The phenomenon of altitude affecting tooth pain is a recognized medical issue known as Barodontalgia, or “tooth squeeze.” This condition involves acute dental pain triggered by changes in ambient pressure, typically during air travel, mountain climbing, or diving operations. Barodontalgia is not a primary disease but a symptom that reveals a pre-existing, often asymptomatic, dental problem. It occurs because the tooth or surrounding tissue contains a space where gas is trapped; a perfectly healthy tooth will not experience this pain. This condition was first noted in military pilots during World War II. The pain usually resolves upon returning to the original pressure, but the underlying issue remains.
The Physics Behind Altitude-Induced Tooth Pain
Boyle’s Law and Gas Expansion
The scientific explanation for Barodontalgia is based on the relationship between gas volume and pressure, which is described by Boyle’s Law. This law states that for a fixed amount of gas at a constant temperature, the volume is inversely proportional to the pressure exerted on it. As a person ascends to a higher altitude, the surrounding atmospheric pressure decreases.
The Mechanism of Pain
The drop in external pressure causes any trapped gas within the teeth to expand. This gas expansion creates internal pressure against the rigid structures of the tooth and the sensitive dental pulp. The resulting pressure differential can begin to cause discomfort at elevations as low as 2,000 to 5,000 feet, but it becomes more common above 9,000 feet. The pain can be sharp and sudden, particularly during the ascent phase.
Descent Pain
Conversely, a rapid decrease in altitude, such as during descent, can also cause pain. This occurs as the external pressure increases and compresses the gas. This compression can sometimes lead to micro-fractures or damage to dental work.
Specific Dental Conditions That Magnify Altitude Pain
Barodontalgia is fundamentally a warning sign that a person has an underlying dental pathology exacerbated by the pressure change. The most common pre-existing conditions involve the presence of a void or space where air or gas can become trapped.
Causes Related to Voids and Decay
These spaces can be created by deep dental caries, which are untreated cavities that have progressed into the dentin. Failing or defective dental restorations are another frequent cause, as old fillings, crowns, or root canals may develop microscopic gaps or leaks. Air can enter the tooth through these imperfections, and the gas cannot escape quickly enough when the pressure changes.
Inflammation and Referred Pain
Furthermore, inflammation of the dental pulp, known as pulpitis, or an infection at the root tip, called a periapical abscess, makes the tissue highly sensitive to pressure changes. Even recent dental work can create a temporary risk, as the internal tissue may still be inflamed or small air pockets might be present beneath a new filling.
In some cases, the pain felt in the upper teeth may be referred pain from a pressure issue in the adjacent maxillary sinuses, a condition known as barosinusitis. However, the majority of Barodontalgia episodes are directly linked to an issue within the tooth structure itself.
Practical Steps for Prevention and Relief
The most effective strategy for preventing altitude-induced tooth pain is to maintain good oral health and address existing dental issues before encountering pressure changes. Scheduling a comprehensive dental check-up before high-altitude travel allows a dentist to identify and correct faulty restorations or deep decay. Dentists can use X-rays to look for lesions or infections that might be invisible during a routine visual exam.
It is also advisable to allow adequate time for healing following any dental procedure. For complex treatments like oral surgery, a waiting period of at least one week before flying or diving is recommended to ensure the tissue has fully recovered and inflammation has subsided.
If pain develops during a flight, over-the-counter pain relievers, such as ibuprofen, can help to reduce inflammation and discomfort temporarily. While experiencing the pain, avoiding extremely hot or cold foods and drinks can prevent further irritation of the sensitive dental pulp. If the pain is severe or persists after returning to ground level, a prompt visit to a dentist is necessary to diagnose and treat the underlying condition. The pain will stop when the pressure equalizes, but the underlying dental pathology will remain and requires professional intervention.