Scuba divers risk more than the bends when they go under the sea. Research from the University of Buffalo School of Dental Medicine indicates that 41% of divers experience dental symptoms while they’re in the water due to the constant jaw clenching and atmospheric pressure fluctuations.
These symptoms include tooth, jaw, and gum pain, as well as loosened crowns and broken dental fillings. Recreational divers, then, should consider consulting with their dentist before diving if they recently received dental care, said Vinisha Ranna, BDS, lead author of the study and a student at the school.
“Divers are required to meet a standard of medical fitness before certification, but there are no dental health prerequisites,” said Ranna, who also is a certified stress and rescue scuba diver who has completed 60 dives. “Considering the air supply regulator is held in the mouth, any disorder in the oral cavity can potentially increase the diver’s risk of injury. A dentist can look and see if diving is affecting a patient’s oral health.”
The research was inspired by Ranna’s first scuba experience in 2013 when she felt a squeezing sensation in her teeth, a condition known as barodontalgia. Published research on dental symptoms experienced while diving was scarce or focused on military divers, so Ranna crafted her own study to identify the dental symptoms divers experienced and detect trends in how or when they occur.
Ranna created an online survey distributed to 100 certified recreational divers. Excluded were those who were younger than the age of 18 years, ill, or taking decongestant medication. Of the 41% who reported dental symptoms, 42% experienced barodontalgia, 24% described pain from holding the air regulator in their mouths too tightly, and 22% reported jaw pain. Also, 5% noted that their crowns were loosened during their dive, and one person reported a broken filling.
“The potential for damage is high during scuba diving,” said Ranna. “The dry air and awkward position of the jaw while clenching down on the regulator is an interesting mix. An unhealthy tooth underwater would be much more obvious than on the surface. One hundred feet underwater is the last place you want to be with a fractured tooth.”
Pain was most commonly reported in the molars. Also, dive instructors, who require the highest level of certification, experienced dental symptoms most frequently, likely because of more time spent at shallowed depths where pressure fluctuations are the greatest. With more than 24 million certifications issued by the Professional Association of Diving Instructors worldwide, Ranna hopes to see oral health incorporated into the overall assessments for certification.
Also, patients should ensure that dental decay and restorations are addressed before a dive, said Ranna. Furthermore, she said, manufacturers should evaluate mouthpiece design to prevent jaw discomfort, especially when investigating symptoms of temporomandibular joint disorder in divers. Ranna is now conducting a follow-up study with an expanded group of more than 1,000 participants.
The study, “Prevalence of Dental Problems in Recreational SCUBA Divers: A Pilot Survey,” was published by the British Dental Journal.