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Diving after Dental surgery

Q: I need a filling and a crown. What do I need to discuss with my dentist to address the possibility of tooth squeeze (barodontalgia) from air pockets? Are there other dental issues with scuba diving about which my dentist should know?

As a diver descends in the water, the ambient pressure increases and subsequently decreases upon ascent. This pressure change is easy to equalize in air spaces that have a natural opening to the outside, such as lungs and ears. When a tooth is damaged or decayed, air may enter but have no way of being equalized. The diver may experience tooth pain (barodontalgia) during descent as the air compresses with depth and/or on the ascent as the air recompresses.  

Tooth pain can also occur if dental care was of poor quality and allows air to enter or if an air space remains within the tooth. Air spaces can cause severe pain and even cause fillings and crowns to become loose or dislodged. Tell your dentist that you are a scuba diver, so it is important to treat caries and repair defective dental work before diving to avoid air entrapment in your teeth. You should address any pain that comes with chewing, because in the course of normal diving you will be biting down on a regulator mouthpiece.

Be sure to allow enough time for complete recuperation from any dental procedures before leaving on a dive trip. Forcefully clenching your teeth on your regulator mouthpiece can damage teeth and dental restoration work. Existing fillings and crowns age or can become damaged. Silver fillings  generally last 10-15 years, while composite fillings last only 5-7 years on
average. Crowns may last 5-15 years. New caries can form. Your dental health should be included in your overall plan to maintain your dive fitness.

Divers naturally give priority to aspects of dive health such as avoiding decompression sickness and monitoring cardiovascular health, and indeed these are high priorities. Severe tooth pain can also quickly ruin a dive trip, especially in remote areas or on liveaboards where there is no dentist to be found. — Sheryl Shea, RN, CHT

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