the cavity had reached the nerve and I may have to have to tooth removed. So she told me to book another appointment and put a seditive tempory filling in. I cant get another appointment till after my holiday.
After looking at the other posts Ive pretty much decided that I wont be able to dive on my holiday (im doing a review dive tonight, but thats in a swimming pool so im hoping there will be no complications). If any of the information ive provided leads someone who understands dentistry and diving to conclude that infact, there would lightly not be an issue, please say so.
What made me decide that diving is most likely not a good idea is because if the cavity has extended deep and into the nerve, the tempory filling will have just covered over the cavity and not actually filled all of it in.

Thanks
Jack.

 

[Laurence Stein DDS]

Hi Jacky Boy,

You said the dentist has drilled on the tooth. What is in it now? Is your tooth sensitive?

When a cavity gets deep enough to affect the nerve, the pulp tissues may begin to devitalize (die). In the process, the pH (acidity) if the pulp may go down... it goes from a relatively neutral pH to a more acid pH. This can have an effect on how local anesthetics work.

It is not uncommon for an infected or inflamed tooth to be difficult or impossible to get completely numb. There a few "tricks" that might work but if these don't help, sometimes the only thing to do is to stop the procedure, and if indicated, place the patient on an appropriate antibiotic.

A person can dive with a temporary filling... it just depends upon what the temporary is made of and how it is placed. Typically "sedative fillings" are made of zinc oxide and clove oil (eugenol). The commercially available sedative filling materials can last from months to up to a year... they are actually pretty strong but will eventually come out, break or wear away. They must be placed into a prepared slot that will mechanically retain them. Just squishing some cement into a decay lined hole won't do.

Cements made of calcium hydroxide are softer and are typically used as temporaries to plug root canal procedures... either between visits or after the root canal completion but before the final restoration. This stuff is much softer and can wash out. There is no sedative medication present so it is usually not used to temporarily fill cavities. Some dentists will do so however if you come in with a hole in your tooth and you need to quickly plug it with something until a definitive restoration can be placed in just a day or so.

It is not safe to dive with a temporary filling in a root canal tooth. Often a piece of cotton is placed under the filling and the water pressure can force the temporary into the hole which will allow saliva and germs to get into the open nerve space. If you must dive with a temporary filling in a root canal tooth, then the entire space must be filled with the cement with no cotton. Even then you may be taking a chance.

In your case, even if the dentist could place a sedative filling before your dives, it is possible that you may experience a barodontalgia as a result of pressure on an unhealthy, devitalizing or infected nerve. Pain is not always the first symptom when a tooth is going bad.

If there is a shallow temporary filling in your tooth now and it is well placed, you might actually be better off than having the deep decay removed (which might set off the tooth) and doing your dive. If you have any symptoms of pain or tenderness to biting pressure before the dive you should not dive. If your tooth becomes painful underwater, abort the dive and don't try again until the dental problem has been resolved.

Hope this helps. There is no absolute answer and you may or may not experience problems.... or not, during your dives.

Toothdoc

 

[Jacky Boy]

Laurence, thankyou for your very thourough response. I was going to phone the dental hospital today and try to have my tooth removed before I go on holiday, but I think she put something below the filling to reduce the infection/inflamation of the nerve, so that she could proceed on our next appointment, I thought it was just to reduce the pain between appointments (she didnt prescribe any anti-biotics). So I think its probably best just to stick to the appointment she gave me, and as luck would have it my Boss at wrk knows a good dentist in the area of portugal im staying in so if there are any complications I have his number. Shame I wont be diving, I suppose theres always next year .