The intense dental discomfort known as “tooth squeeze,” or barodontalgia, is pain triggered by rapid changes in environmental pressure, often experienced during activities like flying or scuba diving. This phenomenon results from pressure differences between the surrounding environment and small, trapped air pockets within or near a tooth structure. While the pain can be acute and severe, the duration of symptoms varies widely, ranging from momentary relief upon pressure normalization to persistent pain lasting days. Understanding the causes and timeline of this dental issue is important for anyone who frequently subjects themselves to significant changes in altitude or depth.
Defining Barodontalgia and Its Immediate Triggers
Barodontalgia is dental pain caused by a change in barometric pressure. It is commonly experienced by professional groups like military pilots and deep-sea divers, as well as commercial air travelers and mountain climbers. The process is governed by Boyle’s Law, which describes the inverse relationship between the volume of a gas and the surrounding pressure.
When a person ascends rapidly, the external pressure decreases, causing trapped air within a tooth or filling to expand. Conversely, during a rapid descent, the external pressure increases, causing trapped gas to compress. This expansion or compression creates a pressure differential that strains the rigid structure of the tooth and irritates the sensitive pulp tissue. The ambient pressure change typically needs to exceed a threshold equivalent to an elevation change of approximately 3,000 feet to trigger an episode.
The Duration of Tooth Squeeze Symptoms
The duration of barodontalgia symptoms is closely tied to the underlying dental issue and whether the pressure returns to its initial level. In straightforward cases, the pain is acute and temporary, resolving almost immediately once the external pressure stabilizes. For instance, a sharp pain felt during a flight’s ascent may vanish as soon as the cabin pressure equalizes or the aircraft lands, suggesting a minor, reversible irritation of the dental pulp.
Pain that persists for hours or even days after the pressure change has ceased indicates a significant, pre-existing dental pathology. This sustained discomfort signals that the pressure change likely exacerbated an existing condition, such as irreversible inflammation of the tooth nerve or infection in the tissues surrounding the root. For pain caused by periapical disease, which involves infection around the root tip, symptoms have been reported to last as long as three days.
Underlying Dental Conditions That Cause Barodontalgia
Barodontalgia is not a disease itself but a symptom revealing an existing dental problem. The pain occurs because the tooth or surrounding tissue contains a sealed space where air or gas can become trapped. The most frequent cause is advanced dental decay, which creates voids that hold air and allow pressure to build up against the sensitive pulp.
Faulty or incomplete dental restorations, such as cracked fillings, leaking crowns, or old root canal treatments, are common culprits. These restorations can act like a one-way valve, allowing gases to enter the space beneath them but preventing them from escaping quickly enough to equalize with the external pressure. This pressure differential can lead to severe pain and, in some cases, generate enough force to fracture the tooth or dislodge the restoration, known as dental barotrauma.
Inflammation of the tooth’s nerve, known as pulpitis, is another factor. Irreversible pulpitis, where the nerve is severely compromised, is frequently associated with barodontalgia that manifests as sharp pain upon ascent. Pain can also be referred from an inflamed maxillary sinus, known as barosinusitis, where pressure changes affect the air-filled sinus cavity located near the roots of the upper molars. This is a common source of referred dental pain, affecting up to nearly 19% of those reporting barodontalgia symptoms.
Managing and Preventing Future Episodes
Immediate management of tooth squeeze during an episode is limited, often involving simply returning to the pressure level at which the pain began. If flying, this may mean asking about cabin pressure or using over-the-counter pain relievers to manage inflammation temporarily. Relying on temporary relief is not a solution, as barodontalgia is a warning sign of underlying pathology that requires attention.
Any instance of barodontalgia, especially if the pain lasts more than a few moments after pressure normalization, necessitates an immediate visit to a dental professional. A thorough dental examination should focus on identifying and correcting conditions like decay, leaky fillings, or signs of pulp or periapical disease. The strategy for prevention involves maintaining optimal oral health and ensuring all existing restorations are intact and sealed.
For individuals who regularly engage in activities involving pressure changes, proactive dental clearance is recommended. Addressing pre-existing decay, replacing defective fillings, and treating any active infections before a pressure change event dramatically reduces the risk of future episodes. Recent dental work, such as extractions or new restorations, should be fully healed before exposing the mouth to significant pressure fluctuations.