Dental Turbulence ahead for High Fliers

Air Cabin Crew including pilots, flight attendants as well as frequent fliers should all consider investing more in their oral health to ensure more pain free flight hours. With the number of air passengers, flight attendants, airline pilots, military pilots and leisure pilots continuing to grow each year, dentists around the world are encountering increasing numbers of their patients who are experiencing flight related oral conditions.

Barodontalgia

Barodontalgia refers to tooth pain or discomfort caused by changes in air pressure, typically experienced during a flight. The toothache is caused by the effect of the pressure change on an existing dental condition such as dental decay, a dental cyst, an abscess, or recent dental treatment including fillings. These pressure changes can affect the air pockets within teeth, leading to pain or sensitivity. Proper dental care and preventive measures are important for individuals prone to this condition. Research carried out in Israel listed faulty restorations, dental decay, dead pulp tissue and infection around the root as the most likely causes of barodontalgia.

Air pressure and the human body

Air pressure in your body must equalise with air pressure in the cabin of the plane. Most body organs adapt quite quickly but some body parts which normally contain air find it difficult to adapt quickly. The sinuses above your nose and the eustachian tube, which connects from your ear to your throat are two body parts which experience this problem. This is why people suck sweets and swallow hard and pinch their noses in an attempt to pop their ears and equalise the pressure difference.

Air pressure and teeth

The same principle regarding air pressure and the human body also applies to teeth. Small pockets of air can become trapped inside teeth with dental decay or inside old fillings that are cracked or inside dentine tubules that are exposed to the outside environment. When a tooth starts to go bad there is a breakdown in the tooth structure and air gets into the tooth through tiny openings. Sometimes air gets trapped in a filling while the filling material is being packed into the tooth and older fillings may have gaps or holes that develop over time. All of these situations may result in air being trapped in teeth.

With changes in cabin pressure the pressure inside the tooth is not able to equalise quickly enough with the outside pressure, as the outlets for the pressure are so small. Pain occurs in the presence of an unrelieved pressure difference which is usually relieved when the plane lands. Cabin pressure can also affect the stability and retention of prosthetic devices in the mouth especially crowns and bridges as adhesive material are adversely affected by changes to the pressure gradient. This problem can be prevented by using a bonding agent instead of regular dental cements when having dental crowns or bridges fitted. A dull ache in your tooth can turn into a searing pain once you are in the air. Any kind of tooth problem can be exacerbated by flying. New problems can arise during flight that you may not be able to do much about until landing.

Air pressure and other areas of the mouth

Swollen mucous membranes such as an episode of sinusitis can in exceptional circumstances give rise to a pressure induced palsy of the face caused by unrelieved pressure on the facial nerve as it passes through the maxillary sinus this condition is called neural paresis.

How to prevent Barodontalgia

The way to prevent barodontalgia is to establish and maintain good oral hygiene practices that includes:

• Twice daily mouth cleaning with toothbrush using correct technique
• Use inter-dental cleaning aids like dental floss or other cleaning devices
• Use antibacterial mouthwash when directed by your dentist
• Establish regular check ups with your dentist once or twice yearly as required
• Arrange dental treatment including fillings and bridgework to coincide with break periods when not flying
• Make sure your dentist knows your occupation
• Never board a flight when having painful symptoms in your mouth
• Allow 48 hours recovery following extensive dental treatment before flying
• If you must fly soon after completion of extensive dental treatment you will need a course of anti-inflammatory analgesics to help prevent a painful episode during flight