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Other namesAerodontalgia, dental barotrauma
Specialty Hyperbaric medicine

Barodontalgia, commonly known as tooth squeeze, is a pain in tooth caused by a change in ambient pressure. The pain usually ceases at ground level. [1] [2] [3] Dental barotrauma is a condition in which such changes in barometric pressure changes cause damage to the dentition.

Tooth hard, calcified structure found in the jaws (or mouths) of many vertebrates and used to break down food

A tooth is a hard, calcified structure found in the jaws of many vertebrates and used to break down food. Some animals, particularly carnivores, also use teeth for hunting or for defensive purposes. The roots of teeth are covered by gums. Teeth are not made of bone, but rather of multiple tissues of varying density and hardness. The cellular tissues that ultimately become teeth originate from the embryonic germ layer, the ectoderm.

The ambient pressure on an object is the pressure of the surrounding medium, such as a gas or liquid, in contact with the object.

Dental trauma

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.



The most common victims 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]

Underwater diving Descending below the surface of the water to interact with the environment

Underwater diving, as a human activity, is the practice of descending below the water's surface to interact with the environment. Immersion in water and exposure to high ambient pressure have physiological effects that limit the depths and duration possible in ambient pressure diving. Humans are not physiologically and anatomically well adapted to the environmental conditions of diving, and various equipment has been developed to extend the depth and duration of human dives, and allow different types of work to be done.

The standard atmosphere is a unit of pressure defined as 101325 Pa. It is sometimes used as a reference or standard pressure. It is approximately equal to the atmospheric pressure at sea level.

Aircraft pilot person controlling an aircraft in flight

An aircraft pilot or aviator is a person who controls the flight of an aircraft by operating its directional flight controls. Some other aircrew members, such as navigators or flight engineers, are also considered aviators, because they are involved in operating the aircraft's navigation and engine systems. Other aircrew members, such as flight attendants, mechanics and ground crew, are not classified as aviators.

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]

Prevalence in epidemiology is the proportion of a particular population found to be affected by a medical condition. It is derived by comparing the number of people found to have the condition with the total number of people studied, and is usually expressed as a fraction, as a percentage, or as the number of cases per 10,000 or 100,000 people. Point prevalence is the proportion of a population that has the condition at a specific point in time. Period prevalence is the proportion of a population that has the condition at some time during a given period, and includes people who already have the condition at the start of the study period as well as those who acquire it during that period. Lifetime prevalence (LTP) is the proportion of a population that at some point in their life have experienced the condition.

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

<i>Luftwaffe</i> Aerial warfare branch of the German military forces during World War II

The Luftwaffe was the aerial warfare branch of the combined German Wehrmacht military forces during World War II. Germany's military air arms during World War I, the Luftstreitkräfte of the Army and the Marine-Fliegerabteilung of the Navy had been disbanded in May 1920 as a result of the terms of the Treaty of Versailles which stated that Germany was forbidden to have any air force.

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]

Israel country in the Middle East

Israel, also known as the State of Israel, is a country in Western Asia, located on the southeastern shore of the Mediterranean Sea and the northern shore of the Red Sea. It has land borders with Lebanon to the north, Syria to the northeast, Jordan on the east, the Palestinian territories of the West Bank and Gaza Strip to the east and west, respectively, and Egypt to the southwest. The country contains geographically diverse features within its relatively small area. Israel's economic and technological center is Tel Aviv, while its seat of government and proclaimed capital is Jerusalem, although the state's sovereignty over Jerusalem has only partial recognition.

World War II 1939–1945 global war

World War II, also known as the Second World War, was a global war that lasted from 1939 to 1945. The vast majority of the world's countries—including all the great powers—eventually formed two opposing military alliances: the Allies and the Axis. A state of total war emerged, directly involving more than 100 million people from over 30 countries. The major participants threw their entire economic, industrial, and scientific capabilities behind the war effort, blurring the distinction between civilian and military resources. World War II was the deadliest conflict in human history, marked by 70 to 85 million fatalities, most of whom were civilians in the Soviet Union and China. It included massacres, the genocide of the Holocaust, strategic bombing, premeditated death from starvation and disease, and the only use of nuclear weapons in war.

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] 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. [14] 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). [14]

Symptom departure from normal function or feeling which is noticed by a patient, reflecting the presence of an unusual state, or of a disease; subjective, observed by the patient, cannot be measured directly

A symptom is a departure from normal function or feeling which is apparent to a patient, reflecting the presence of an unusual state, or of a disease. A symptom can be subjective or objective. Tiredness is a subjective symptom whereas cough or fever are objective symptoms. In contrast to a symptom, a sign is a clue to a disease elicited by an examiner or a doctor. For example, paresthesia is a symptom, whereas erythema is a sign. Symptoms and signs are often nonspecific, but often combinations of them are at least suggestive of certain diagnoses, helping to narrow down what may be wrong. In other cases they are specific even to the point of being pathognomonic.

Inflammation signs of activation of the immune system

Inflammation is part of the complex biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or irritants, and is a protective response involving immune cells, blood vessels, and molecular mediators. The function of inflammation is to eliminate the initial cause of cell injury, clear out necrotic cells and tissues damaged from the original insult and the inflammatory process, and initiate tissue repair.

Cyst closed sac growth on the body

A cyst is a closed sac, having a distinct membrane and division compared with the nearby tissue. Hence, it is a cluster of cells that has grouped together to form a sac ; however, the distinguishing aspect of a cyst is that the cells forming the "shell" of such a sac are distinctly abnormal when compared with all surrounding cells for that given location. It may contain air, fluids, or semi-solid material. A collection of pus is called an abscess, not a cyst. Once formed, sometimes a cyst may resolve on its own. When a cyst fails to resolve, it may need to be removed surgically, but that would depend upon its type and location.


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]


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. [15] Typically this is seen in underwater divers [4] or aviators [16] 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. [17]

See also

Related Research Articles

Dentistry branch of medicine

Dentistry, also known as Dental and Oral Medicine, is a branch of medicine that consists of the study, diagnosis, prevention, and treatment of diseases, disorders, and conditions of the oral cavity, commonly in the dentition but also the oral mucosa, and of adjacent and related structures and tissues, particularly in the maxillofacial area. Although primarily associated with teeth among the general public, the field of dentistry or dental medicine is not limited to teeth but includes other aspects of the craniofacial complex including the temporomandibular joint and other supporting, muscular, lymphatic, nervous, vascular, and anatomical structures.

Human tooth calcified whitish structure in humans mouths used to break down food

The human teeth function to mechanically break down items of food by cutting and crushing them in preparation for swallowing and digesting. 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.

Barotrauma Injury caused by pressure

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 fluid. The initial damage is usually due to over-stretching the tissues in tension or shear, either directly by 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 normal function of an organ by its presence.

Hyperdontia An extra tooth, erupted or unerupted, resembling or unlike the other teeth in the group to which it belongs. Its presence may cause malposition of adjacent teeth or prevent their eruption.

Hyperdontia is the condition of having supernumerary teeth, or teeth that appear in addition to the regular number of teeth. They can appear in any area of the dental arch and can affect any dental organ. The opposite of hyperdontia is hypodontia, where there is a congenital lack of teeth, a condition which is seen more commonly than hyperdontia. The scientific definition of hyperdontia is "any tooth or odontogenic structure that is formed from tooth germ in excess of usual number for any given region of the dental arch." The additional teeth, which may be few or many, can occur on any place in the dental arch. Their arrangement may be symmetrical or non-symmetrical.

Dysbarism refers to medical conditions resulting from changes in ambient pressure. Various activities are associated with pressure changes. Underwater diving is the most frequently cited example, but pressure changes also affect people who work in other pressurized environments, and people who move between different altitudes.

Aviation medicine medical specialty in effect of aviation on the body

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.

Toothache medical condition

Toothache, also known as dental 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.

Mouthguard protective device for the mouth

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. 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. Depending on application, it may also be called a mouth protector, mouth piece, gumshield, gumguard, nightguard, occlusal splint, bite splint, or bite plane.

Acid erosion loss of tooth structure due to chemical dissolution by acids not of bacterial origin

Acid erosion is a type of tooth wear. It is defined as the irreversible loss of tooth structure due to chemical dissolution by acids not of bacterial origin. Dental erosion is the most common chronic disease of children ages 5–17, although it is only relatively recently that it has been recognised as a dental health problem. There is generally widespread ignorance of the damaging effects of acid erosion; this is particularly the case with erosion due to fruit juices, because they tend to be seen as healthy. Acid erosion begins initially in the enamel, causing it to become thin, and can progress into dentin, giving the tooth a dull yellow appearance and leading to dentin hypersensitivity.

Aerosinusitis Barotrauma of the sinuses

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.

Diving disorders, or diving related medical conditions, are conditions associated with underwater diving, and include both conditions unique to underwater diving, and those that also occur during other activities. This second group further divides into conditions caused by exposure to ambient pressures significantly different from surface atmospheric pressure, and a range of conditions caused by general environment and equipment associated with diving activities.

Dental extraction operation (usually by a dentist or oral surgeon) to remove a tooth

A dental extraction is the removal of teeth from the dental alveolus (socket) in the alveolar bone. Extractions are performed for a wide variety of reasons, but most commonly to remove teeth which have become unrestorable through tooth decay, periodontal disease, or dental trauma, especially when they are associated with toothache. Sometimes wisdom teeth are impacted and may cause recurrent infections of the gum (pericoronitis). In orthodontics if the teeth are crowded, sound teeth may be extracted to create space so the rest of the teeth can be straightened.

Tooth gemination is a dental phenomenon that appears to be two teeth developed from one. There is one main crown with a cleft in it that, within the incisal third of the crown, looks like two teeth, though it is not two teeth. The number of the teeth in the arch will be normal.

Talon cusp

Talon Cusp is a rare dental anomaly. Generally a person with this develops "cusp-like" projections located on the inside surface of the affected tooth. Talon cusp is an extra cusp on an anterior tooth. Although talon cusp may not appear serious, it can cause clinical, diagnostic, functional problems and alters the aesthetic appeal.

Ear clearing Equalising of pressure in the middle ears

Ear clearing or clearing the ears or equalization is any of various maneuvers to equalize the pressure in the middle ear with the outside pressure, by letting air enter along the Eustachian tubes, as this does not always happen automatically when the pressure in the middle ear is lower than the outside pressure. This need can arise in scuba diving, freediving/spearfishing, skydiving, fast descent in an aircraft, fast descent in a mine cage, and being put into pressure in a caisson or similar pressure-bearing structure, or sometimes even simply travelling at fast speeds in an automobile.

Dental pertains to the teeth, including dentistry. Topics related to the dentistry, the human mouth and teeth include:

Cracked tooth syndrome

Cracked tooth syndrome (CTS) is where a tooth has incompletely cracked but no part of the tooth has yet broken off. Sometimes it is described as a greenstick fracture. The symptoms are very variable, making it a notoriously difficult condition to diagnose.

Dental avulsion

Dental avulsion is the complete displacement of a tooth from its socket in alveolar bone owing to trauma.


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