What is and how to prevent barodontalgia?

Although barodontalgia is rare, its presence can ruin a trip or sports activity. We will tell you what it is about and how you can avoid its appearance.

Last update: January 11, 2022

Did you feel pain in a tooth when traveling by plane? Do you dive frequently and come out of the water with severe teeth discomfort? You may have barodontalgia.

This little-known condition can constitute a true impact on the quality of life of certain people who carry out activities in height or in the depths of the water. Mountaineers, divers, pilots or employees who have to constantly travel by plane … All of them are susceptible to barodontalgia.

But not only the profession or sports activity are responsible. A primary risk factor is poor oral hygiene or neglect of pathologies of the oral cavity, such as cavities. The latter, without a proper approach, increase the chances of having pain when the atmospheric pressure changes.

Considering that nobody wants to have discomfort in the mountains, on board a plane or submerged in the ocean, we will tell you why barodontalgia occurs and what you can do to prevent it. Do not miss it.

What do we call barodontalgia?

The term barodontalgia It is made up of two parts. The first is baro, which means ‘pressure’. On the other hand, toothache it’s tooth pain.

In this way, we understand that the concept refers to a pain in the teeth caused by the change in atmospheric pressure to which a person submits. This change in pressure can occur due to a rise to high altitudes or a descent to considerable depths underwater and then return to the surface.

In English we use the expression tooth squeeze to describe the phenomenon and the sensations of the patients. It could be translated as ‘teeth squeeze’ in Spanish, since along with pain is the perception that the dental element itself exerts pressure out of itself.

Who can get barodontalgia?

Barodontalgia can appear at any age and affect anyone. Anyway, the requirement of passing through a change in atmospheric pressure must be met. That is, if there is pain in a tooth without being at high altitude or without being submerged, then we cannot talk about this disorder.

In this sense, there are population groups that are more exposed by their work or recreational activities. Among them we can mention the following:

  • Mountaineers, hikers and mountaineers.
  • Aircraft pilots, stewardesses and aircrew.
  • Soldiers and militia personnel performing aviation or diving duties.
  • Professional or sport divers.
  • People who because of their work have to travel frequently by airplanes to fulfill tasks in different destinations.

But as we anticipated in the introduction, within these most exposed groups there are risk factors that increase the possibility of suffering from barodontalgia. That is, not everyone who gets on a plane will have tooth pain.

Those with any of the following conditions are more likely to be affected:

  • Gingivitis or inflammation of the gums.
  • Dental fillings or repairs.
  • Cavities.

This greater susceptibility is explained by the exposure of the dental pulp in these patients. It is in this tissue that the dental nerve is located, which is ultimately the one in charge of registering the atmospheric pressure change and reacting with pain in front of it.

Diving is linked to trauma that is related to pressure changes, such as those affecting the ear and teeth.

The pain mechanism responds to physics

To understand why there is dental pain when the atmospheric pressure changes, we have to refer to a principle of physics which is the Boyle-Mariotte law. It establishes that the volume of a gas trapped in a closed container, at a constant temperature, changes according to the variations in the pressure it receives.

This change is inverse. If the surrounding pressure increases, the enclosed gas decreases in volume. On the contrary, if the pressure is reduced, then the gas increases in volume.

In barodontalgia this applies to the gas that is within the dental elements (especially if there is cavities). As you rise above sea level, the atmospheric pressure decreases; This causes the gas contained in a tooth to expand, increasing its volume and pushing outward.

In diving, the same happens when you rise to the surface again. The diver is subjected to more atmospheric pressure when descending, but rising out of the water begins the opposite process, which would be equivalent to ascending a mountain.

Now why is gas trapped inside the tooth? The routes by which the air reaches the interior of the pulp chamber are varied. Although the cause could not be determined, it is most likely that some factor has played a role in causing the gas to settle in contact with the dental nerve.

If there was death of any part of the pulp tissue, the gas could find a place to occupy. In the same way, it would be difficult for it to get out through the blood because the vascularization is poor, due to the necrosis of the area.

In the case of having suffered a fracture in a tooth, the fissure serves as a channel for the gas to move inwards and it is difficult for it to get out. It is as if it were a one-way path for air to enter, but not exit. The same explanation applies to a filling that is misfit or has leaking spaces.

Again, we emphasize that barodontalgia has as a risk factor the fact of having a previous dental pathology. Then, what the change in atmospheric pressure does is stimulate the trapped gas to change its volume. And there the pain appears.

That is why it is understood that this process is a symptom, but not a disease in itself. If pressure change pain appears, a dentist should be consulted to determine which underlying clinical picture is the culprit.

Symptoms of barodontalgia

Of course, the cardinal symptom of barodontalgia is tooth pain or feeling of tightness from within the tooth element when atmospheric pressure changes. But there are associated signs that may suggest the underlying pathology.

For example, the sharpest and most intense pain is associated with cavities. On the other hand, when small hemorrhages appear around the affected tooth, it is usually due to a recent oral surgery.

It is rare and infrequent for gas to cause a dental fracture by expanding. Anyway, Yes it can complicate or aggravate a clinical picture that is already present on the patient beforehand.

There is a classification for barodontalgia that considers the symptoms and the possible underlying pathology. Is the next:

  • Class 1: pain appears suddenly when ascending, but the patient feels nothing when descending. Most likely it is an acute or irreversible pulpitis.
  • Class 2: throbbing and dull pain on ascending, which appears progressively, but without symptoms on descending. It could be a chronic pulpitis.
  • Class 3: the presence of pain equal to that of class 2, but which occurs when descending and not when ascending, is indicative of necrotic pulpitis.
  • Class 4: finally, the intense pain both when ascending and descending, raises the suspicion of apical periodontitis.

How to prevent it?

Preventing barodontalgia is relatively straightforward. Some precautions must be taken when we know that we will be in situations of atmospheric pressure changes. And especially, those patients with cavities, pulpitis, dental fractures or who received oral surgery recently, should take extreme measures.

Therefore, it is logical to emphasize that the main prevention is in good oral hygiene. As long as the factors that affect the production of pathologies of the mouth are reduced, there will be less risk of pressure pain.

It will also be necessary to have periodic reviews with a trusted dentist. If we had oral surgery, a dental extraction or a repair and we have to get on a plane, we can ask the professional what security is there to take the flight.

In the same way, if we frequently practice sports activities such as mountaineering or diving, we will also have to receive authorization from the dentist and medical discharge to resume these disciplines. A tentative date can be provided in the office to resume practices after an intervention.

For divers attending sports schools, it is essential that instructors are aware of their oral condition. They will also be able to recommend or not the immersion according to their experience with the subject.

Equalize pressures

There are two natural and simple methods that can help to equalize the pressures between the outside and the inside of the body a bit when we change altitude. They will not always prevent barodontalgia, and they may not help much if there are serious pathologies of the teeth, but in mild cases they make a difference.

One option is to chew gum. The act of chewing mobilizes air within the mouth and causes changes in the Eustachian tube, which is an anatomical structure that connects the pharynx with the ears. In this way, the internal and external pressures tend to equalize.

The Valsalva maneuver pursues the same objective. This consists of trying to exhale the air with the nose and the mouth blocked. The most practical thing is to close your mouth, cover your nose with your hands and use force to expel the trapped air against the obstruction that we deliberately generate.

Tooth decay is a risk factor for barodontalgia. For this reason, they should be treated promptly in patients traveling by plane or diving.

The role of the dentist in the prevention of barodontalgia

The prevention of barodontalgia also depends on the dental professional. Due to the fact that many times the pain picture appears on pre-existing oral pathologies or due to the leakage of air within dental elements operated before, it must be recognized that bad fillings or wrong approaches in the office can be risk factors for patients.

Dentists should be aware that some materials used in clinical practice are more effective in preventing barodontalgia. This is the case of resin against zinc phosphate and against glass ionomers. This substance better withstands changes in atmospheric pressure, so it would be the first option for treatments in aircraft pilots or divers, for example.

In turn, if the professional knows that his patient has frequent activities at high altitudes or is diving, then he should take the initiative to reduce risk factors. This implies reviewing old arrangements and not letting signs of cavities evolve untreated.

Barodontalgia is a sign of something else

It is important to make it clear that barodontalgia indicates a pathology in the mouth. So, if you suffer from it frequently or it has happened to you in recent time, it is essential to consult a dentist.

There are surely tooth decay, pulpitis, or fractures that need an immediate approach. This will prevent further episodes of pressure pain, but will also limit the complications of the disease in question.

In short, oral health and dental hygiene are the pillars of barodontalgia prevention. If you like mountaineering or diving, or for work reasons you must spend a lot of time on airplanes, so don’t stop brushing your teeth and visit the dentist regularly.

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