RobbieLJB:
I am a new diver in the process of getting my certification. In the beginning, I had trouble with sinus pain and getting my ears to clear. I've since learned how to work through that, and I was on my way to certification. On my 2nd of 4 final test dives, I got this intense pain in my face at 8 feet. I surfaced and the pain last through 2 rounds of Aleve and into the night.
The next day, I attempted to dive again, but at 8 feet, my face started to hurt. The pain was in my cheek, above my teeth. It felt like the pain was coming from my teeth, but I can't be certain.
I don't want to go to the dentist to have the filling replaced if that's not really the issue. How can I tell where the pain is coming from?
Thanks in advance!
Hi RobbieLJB,
I would agree with DocV. It is most likely sinus pain.
So how CAN you really tell? You can't. Some clues though...if the pain affects the upper molar or bicuspid teeth and your dental health is good, it is most likely sinus related.
The roots of the upper molars and bicuspids are often found bordering the maxillary sinuses. Radiographically, the roots may appear to actually penetrate the sinus. There can actually be a small window in the bone separating the root from the sinus called a fenestration. The only thing that may separate the tooth from the sinus is the sinus membrane.
Any unequalized pressure within the sinus can also apply that pressure to the root ends and the nerve that enters the tooth. Also, the nerves within the sinuses come from the same root as the upper teeth. A real or referred pain is very possible and it may be impossible to separate tooth from sinus.
Most barodontalgias are, statistically, related to the sinuses. If you have a history of sinus problems, allergies, etc., it would tend to increase sinus suspicion. A recent cold, even if you don't think you had sinus involvement, would be a red flag. Sinus related barodontalgia can occur on descent or ascent. Barodontalgia coming from a tooth...especially if there is pulpal pathology, is more likely on ascent...but can occur on descent as well.
If you haven't had a recent dental check-up, then you might want to have it checked out...for peace of mind. If the problem persists, and the teeth check out OK, then see the ENT. Sinus problems are often difficult to control.
BTW, if you cannot locate any offending tooth, DO NOT start replacing fillings "just in case". This can actually cause the problem you are trying to solve. Recently, treated teeth may have a residual pulpitis that lasts for several weeks and could result in a real tooth related barodontiagia. If your dentist actually finds a failing filling or other dental problem...especially involving the area that has hurt you during dives, then you should certainly treat the problem.
I hope this helps.
Laurence Stein, DDS
