Incidence and possible causes of dental pain during simulated high altitude flights

By Kollmann W

Date: 01/1993
Journal: JOE

Purpose:

Investigate incidence and possible causes of dental pain during simulated high altitude flights.

Materials/Methods:

N = 11,617 military personnel participating in simulated high altitude flights

Subjects experiencing pain during simulation referred to institute’s dentist. None had any dental pain prior to simulation. Sensibility testing completed in arch pt reported experiencing pain. PAs taken in all cases. Panos or occipitomental radiographs taken if suspect etiology is maxillary sinus. All suspected teeth with restorations were replaced. Endo was completed prior to new restoration if indicated.

Results:

  • 0.25% (30/11,617) reported dental pain.
  • 25/30 underwent dental exam. 28 cases evaluated.
  • Pain description: 16 = abrupt sharp shooting sensation.

10 = dull pain that increases in intensity

& spreads diffusely.

  • Pain experienced at altitudes between 5,000-35,000 feet.

Avg = 20,160 ft.

  • 10/10 pts who received dental treatment underwent another flight simulation, and all were free of pain.

Hypothesis for barodontalgia mechanism

1.Trapped air bubbles adjacent to vital dentin expands with ↓ ambient pressures to stimulate nociceptors.

2.Mx sinus nociceptors stimulated by tensions in tissues during pressure changes.

3.Stimulation of nerve endings of a chronically inflamed pulp.

Clinical Significance:

Etiology of barodontalgia is most often due to chronic pulpitis.