A diving physician's experience of dental barotrauma during hyperbaric chamber exposure: case report. 2022

Busra Dilara Altun, and Selin Gamze Sümen, and Asim Dumlu
Marmara University, Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Istanbul, Turkey.

Previous cases of dental barotrauma have been reported in pilots and divers. We report a case of dental barotrauma and barodontalgia in a diving physician accompanying patients during hyperbaric oxygen treatment, and due to pressure changes in the hyperbaric chamber. The physician developed sharp pain localised to the right maxillary molars but radiating to the face, ear and head during decompression from 243 kPa (2.4 atmospheres absolute). The pain intensified following completion of decompression and was consistent with irreversible pulpitis. Clinical examination and panoramic radiography suggested fracture of a heavily restored tooth due to barotrauma. This was managed by tooth extraction. The physician subsequently discontinued accompanying the patients during their hyperbaric oxygen treatment sessions. Dentists and maxillofacial surgery specialists suggest waiting for a minimum of four weeks or until the tooth socket and/or oral tissue has healed sufficiently to minimise the risk of infection or further trauma before exposure to further pressure change. Although seemingly rare, and despite the comparatively slow pressure changes, dental barotrauma can occur in hyperbaric chamber occupants.

UI MeSH Term Description Entries
D010820 Physicians Individuals licensed to practice medicine. Physician
D004242 Diving An activity in which the organism plunges into water. It includes scuba and bell diving. Diving as natural behavior of animals goes here, as well as diving in decompression experiments with humans or animals. Divings
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D006931 Hyperbaric Oxygenation The therapeutic intermittent administration of oxygen in a chamber at greater than sea-level atmospheric pressures (three atmospheres). It is considered effective treatment for air and gas embolisms, smoke inhalation, acute carbon monoxide poisoning, caisson disease, clostridial gangrene, etc. (From Segen, Dictionary of Modern Medicine, 1992). The list of treatment modalities includes stroke. Oxygenation, Hyperbaric,Hyperbaric Oxygen Therapy,Hyperbaric Oxygen Therapies,Hyperbaric Oxygenations,Oxygen Therapies, Hyperbaric,Oxygen Therapy, Hyperbaric,Oxygenations, Hyperbaric,Therapies, Hyperbaric Oxygen,Therapy, Hyperbaric Oxygen
D001469 Barotrauma Injury following pressure changes; includes injury to the eustachian tube, ear drum, lung and stomach. Barotraumas
D014098 Toothache Pain in the adjacent areas of the teeth. Odontalgia,Odontalgias,Toothaches

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