Barodontalgia
Encyclopedia
Barodontalgia, commonly known as tooth squeeze and previously known as aerodontalgia, is a pain in tooth
caused by a change in atmospheric pressure
. The pain usually ceases at ground level.
The most common victims are SCUBA divers
because in deep dives pressures can increase by several atmospheres
, and military pilots because of rapid changes.
In pilots, barodontalgia may be severe enough to cause premature cessation of flights.
Most of the available data regarding barodontalgia is derived from high-altitude chamber simulations rather than actual flights. Barodontalgia prevalence
was between 0.7% and 2% in the 1940s, and 0.3% in the 1960s.
Similarly, cases of barodontalgia were reported in 0.3% of high altitude-chamber simulations in the Luftwaffe
.
The rate of barodontalgia was about 1 case per 100 flight-years in the Israel
i Air Force
. During War World II, about one-tenth of American aircrews had one or more episodes of barodontalgia. In a recent study, 8.2% of 331 Israeli Air Force aircrews, reported at least one episode of barodontalgia.
Barodontalgia is a symptom
of dental disease
, for example inflammatory
cyst
in the mandible.
Indeed, most of the common oral pathologies have been reported as possible sources of barodontalgia: dental caries
, defective tooth restoration, pulpitis
, pulp necrosis, apical periodontitis, periodontal pockets, impacted teeth, and mucous retention cyst
s. One exception is barodontalgia manifested as referred pain from barosinusitis
or barotitis-media. The latter two conditions are generated from pressure changes rather than pressure-related flare-up of pre-existing conditions.
A meta-analysis
of studies conducted between 2001 and 2010 reveled a rate of 5 episodes/1,000 flight-years. Maxilla
ry and mandibular dentition
s were affected equally in flight, but in diving, maxillary dentition was affected more than the mandibular dentition, which can indicate a greater role for maxillary sinus
pathology in diving barodontalgia. Surprisingly, despite the cabin pressurization
- the current in-flight barodontalgia incidence is similar to the incidence in the first half of the 20th century; despite the more fluctuation in divers' pressures - the weighted incidence of barodontalgia among aircrews are similar to the weighted incidence among divers; and as opposed to a common belief, and in contrast to diving conditions - the role of facial barotrauma in the etiology of in-flight barodontalgia is only minor (about one-tenth of cases).
describes 4 classes of barodontalgia. The classes are based on signs and symptoms. They also provide specific and valuable recommendations for therapeutic intervention.
Tooth
Teeth are small, calcified, whitish structures found in the jaws of many vertebrates that are used to break down food. Some animals, particularly carnivores, also use teeth for hunting or for defensive purposes. The roots of teeth are embedded in the Mandible bone or the Maxillary bone and are...
caused by a change in atmospheric pressure
Atmospheric pressure
Atmospheric pressure is the force per unit area exerted into a surface by the weight of air above that surface in the atmosphere of Earth . In most circumstances atmospheric pressure is closely approximated by the hydrostatic pressure caused by the weight of air above the measurement point...
. The pain usually ceases at ground level.
The most common victims are SCUBA divers
Scuba diving
Scuba diving is a form of underwater diving in which a diver uses a scuba set to breathe underwater....
because in deep dives pressures can increase by several atmospheres
Atmosphere (unit)
The standard atmosphere is an international reference pressure defined as 101325 Pa and formerly used as unit of pressure. For practical purposes it has been replaced by the bar which is 105 Pa...
, and military pilots because of rapid changes.
In pilots, barodontalgia may be severe enough to cause premature cessation of flights.
Most of the available data regarding barodontalgia is derived from high-altitude chamber simulations rather than actual flights. Barodontalgia prevalence
Prevalence
In epidemiology, the prevalence of a health-related state in a statistical population is defined as the total number of cases of the risk factor in the population at a given time, or the total number of cases in the population, divided by the number of individuals in the population...
was between 0.7% and 2% in the 1940s, and 0.3% in the 1960s.
Similarly, cases of barodontalgia were reported in 0.3% of high altitude-chamber simulations in the Luftwaffe
Luftwaffe
Luftwaffe is a generic German term for an air force. It is also the official name for two of the four historic German air forces, the Wehrmacht air arm founded in 1935 and disbanded in 1946; and the current Bundeswehr air arm founded in 1956....
.
The rate of barodontalgia was about 1 case per 100 flight-years in the Israel
Israel
The State of Israel is a parliamentary republic located in the Middle East, along the eastern shore of the Mediterranean Sea...
i Air Force
Israeli Air Force
The Israeli Air Force is the air force of the State of Israel and the aerial arm of the Israel Defense Forces. It was founded on May 28, 1948, shortly after the Israeli Declaration of Independence...
. During War World II, about one-tenth of American aircrews had one or more episodes of barodontalgia. In a recent study, 8.2% of 331 Israeli Air Force aircrews, reported at least one episode of barodontalgia.
Barodontalgia is a symptom
Symptom
A symptom is a departure from normal function or feeling which is noticed by a patient, indicating the presence of disease or abnormality...
of dental disease
Dental disease
Dental diseases may affect the teeth, the gums, or other tissues and parts of the mouth. Dental diseases can cause much more serious problems than a toothache; they can affect our ability to chew, smile, or speak properly. Their severity may range from a simple aphthous ulcer, to a common tooth...
, for example inflammatory
Inflammation
Inflammation is part of the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. Inflammation is a protective attempt by the organism to remove the injurious stimuli and to initiate the healing process...
cyst
Cyst
A cyst is a closed sac, having a distinct membrane and division on the nearby tissue. It may contain air, fluids, or semi-solid material. A collection of pus is called an abscess, not a cyst. Once formed, a cyst could go away on its own or may have to be removed through surgery.- Locations :* Acne...
in the mandible.
Indeed, most of the common oral pathologies have been reported as possible sources of barodontalgia: dental caries
Dental caries
Dental caries, also known as tooth decay or a cavity, is an irreversible infection usually bacterial in origin that causes demineralization of the hard tissues and destruction of the organic matter of the tooth, usually by production of acid by hydrolysis of the food debris accumulated on the...
, defective tooth restoration, pulpitis
Pulpitis
- Symptoms :Increased sensitivity to stimuli, specifically hot and cold, is a common symptom of pulpitis. A prolonged throbbing pain may be associated with the disease...
, pulp necrosis, apical periodontitis, periodontal pockets, impacted teeth, and mucous retention cyst
Mucous retention cyst
A mucous retention cyst is a cyst caused by an obstruction of a duct, usually belonging to the parotid gland or a minor salivary gland. See also Mucocele....
s. One exception is barodontalgia manifested as referred pain from barosinusitis
Barotrauma
Barotrauma is physical damage to body tissues caused by a difference in pressure between an air space inside or beside the body and the surrounding fluid...
or barotitis-media. The latter two conditions are generated from pressure changes rather than pressure-related flare-up of pre-existing conditions.
A meta-analysis
Meta-analysis
In statistics, a meta-analysis combines the results of several studies that address a set of related research hypotheses. In its simplest form, this is normally by identification of a common measure of effect size, for which a weighted average might be the output of a meta-analyses. Here the...
of studies conducted between 2001 and 2010 reveled a rate of 5 episodes/1,000 flight-years. Maxilla
Maxilla
The maxilla is a fusion of two bones along the palatal fissure that form the upper jaw. This is similar to the mandible , which is also a fusion of two halves at the mental symphysis. Sometimes The maxilla (plural: maxillae) is a fusion of two bones along the palatal fissure that form the upper...
ry and mandibular dentition
Dentition
Dentition pertains to the development of teeth and their arrangement in the mouth. In particular, the characteristic arrangement, kind, and number of teeth in a given species at a given age...
s were affected equally in flight, but in diving, maxillary dentition was affected more than the mandibular dentition, which can indicate a greater role for maxillary sinus
Maxillary sinus
The pyramid shaped maxillary sinus is the largest of the paranasal sinuses, and drains into the nose. It is present at birth as rudimentary air cells, and develops throughout childhood.-General characteristics:...
pathology in diving barodontalgia. Surprisingly, despite the cabin pressurization
Cabin pressurization
Cabin pressurization is the pumping of compressed air into an aircraft cabin to maintain a safe and comfortable environment for crew and passengers when flying at altitude.-Need for cabin pressurization:...
- the current in-flight barodontalgia incidence is similar to the incidence in the first half of the 20th century; despite the more fluctuation in divers' pressures - the weighted incidence of barodontalgia among aircrews are similar to the weighted incidence among divers; and as opposed to a common belief, and in contrast to diving conditions - the role of facial barotrauma in the etiology of in-flight barodontalgia is only minor (about one-tenth of cases).
Classification
The Fédération dentaire internationaleFDI World Dental Federation
The FDI World Dental Federation, established in Paris in 1900 as the Fédération dentaire internationale, is the world's leading organization representing the dental profession...
describes 4 classes of barodontalgia. The classes are based on signs and symptoms. They also provide specific and valuable recommendations for therapeutic intervention.