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Barodontalgia is defined as tooth pain occurring with changes in pressure environment. It commonly affects pilots and
divers, as they are frequently subjected to barometric pressure changes during their work. AIM: To measure the prevalence
of barodontalgia among pilots flying non-commercial war planes and divers practicing in air bases, naval bases and diving
schools in Saudi Arabia and Kuwait. MATERIAL AND METHODS: Three-hundred and fifty questionnaires consisting of
demographic data and questions about the occurrence of tooth pain during flying or diving were distributed among pilots
and divers. RESULTS: There was a response rate of 72.8% in Saudi Arabia and 80% in Kuwait. Almost thirty-four percent
of the sample experienced barodontalgia at one point in time during their practice. More pilots had an occurrence of pain
while flying (49.6%) than did divers while diving (17.3%). Pilots had higher incidence of pain while ascending (30.4%) than
descending (19.3%), while divers had higher incidence of pain while diving (13.9%) than resurfacing to sea level (3.6%).
The highest percentage of tooth pain occurred in pilots while flying at an altitude that ranged from 11,000 - 20,000 ft (3300
- 6000 m) and with divers while diving with a depth that ranged from 60 - 80 ft (18 – 24 m). Recurrence of tooth pain
after treatment occurred in 16.4% of pilots and 25.0% of divers during their practice. CONCLUSIONS: Barodontalgia is
common in Saudi Arabia and Kuwait with a prevalence rate as high as 33.6%. Pilots reported high occurrence than divers.
It was common on ascent while flying and descent while diving. Recurrence of pain after treatment was not frequent.
40
population inquiring about incidence,
nature of the incident and the treatment
rendered, as this was a pioneer study in
this field in the area, and preliminary
20
data was required about the incidence of
15.3 this phenomenon before more elaborate
5.6
2.8 2.8
studies can be designed.
0 The data showed that there was a high
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and recall may be factors that significantly Most of the pilots and divers included
increased prevalence of barodontalgia in our study had restorative treatment
during subsequent flights. An in-depth done after reporting to the dental office.
investigation of the factors leading to It may be that their complaint was
the high significance of barodontalgia is an obvious one that could have been
required. apparent on ground level and not present
a diagnostic difficulty. If this were the
There was no correlation between
case, proper diagnosis and treatment
either the age of the pilots or divers and
could have prevented the problem in the
their age. Similar results were reported by first place.
SGADF-HPD411.6 In this study, recurrence of pain after
Higher prevalence of barodontalgia treatment was reported by a relatively
was reported among pilots (49.6%) than smaller groups of pilots and divers at
among divers (17.3%). This could be due 16.4% and 25% respectively, which
to higher pressure changes that pilots indicated that proper diagnosis was
are exposed to during flying than divers done. For the cases in which there was
are during diving. The prevalence among recurrence, the causes might be non-
pilots was more common with an altitude odontogenic pain or another offending
that ranged from 11,000 - 20,000 feet. tooth than was treated. Many cases of
Similar results were reported by Kollman,1 recurrence need further invesitigations
Hodges,4 and the SGADF-HPD411.6 that may involve leaking restorations and
Not surprisingly, the prevalence among periapical pathology which were beyond
pilots was common on ascent in the the scope of our study.
study. Similar finding had been reported In this study, no clinical examination
in SGADF-HPD411.6 Furthermore, it had was conducted. Correlation of the
been suggested that pain on ascent was information obtained from the
associated with an inflamed tooth, while questionnaires with clinical findings
pain on descent was associated with a obtained from examination could provide
necrotic tooth.15 This seemed logical in more specific results in term of incidence
this population as they had undoubtadely and causes of barodontalgia.
been dentally examined at some point Our sample was a convenient one
targeting pilots flying non-commercial
before flying and it was unlikely that
war planes. No attempt was made to
dental decay could progress to lead to
specify the type of planes as this was
necrosis in a short period of time.
considered classified information and
The pain was mostly diagnosed as
this could limit any attempt to generalize
tooth pain (73.6%). This is in contrast to
pilots flying different kind of war planes.
Kollman, who found the most common Also all types of divers were considered in
pain was earache (2.27%) followed by pain this study, and no attempt was made to
from teeth and from the paranasal sinuses specify which kind of diving equipment
at 0.26% and 0.18%, respectively.1 This was used. The safety of aircrew and
difference could be attributed to the fact diving personnel can be comprised by
that many centers internationally have barodontalgia as the intensity of pain is
flight surgeons as the primary health often such that effective performance is
personnel performing the diagnosis, not possible.6 Distractions during critical
whereas in this study all pilots and divers flights or dives, or abortion of important
reported to a dentist who was expected to missions can occur as a result of pain
be more adept at diagnosing dental pain. during a flight or dive.
RECOMMENDATIONS REFERENCES
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The authors would like to express their
10. Bureau of Medicine and Surgery News
thanks to all those who participated in
Letter, Vol 6, No. 1, 1946.
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