| Barodontalgia | |
|---|---|
| Other names | Aerodontalgia, dental barotrauma |
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| Specialty | Hyperbaric medicine |
Barodontalgia, commonly known as tooth squeeze, is a pain in a tooth caused by a change in ambient pressure. The pain usually ceases at return to the original pressure. [1] [2] [3] Dental barotrauma is a condition in which such changes in ambient pressure cause damage to the dentition.
The most common subjects are underwater 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]
In addition, a large epidemiologic study suggested that changes in barometric pressure were the reason for the initiation and/or exacerbation of various oral pains observed in dental emergency departments. [12]
Barodontalgia is a symptom of dental disease, for example inflammatory cyst in the mandible. [13] 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. [14] A meta-analysis of studies conducted between 2001 and 2010 [15] revealed 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. [15] Surprisingly, despite cabin pressurization, the current in-flight barodontalgia incidence is similar to the incidence in the first half of the 20th century. Also, despite the greater fluctuation in divers' pressures, the weighted incidence of barodontalgia among aircrews is similar to the weighted incidence among divers. Furthermore, contrary to common belief, and in contrast to diving conditions, the role of facial barotrauma in the cause of in-flight barodontalgia is only minor (about one-tenth of cases). [15]
The Fédération dentaire internationale describes 4 classes of barodontalgia. [1] The classes are based on signs and symptoms. They also provide specific recommendations for therapeutic intervention. [1]
Sometimes, pressure changes damage teeth (rather than just causing pain). When the external pressure rises or falls and the trapped air within the void cannot expand or contract to balance the external pressure, the pressure difference on the rigid structure of the tooth can occasionally induce stresses sufficient to fracture the tooth or dislodge a filling. [16] Typically this is seen in underwater divers [4] or aviators [17] who experience pressure changes in the course of their activity. Identifying the pain during a pressure change is a diagnostic indicator for the clinician. Treatment involves removing the void space by carefully replacing the offending restoration, repeating the endodontic treatment or removing the tooth. [18]
Dentistry, also known as dental medicine and oral medicine, is the branch of medicine focused on the teeth, gums, and mouth. It consists of the study, diagnosis, prevention, management, and treatment of diseases, disorders, and conditions of the mouth, most commonly focused on dentition as well as the oral mucosa. Dentistry may also encompass other aspects of the craniofacial complex including the temporomandibular joint. The practitioner is called a dentist.
Human teeth function to mechanically break down items of food by cutting and crushing them in preparation for swallowing and digesting. As such, they are considered part of the human digestive system. Humans have four types of teeth: incisors, canines, premolars, and molars, which each have a specific function. The incisors cut the food, the canines tear the food and the molars and premolars crush the food. The roots of teeth are embedded in the maxilla or the mandible and are covered by gums. Teeth are made of multiple tissues of varying density and hardness.
The third molar, commonly called wisdom tooth, is the most posterior of the three molars in each quadrant of the human dentition. The age at which wisdom teeth come through (erupt) is variable, but this generally occurs between late teens and early twenties. Most adults have four wisdom teeth, one in each of the four quadrants, but it is possible to have none, fewer, or more, in which case the extras are called supernumerary teeth. Wisdom teeth may become stuck (impacted) and not erupt fully, if there is not enough space for them to come through normally. Impacted wisdom teeth are still sometimes removed for orthodontic treatment, believing that they move the other teeth and cause crowding, though this is no longer held as true.
Barotrauma is physical damage to body tissues caused by a difference in pressure between a gas space inside, or in contact with, the body and the surrounding gas or liquid. The initial damage is usually due to over-stretching the tissues in tension or shear, either directly by an expansion of the gas in the closed space or by pressure difference hydrostatically transmitted through the tissue. Tissue rupture may be complicated by the introduction of gas into the local tissue or circulation through the initial trauma site, which can cause blockage of circulation at distant sites or interfere with the normal function of an organ by its presence. The term is usually applied when the gas volume involved already exists prior to decompression. Barotrauma can occur during both compression and decompression events.
Aviation medicine, also called flight medicine or aerospace medicine, is a preventive or occupational medicine in which the patients/subjects are pilots, aircrews, or astronauts. The specialty strives to treat or prevent conditions to which aircrews are particularly susceptible, applies medical knowledge to the human factors in aviation and is thus a critical component of aviation safety. A military practitioner of aviation medicine may be called a flight surgeon and a civilian practitioner is an aviation medical examiner. One of the biggest differences between the military and civilian flight doctors is the military flight surgeon's requirement to log flight hours.
Toothaches, also known as dental pain or tooth pain, is pain in the teeth or their supporting structures, caused by dental diseases or pain referred to the teeth by non-dental diseases. When severe it may impact sleep, eating, and other daily activities.
A mouthguard is a protective device for the mouth that covers the teeth and gums to prevent and reduce injury to the teeth, arches, lips and gums. An effective mouthguard is like a crash helmet for teeth and jaws. It also prevents the jaws coming together fully, thereby reducing the risk of jaw joint injuries and concussion. A mouthguard is most often used to prevent injury in contact sports, as a treatment for bruxism or TMD, or as part of certain dental procedures, such as tooth bleaching or sleep apnea treatment. Depending on the application, it may also be called a mouth protector, mouth piece, gumshield, gumguard, nightguard, occlusal splint, bite splint, or bite plane. The dentists who specialise in sports dentistry fabricate mouthguards.
Hypodontia is defined as the developmental absence of one or more teeth excluding the third molars. It is one of the most common dental anomalies, and can have a negative impact on function, and also appearance. It rarely occurs in primary teeth and the most commonly affected are the adult second premolars and the upper lateral incisors. It usually occurs as part of a syndrome that involves other abnormalities and requires multidisciplinary treatment.
In orthodontics, a malocclusion is a misalignment or incorrect relation between the teeth of the upper and lower dental arches when they approach each other as the jaws close. The English-language term dates from 1864; Edward Angle (1855–1930), the "father of modern orthodontics", popularised it. The word derives from mal- 'incorrect' and occlusion 'the manner in which opposing teeth meet'.
Aerosinusitis, also called barosinusitis, sinus squeeze or sinus barotrauma is a painful inflammation and sometimes bleeding of the membrane of the paranasal sinus cavities, normally the frontal sinus. It is caused by a difference in air pressures inside and outside the cavities.
Dilaceration is a developmental disturbance in shape of teeth. It refers to an angulation, or a sharp bend or curve, in the root or crown of a formed tooth. This disturbance is more likely to affect the maxillary incisors and occurs in permanent dentition. Although this may seem more of an aesthetics issue, an impacted maxillary incisor will cause issues related to occlusion, phonetics, mastication, and psychology on young patients.
Tooth gemination [also known as schizodontia, twinning, or double teeth] occurs when a single tooth germ splits during development. Splitting of the tooth may be partial or complete. If the splitting is complete, the extra tooth is known as a supernumerary tooth. Tooth gemination is difficult to distinguish from tooth fusion, thus, both conditions are often referred to as “double teeth”.
Talon cusp is a rare dental anomaly resulting in an extra cusp or cusp-like projection on an anterior tooth, located on the inside surface of the affected tooth. Sometimes it can also be found on the facial surface of the anterior tooth.
Dental radiographs, commonly known as X-rays, are radiographs used to diagnose hidden dental structures, malignant or benign masses, bone loss, and cavities.
Dental pertains to the teeth, including dentistry. Topics related to the dentistry, the human mouth and teeth include:
Enamel hypoplasia is a defect of the teeth in which the enamel is deficient in quantity, caused by defective enamel matrix formation during enamel development, as a result of inherited and acquired systemic condition(s). It can be identified as missing tooth structure and may manifest as pits or grooves in the crown of the affected teeth, and in extreme cases, some portions of the crown of the tooth may have no enamel, exposing the dentin. It may be generalized across the dentition or localized to a few teeth. Defects are categorized by shape or location. Common categories are pit-form, plane-form, linear-form, and localised enamel hypoplasia. Hypoplastic lesions are found in areas of the teeth where the enamel was being actively formed during a systemic or local disturbance. Since the formation of enamel extends over a long period of time, defects may be confined to one well-defined area of the affected teeth. Knowledge of chronological development of deciduous and permanent teeth makes it possible to determine the approximate time at which the developmental disturbance occurred. Enamel hypoplasia varies substantially among populations and can be used to infer health and behavioural impacts from the past. Defects have also been found in a variety of non-human animals.
Dental trauma refers to trauma (injury) to the teeth and/or periodontium, and nearby soft tissues such as the lips, tongue, etc. The study of dental trauma is called dental traumatology.
Dental subluxation is a traumatic injury to the periodontal tissue in which the tooth has increased mobility but has not been displaced from its tooth socket.
Dental avulsion is the complete displacement of a tooth from its socket in alveolar bone owing to trauma, such as can be caused by a fall, road traffic accident, assault, sports, or occupational injury. Typically, a tooth is held in place by the periodontal ligament, which becomes torn when the tooth is knocked out.
Tooth transplantation is mainly divided into two types:
