In-flight barodontalgia: Analysis of 29 cases in military aircrew

Objective: The purpose of this study was to assess the current in-flight incidence of barodontalgia, defined as dental pain caused by a change in barometric pressure in an otherwise asymptomatic tooth, and to identify the associated dental pathologies and etiologic factors. Methods: A total of 450 questionnaires were e-mailed to permanent fighter, helicopter, and transport aircrews of the Israeli Air Force. They were asked to report whether they had ever suffered from a toothache during flight. If a positive answer was reported, the subject was interviewed and his dental file was reviewed to obtain details about the incidence. Results: There were 331 (73.6%) aircrew members who responded. Of those, 27 (8.2%) reported at least 1 case of barodontalgia; their mean age ± SD was 29.7 ± 7.3 yr and the occurrence by aircraft platform were 9.0% of fighter, 8.0% of helicopter, and 7.0% of transport respondents. Many of the cases originated from vital and/or inflamed pulp (40.7%), whereas the other cases were due to pulp necrosis or peri-apical periodontitis (18.5%) and barosinusitis (18.5%). None of the patients reported premature mission termination due to dental pain. The incidence of barodontalgia was estimated as 1 case per 100 flight-years. Conclusions: Even with modern dental care, military aircrews from all the flight platforms may occasionally experience barodontalgia. Flight surgeons and dentists should be aware of this phenomenon and use preventive measures to minimize its incidence and severity.