Tooth problems?

[Paco]

I was wondering if anyone has had a problem similar to mine. During a week long dive trip to Roatan, I had tooth pain, on and off, the entire week. Sometimes the pain was during a dive, sometimes not, sometimes on the boat, during the middle of the night, anytime, and the pain usually lasted an hour or two each time. A day after the trip, the pain left and hasn't been back. There were actually two teeth bothering me; one on which I had already had a root canal and another two teeth away. On return from the trip, I went to my dentist, who couldn't find anything at all. He sent me to the endodontist that did the root canal. He found a tooth with apparent necrotic tissue beneath and will be doing a root canal on it. The endodontist used to dive a lot and knows something about pressure related issues but even he did not seem convinced that my pain was pressure related because as he said, and I was told, pressure related tooth problems are very rare. So, does this make sense to anyone?

 

[DocVikingo]

I am alerting our diving dental maven, Laurence Stein, DDS, of your post.

Stay tuned.

DocVikingo

 

[Laurence Stein DDS]

Huh! What...er...I was sleeping...sorry I missed this.

Paco,

The endodontist is actually correct. Barodontalgia is very rare. I'm starting to think it's a lot more common since writing the article for DAN.

It is extremely rare in the entire population but I'm beginning to think that among divers, it is more common but not reported...especially occasional divers.

The pain you experienced was not typical for a dive related barodontalgia. Typically, there is pain on ascent or even descent especially in the first 30 feet.

Your symptoms, while possibly dive related, could have also just been from you biting on a tooth that was going bad and was starting to give you trouble.

Common symptoms that a tooth is going bad is cold and hot sensitivity, percussion and/or bite sensitivity, intermittent to continuous pain, throbbing.

A fractured tooth can produce similar symptoms and, in fact be the cause of the nerve dying. It also can produce a sharp, sudden pain when the tooth is compressed with your bite and possibly a "rebound" sensitivity upon release of your bite.

You did not report pain on CHANGE of depth so I would be inclined to agree with your endodontist.

Let me know how it goes.

Larry Stein:doctor:

 

[ssra30]

Hmm, on my last dive a week ago, I also had some problems. When I descent, 2 of my teeth hurt a bit but got significantly worse when I did a valsalva. No problem during ascend.
This has never happened before. I am planning a couple of multiday dive trips in the next several weeks. Is this something that I should get taken care off before my trip? I plan to do one day trip next weekend to see if the problem recur again but this sounds like something that I will have to deal with first.

Thanks for your help

 

[Paco]

My pain was intermittant throughout the week. I couldn't really say it started on ascent or descent. There were times that I was sure the pain was from a "dead" molar, but would wake during the night with the suspect bicuspid (sp?) very sensitive to bite pressure. In any case, the root canal is on Tuesday, but I suppose it will be several weeks before I dive deep as local diving rarely exceeds 30 ft. or so. Thanks ssra30, Doc Vikingo and Dr. Stein for your responses.

 

[Laurence Stein DDS]

ssra30,

You might want to have the teeth checked. Sinus pressure may also refer to the teeth as well. If you pinched your nose while clearing you may have increased the pressure in the maxillary sinuses.

Sinus problems are a more likely cause of dental pain than teeth but a dental problem has to be ruled out.

Paco,

A "dead" tooth means something different to a dentist than the patient. To me, a dead tooth is a non-vital tooth. It needs a root canal.

To a patient, they often refer to any tooth without a live nerve. The tooth may be non-vital and not root canaled or have had a root canal.

For simplicity, a dentist may refer to an abscessed tooth as a "dead" or "dying" tooth for simplicity in patient communication.

In your case, you seem to be referring to a tooth that had a non-vital nerve and it is getting a root canal on Tuesday. This was a perfect recipe for barodontalgia.

Good luck.

Larry Stein

 

[ssra30]

Thanks for all the help. My dentist/diving friend is coming back to town this week so I will give her a call. Hopefully everything will be ok. Did I mention, I am very scare of dentist (should not have watch that Marathon Man movie!)

 

[Paco]

When I referred to a "dead" tooth, I was referring to a tooth after a root canal had been performed on it. The pain I experienced was on a tooth in which there should have been no pain; that is why I was told that the nerves were sending mixed signals to my brain, and that the pain could have been coming from another tooth. I understand the explanations I have read here and from my dentist and endodontist, but I'm still convinced, form my week of diving, that the pain I experienced way pressure relalted. I guess it might be empirically significant if I could return to AKR for a week right after tomorrow's root canal. Anyone ready to donate to scientific research? Thanks again to all. Let's see..

 

[DocVikingo]

(nt)

 

[Laurence Stein DDS]

Duh, duh, duh, duh....:sharky: