Tooth Abscess and diving

[brennz]

This is a first post from a long time reader of ScubaBoard..

I have a tooth abscess under one of my main molars and am scheduled for a root canal in a months time (the first possible appointment at my endodontist!).
The only symptom I have present is the swelling inside my mouth on my gum which is only painful if pushed.

My question is am I able to dive before the treatment starts?

I have researched this subject within the ScubaBoard forums and have only been able to come up with advice for divers who want to dive once the treatment has started (in-between appointments).
My concern is the effect of compression/decompression on the abscess itself and if a rupture or other nasty outcome is possible..

 

[DocVikingo]

Hi brennz,

The changes in ambient pressure inherent in recreational SCUBA affect only air-containing spaces, not tissues or fluids (e.g., pus). As such, rupture or forced drainage of an incipient tooth abscess as the sole result of diving would not be anticipated.

That an endodontist considers the abscess not serious enough to require a root canal any sooner than a month's time might suggest that the infection is quite limited at the moment. Still, most persons with this condition are placed on an antibiotic prior to actual endodontic intervention.

Divers in such a situation will want to make sure that holding the second stage mouth piece in the oral cavity does not cause significant pain. Also, if pain medication is being taken it should be of a type that does not pose a risk to safe diving, e.g., non-narcotic.

Helpful?

DocVikingo

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such.

 

[ScubaMarc]

I had a reverse squeeze 2 years ago. VERY PAINFULL. If you do dive and if you have pain on the way up from the line. Bounce a little and use every last breath to go up the line very very slowly.

 

[brennz]

Thanks DocVikingo,

That all makes sense, my only other concern is that the endodontist mentioned the tooth may possibly be cracked through the root. This wouldn't allow gas to enter the abscess from the bloodstream would it?

I have a free week in-between jobs coming up and was planning to dive from a liveaboard out of Cairns, Australia or dive the Poor Knights (I live in New Zealand).
I'm thinking the trip to Cairns might have to wait and to maybe go with the closer and cheaper option in case it all goes downhill in the next couple of weeks..

Thanks again

 

[Papa_Bear]

A friend of mines Grandson (17) went diving with us in Cozumel and we went to about 80ft... On the way up he grabbed his head and looked like he was in pain! Once on the boat we was in obvious pain and crying! He had blown out the side of his tooth and had to have a Root-Canal in San Miguel and couldn't dive for the rest of the week! He did get a good deal and a gold filling!

 

[brennz]

Thanks ScubaMarc and PapaBear I have taken your experiences onboard!
I think I will be erring on the side of safety and choosing to dive closer to home...

 

[DocVikingo]

Hi brennz,

Small world--many years ago I dove the Poor Knights Islands myself. Rather a marked, but lovely, change of pace from my usual Caribbean SCUBA fare. Did a quickie down in Milford Sound, too, (with an ex-helicopter pilot of Jacques Cousteau) and still haven't fully warmed up ; )

The dental situation described is becoming more complex as the thread unfolds, and dentistry certainly is not a specialty of mine.

The possibility that a crack in the root of the tooth could "allow gas to enter the abscess from the bloodstream" does not appear a realistic concern. However, the nature and extent of this possible "crack through the root of the tooth" is as yet not well detailed. Any compromise that could allow air from the mouth to enter the body of the tooth could open the door to very significant problems.

Also, if the diver isn't on antibiotics while awaiting the root canal, there is no guarantee that the abscess could not rapidly become worse.

IMHO, a diver in this situation would be prudent not to push his luck.

Regards,

DocVikingo

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such.