Tooth Pain & Braces

[esqeddy]

Mt 11 year old son had braces put on his teeth about 4 or 5 months ago. He dove previously without incident. However, on the last two trips he has experienced sever tooth pain.

On the first occasion, he made a couple of dives without incident, but upon decent on the third dive he immediately experienced severe tooth pain in a upper rear tooth. Yesterday, he made a shallow dive in the Keys without a problem, but on the next dive he was again struck with severe tooth pain at about 15 feet of depth. The pain was much more severe this time. He immediately surfaced as was in agony. The pain persisted for a half hour or so before disipating.

I took my son to a dentist in Key West this morning who said the filling in the suspect tooth was fine. He theorizes that some interaction with the pressure and the braces may be causing the problem. I'm no dentist, but I do not see how this could be. Braces would apply some lateral force to a tooth and I do not see how a uniform pressure from all directions would make in difference.

I am suspicious that the cause may be other than dental.

Anyone ever seen or experienced similar difficulties?

 

[Laurence Stein DDS]

Mt 11 year old son had braces put on his teeth about 4 or 5 months ago. He dove previously without incident. However, on the last two trips he has experienced sever tooth pain.

On the first occasion, he made a couple of dives without incident, but upon decent on the third dive he immediately experienced severe tooth pain in a upper rear tooth. Yesterday, he made a shallow dive in the Keys without a problem, but on the next dive he was again struck with severe tooth pain at about 15 feet of depth. The pain was much more severe this time. He immediately surfaced as was in agony. The pain persisted for a half hour or so before disipating.

I took my son to a dentist in Key West this morning who said the filling in the suspect tooth was fine. He theorizes that some interaction with the pressure and the braces may be causing the problem. I'm no dentist, but I do not see how this could be. Braces would apply some lateral force to a tooth and I do not see how a uniform pressure from all directions would make in difference.

I am suspicious that the cause may be other than dental.

Anyone ever seen or experienced similar difficulties?

Hi Esqeddy,

What you've described is typical of a sinus problem. I have had patients call me with a dental emergency following their arrival at the airport. Typically, the pain starts on descent for a landing rather than ascent to altitude. They will report a toothache or tooth pain of their upper teeth.

By the time they arrive at my office, their pain has gone away. There is nothing to be found upon examination. An x-ray of the affected area is negative for an abscess or a cavity. Occasionally, cloudiness may be noted on the x-ray in the maxillary sinus. Dental x-rays are not very good for diagnosing sinus problems however.

The patient may report a recent cold or allergy symptoms.

If there are filled teeth in the area of the reported pain, a failing/leaking restoration may be suspected. If there is a recently placed filling, replacing it with a sedative filling might be suggested. Checking the teeth for fractures is also done. The diagnosis of a sinus related pain is highly suspected if there are no fillings or other pathology on x-ray.

All this being said, orthodontic movement is traumatic to a tooth and while it is a "stretch", it is within the realm of possiblity that some pupal pathology within a tooth is possible.

Since your dentist can't find a tooth problem, I would suggest that you contact an ENT physician. There doesn't have to be an infection for there to be a sinus problem. He might suggest sinus x-rays, a decongestant and a steroid nasal spray.

Let us know what happens.

Regards,

Laurence Stein, DDS

 

[Giggi]

One thing I noticed about diving since I got my braces on is that in order to keep the regulator in my mouth, I have to bite considerably harder on the mouthpiece than I did before I got braces. After a week of diving, the discomfort was about equal to having had a regular adjustment. Is it possible that his toothache is due to additional exertion from the regulator? I would check it out with his orthodontist, as well.