Barodontalgia among aircrew and divers

BACKGROUND: Barodontalgia, barometric pressure-induced dental pain, may jeopardize diving/flight safety. The aim of this systematic review was to investigate the rate of barodontalgia among military and civilian divers and aircrews based on previous reports. METHODS: We analyzed the data of 4894 aircrew/divers reported in the literature. Barodontalgia rates (flight vs. diving, military vs. civilian, pressurized vs. non-pressurized aircrafts) were analyzed. The Chi-squared test was used to compare between groups. RESULTS: Of the 4894 individuals, 402 (8.2%) suffered from barodontalgia. Divers (9.8%) were more vulnerable than aircrews (5.8%). Barodontalgia experience rate was 5.4% and 6.5% in military and civilian aircrews, respectively, and 7.3% and 12.8% in military and civilian scuba divers, respectively. Barodontalgia was more common among aircrews of pressurized than non-pressurized aircrafts (7.3% vs. 3.2%, respectively). DISCUSSION: The greater amplitude of barometric pressure changes explains the higher rate of barodontalgia in divers than aircrew. The higher rate during pressurized flights is possibly because intracabin pressure in the pressurized cabin is still routinely higher than in nonpressurized aircrafts. Improved oral care and mandatory annual dental checkups may be the reason for the significantly lower rate of barodontalgia experienced among military aircrews and divers compared to their civilian counterparts. These results emphasize the essential role of atmospheric pressure change in the generation of pain during flight or diving and the importance of proper dental care.