Barodontalgia among SLAF air crew

Abstract

Barodontalgia, a dental pain evoked by a change in barometric pressure in an otherwise asymptomatic tooth, may be severe enough to cause inflight vertigo, incapacitation, and premature cessation of flights and altitude-chamber simulations. The purpose of this study was to assess the current in-flight incidence of barodontalgia, and to identify the associated dental pathologies and etiological factors. A total of 40 questionnaires were e-mailed to fighter,helicopter, and transport aircrews of the Sri Lankan 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. There were 31 (77.5%) aircrew members who responded.Out of those, 4(12.9%) reported at least 1 case of barodontalgia; their mean age - SD was 29.7 - 7.3 yr and the occurrence by aircraft platform were 6.45% of fighter, 3.2% of helicopter, and 3.2% 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. Even with modern dental care, military aircrews from all the flight platforms may occasionally experience barodontalgia. The key to avoid barodontalgia is good oral health. Clinicians must pay close attention to areas of dentin exposure, caries, fractured cusps, the integrity of restorations and periapical pathology in those at risk.