diving and hurting tooth

Hi Andrea,

Your dentist may say the tooth is perfectly fine, but it had been filled recently and was hurting during the dive. So it really sounds like it was not perfectly fine. It sounds like there was a little airpocket with expanding air during ascent.

I don't know how long it has been since, you may be ok now or maybe not. If possible, before planning a vacation, get some local dives in to check.

Go back to your dentist and get an x-ray to see if there's any place air might be trapped under the filling. If expanding air presses on a nerve, it will happen on ascent, just as you describe, and then once the nerve is irritated, it will hurt for quite some time before the pain subsides overnight, especially if you irritate it with multiple dives in one day.

Thanks guys for taking the time!

This is really confusing. I had an x-ray since then and the filling is fine. If there were an airpocket – shouldn’t it have hurt on each dive? And especially on the first and deepest dive of each day when the air gets most compressed?

One dive guide reckoned I must have had blocked paranasal sinuses. I did not feel sick or having a cold at all, the guide said that it is common not to feel the blockage and ususally takes weeks and that there is nothing you can do about it.

Tought about doing some dives before the trip but since there are very few possibilities here I would need to go on a short diving trip to really test it but then I would still not know for sure since it took like a week of intensive diving before the problem occured the first time..

Don’t know if this is of any help but when it started to hurt during the dives I was having the same pain (just not as strong and once in a while) when descending, and on airplanes.

While what you describe--pain on ascent and worse as you get shallower is pretty typical of barodontalgia (barotrauma in a tooth), it is also typical of a reverse block in the sinus, and it could in fact be a sinus problem.

Is it an upper molar? I know that the nerves in those teeth extend up to the sinuses and a sinus squeeze in the maxillary sinus can press on the nerves of a maxillary molar, making it feel like a toothache. It's even possible to effectively clear your ears even with a blocked sinus, so the ability to clear or not isn't a decisive factor in figuring out whether it's a sinus squeeze or actually barodontalgia. Perhaps the tooth is especially sensitive after the treatment and a little squeeze was enough to cause significant pain.

Try a little test--bend over with your head hanging down for a few minutes. Do you get a sensation of pressure and heaviness under your eyes? If so, you might have some congestion or even an infection in the sinus.

It can sometimes be impossible for a person to differentiate sinus from tooth pain. You really need professional medical advice. Review your x-rays again with your dentist to make sure you don't have a cracked tooth or root (though the x-ray may not actually reveal the crack at all, so perhaps you'll have to have the tooth reopened), and if/when you have been cleared by the dentist, go to an ENT to have your sinuses checked out.

interesting quero
and yes, the tooth was sensitive after the treatment
it was a molar in the lower jaw though. the diving trip is months back now (and the pain stopped basically after the last dive/flight, just having felt some pain for some seconds from time to time for some more weeks after diving)

will check again with dentist and ENT
any idea whether there is anything you can do to prevent sinus problems when diving? try to keep warm, cover up to prevent from wind when going back on the boat and hair beeing wet etc..?

I tend to get sinus congestion, and for me prevention includes keeping my head warm. I sometimes have to sleep wearing a fleece hat in an air conditioned cabin of a liveaboard, for example, and I may wear a hoodie when the boat is moving and there's a lot of wind. I also take long-acting loratadine to help open up the passages. Afrin is great for shrinking tissues, but is addictive, so it's not a good solution for more than four days. Check any plan you have for self-medication with your health care provider, though.

Read this info from DAN: http://www.diversalertnetwork.org/medical/faq/Diving_and_Wisdom_Teeth