Granny Scuba
Let's take these a question at a time:
1) I dove 2 weeks ago at Vortex springs and experienced no pain. Could something have happened to the tooth since then? Surely if air was trapped in my tooth it would have hurt at Vortex. Could it be infection in the tooth?
The simple answer is YES. Things can change and your experience at Vortex may not be the same as currently. I doubt that air was trapped within your tooth (because trapped air is often blamed for all dental barotrauma problems and it is not true). Could trapped air be a problem? Yes. You could have also fractured an already brittle tooth and gas or infection may have gotten in.
As Bob DBF pointed out, teeth may have more canals than expected. Sometimes they can be seen on an x-ray, sometimes they are detected during the procedure... occasionally using an operating microscope (they are that small) and sometimes they completely escape detection.
BTW, Bob, I'm giving you a big THANKS for sharing that the shot wiped out the feeling in you jaw! That's a confidence builder! However, I will admit that anesthetic paresthesias can happen albeit uncommon and rarely permanent. but I digress.
Granny, if you have your wisdom teeth out, then the tooth you are describing is the maxillary second bicuspid. It typically has one canal but can have two or even three canals. If you have your wisdom teeth in your mouth, then your root canal is in your maxillary first molar. This typically has 3 canals but can have 4 or 5. About 30% of the time there is a tiny canal right next to the canal associated with the front, cheek side canal and it typically takes a microscope to find it.
2) This tooth is in the back, why would my front teeth area go numb? (they were only numb for about 20 minutes)
Ah! Here's the rub! You're pain may not be a result of a tooth! What you are describing is a paresthesia affecting multiple branches of the main nerve to your upper teeth. Typically, there are three branches and they supply the molars, the bicuspids and the front teeth with overlap of any two branches for some teeth. Your front teeth should not go numb from a problem with an individual tooth in the molar or bicuspid positions.
This makes me think that you are experiencing a barotrauma of the maxillary sinus.
Jim, I think you're on to something. Reverse block can produce an environment that can lead to the numbness symptoms.
While we think of the sinuses sort of like caves within the face completely encased with bone, this may not exactly be true. There can be perforations within that bone that is lined with the sinus membrane only... kind of like the membrane on the inside of an egg.
If a perforation in the sinus happens to be in an area where a nerve passes, than as pressure increases within the sinus (like on ascent), the membrane expands outwards and can press on this nerve. Behind and under the eye socket and next to the molars passes all the nerves that supply feeling to your upper teeth and lips. Even farther back is the main switching center for all the nerves that supply feeling to the right or left halves of your face.
If the sinus membrane presses outwards on the nerve fibers that pass through the infraorbital foramen, then you will experience the loss of feeling of the upper front teeth, gums and lips on one side of your face. If pressure is placed farther back, you will have a paresthesia of 1/2 of your face.
Most of the time, these perforations in the sinus wall are normal variations of human anatomy. They can be a result of infections or surgery in the area however.
3) I dont want to miss my special dive trip in a week. I can deal with the pain, (unless there is danger my tooth will explode sending shrapnel into my brain) Should I just deal with the pain and consult my Dentist after my scuba trip.
OK. Here's the deal. Pain is you body trying to tell you something is wrong and that you should do things to 1) Not make it worse and 2) Try to fix it. All the posters on SB except the docs can tell you anything they want. The proper medical/dental advice is to see your dentist or ENT before diving again. So, deal with the pain at your own risk and remember that you already experienced a change from your first painless dives to the ones that now cause pain on ascent. The next thing can be long lasting numbness or the failure to detect some other medical/dental problem.
Back to Bob DBF... Actually, a tooth can implode! It's called odontocraxis... look it up. The good news is that there is no schrapnel. Getting the little pieces out is a bitch
If there is an infection somewhere, continued diving can drive it into deeper tissues around the tooth or sinus but not into your body... like say your liver. There are dental infections that have been known to move up into the brain. But, hey, it's just 6 inches...NOT THE WHOLE BODY!
4) Would an X - Ray show if :
(a) I have an infection (b) an incomplete root canal or (c) air trapped in the crown.
Maybe, maybe, no. Not everything is visible on x-rays if they are small enough and heck... air is invisible anyway. You're not going to see it on an x-ray.
5) Would going deeper be worse?
Would sticking you finger into a lit candle hurt? Would sticking you finger into a blow torch be worse? Actually, most barodontalgias occur on ascent. Since you get the greatest percentage change in pressure within the first 33 feet, most dental/sinus pains occur as you get closer to the surface.
6) I wonder why I didnt feel pain on the first dive (also I only had 1 dive at Vortex....I wonder if I had made several dives also, would I have felt pain on the subsequent dives.
There is no way to tell. We don't know the exact cause of the pain, i.e., cracked tooth, infection, sinus infection, sinus congestion, etc. and we don't know when the condition became significant enough to create symptoms. So, if let's say your problem was sinus congestion and it gets worse the more dives you make, then you might very well have had a problem at Vortex had you continued diving. If, on the other hand, you cracked a tooth two days after your dive at Vortex and were unaware of it and then did your more recent dives, then you had a condition that did not exist at Vortex and no comparison can be made.
So, Granny, I would have this checked out by your dentist first to double check the root canal. If he finds nothing you might want to check with the ENT and tell him that your dentist has cleared you. The numbness of your front teeth makes me think a sinus problem.
Certainly, some sinus problems can clear on their own. If you had a cold, or congestion left over from a cold or allergy attack, this could explain your symptoms.
If you don't go to the doctor's offices, you might try an oral decongestant and/or nasal spray before your next dive. You must take it long enough before the dive to be effective and you can have no contraindication like allergy to the medication or high blood pressure or taking medication that interact with the decongestants. This option is only a possibility if you know that you had congestion at the time of you dives subsequent to Vortex and if you have no condition(s) that prohibit you from taking the medications. Certainly, if you dive again and the problem recurs DON'T DIVE AGAIN until a doctor clears you.
I should also make it clear that I, as a dentist would still view a recent root canal of an upper tooth and an maxillary paresthesia with some suspicion vis a vis causality. The question I might ask myself is was the condition that caused you to seek a root canal (I'm assuming pain or sensiitivity) actually coming from a tooth or did you have an underlying sinus condition that referred pain to a tooth. It can sometimes be impossible to differentiate tooth from sinus pain. The patient points to the tooth and the symptoms indicate the same tooth. Or... could you have had two different conditions with similar symptoms that overlapped?
Finally, DB I think that you SHOULD play a doctor on TV... like a coroner
