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Barodontalgia

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Title: Barodontalgia  
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Subject: Aviation medicine, Dental barotrauma, Diving medicine, Sports medicine, Outline of dentistry and oral health
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Barodontalgia

Barodontalgia
Classification and external resources
ICD-10 W94
ICD-9 993.2

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.[1][2][3] The most common victims are SCUBA divers because in deep dives pressures can increase by several atmospheres,[4] and military pilots because of rapid changes.[5][6][7][8] In pilots, barodontalgia may be severe enough to cause premature cessation of flights.[9]

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.[7]

Similarly, cases of barodontalgia were reported in 0.3% of high altitude-chamber simulations in the Luftwaffe.[10]

The rate of barodontalgia was about 1 case per 100 flight-years in the Israeli Air Force.[11] During World War II, about one-tenth of American aircrews had one or more episodes of barodontalgia.[9] In a recent study, 8.2% of 331 Israeli Air Force aircrews, reported at least one episode of barodontalgia.[11]

Barodontalgia is a symptom of dental disease, for example inflammatory cyst in the mandible.[12] 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 cysts. 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.[13] A meta-analysis of studies conducted between 2001 and 2010[14] reveled a rate of 5 episodes/1,000 flight-years. Maxillary and mandibular dentitions 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.[14] Surprisingly, despite 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).[14]

Classification

The Fédération dentaire internationale describes 4 classes of barodontalgia.[1] The classes are based on signs and symptoms. They also provide specific and valuable recommendations for therapeutic intervention.[1]

See also

References

  1. ^ a b c Robichaud, R; McNally, ME (January 2005). "Barodontalgia as a differential diagnosis: symptoms and findings". J Can Dent Assoc 71 (1): 39–42.  
  2. ^ Rauch, JW (1985). "Barodontalgia--dental pain related to ambient pressure change". Gen Dent 33 (4): 313–5.  
  3. ^ Weiner, R (2002). "Barodontalgia: caught between the clouds and the waves". J Mass Dent Soc 51 (3): 46–9.  
  4. ^ Zadik, Yehuda; Drucker Scott (September 2011). "Diving dentistry: a review of the dental implications of scuba diving". Aust Dent J. 56 (3): 265–71.  
  5. ^ Brubakk, Alf O; Neuman, Tom S (2003). Bennett and Elliott's physiology and medicine of diving, 5th Rev ed. United States: Saunders Ltd. p. 800.  
  6. ^ Lyons, KM; Rodda, JC; Hood, JA (March 1999). "Barodontalgia: a review, and the influence of simulated diving on microleakage and on the retention of full cast crowns". Mil Med 164 (3): 221–7.  
  7. ^ a b Dehart, RL; Davis, JR (2002). Fundamentals Of Aerospace Medicine: Translating Research Into Clinical Applications, 3rd Rev Ed. United States: Lippincott Williams And Wilkins. p. 720.  
  8. ^ Gonzalez Santiago, Maria del Mar; Martinez-Sahuquillo Marquez, Angel; Bullón-Fernández, Pedro (2004). "Incidence of barodontalgias and their relation to oral/ dental condition in personnel with responsibility in military flight" (PDF). Med Oral 9 (2): 98–105, 92–8.  
  9. ^ a b Zadik, Yehuda (January 2009). "Aviation dentistry: current concepts and practice". British Dental Journal 206 (1): 11–6.  
  10. ^ Goethe, WH; Bäter, H; Laban, C (October 1989). "Barodontalgia and barotrauma in the human teeth: findings in navy divers, frogmen, and submariners of the Federal Republic of Germany". Mil Med 154 (10): 491–5.  
  11. ^ a b Zadik, Yehuda; Chapnik, L; Goldstein, L (June 2007). "In-flight barodontalgia: analysis of 29 cases in military aircrew". Aviat Space Environ Med 78 (6): 593–6.  
  12. ^ Zadik, Yehuda (August 2006). "Barodontalgia due to odontogenic inflammation in the jawbone". Aviat Space Environ Med 77 (8): 864–6.  
  13. ^ Zadik, Yehuda (April 2009). "Barodontalgia". J Endod 35 (4): 481–5.  
  14. ^ a b c Zadik, Yehuda (April 2010). "Barodontalgia: what have we learned in the past decade?". Oral Surg Oral Med Oral Pathol Oral Radiol Endod 109 (4): e65–9.  
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