Dental Approach to Barodontalgia in Scuba Divers: A Narrative Review
DOI:
https://doi.org/10.12775/QS.2026.73.74993Keywords
barodontalgia, scuba diving, dental barotrauma, Diving, diving dentistry, dental preventionAbstract
Background. Barodontalgia is dental or oral pain triggered by changes in ambient pressure. In scuba divers, this condition is clinically relevant because it may indicate previously undetected dental pathology and may affect comfort, concentration and underwater safety.
Aim. The aim of this narrative review is to summarize current knowledge on barodontalgia in scuba divers from a dental perspective, with emphasis on risk factors, clinical presentation, diagnosis, management and prevention.
Results. The literature indicates that barodontalgia is usually associated with pre-existing oral pathology, including dental caries, defective restorations, pulpitis, pulp necrosis, apical periodontitis, periodontal disease, residual air spaces, impacted teeth and maxillary sinus disorders. Dental barotrauma may additionally involve fracture or dislodgement of restorations, crowns or prosthetic components. Diagnosis can be difficult because symptoms may occur only during descent or ascent and may not be reproducible during routine dental examination.
Conclusions. Dentists should consider barodontalgia in divers who report pressure-related tooth pain. A practical dental approach should include elimination of active odontogenic disease, assessment of restorations and endodontically treated teeth, differential diagnosis of sinus- and temporomandibular-related pain, and preventive counselling before diving activity.
References
1. Alolaiwi, L. A., Alzahrani, F. A., & AlShammari, S. A. (2025). Diving into discomfort: Orofacial pain dynamic - A systematic review. Frontiers in Public Health, 13, 1553541. https://doi.org/10.3389/fpubh.2025.1553541
2. Alwohaibi, D. M., Alohali, L. M., Al-Takroni, G. S., Al-Abdulwahab, B., & El-Metwally, A. (2020). Dental and orofacial barotraumas among Saudi military naval divers in King Abdul Aziz Naval Base Armed Forces in Jubail, Saudi Arabia: A cross-sectional study. Journal of International Society of Preventive and Community Dentistry, 10(5), 643-651. https://doi.org/10.4103/jispcd.JISPCD_165_19
3. Ata, S. O., Akay, C., Mumcu, E., & Ata, N. (2022). Influence of atmospheric pressure changes on dentin bond strength of conventional, bulk-fill and single-shade resin composites. Diving and Hyperbaric Medicine, 52(3), 175-182. https://doi.org/10.28920/dhm52.3.175-182
4. Calder, I. M., & Ramsey, J. D. (1983). Ondontecrexis - The effects of rapid decompression on restored teeth. Journal of Dentistry, 11(4), 318-323. https://doi.org/10.1016/0300-5712(83)90116-1
5. García-Torres, J., & Segura-Egea, J. J. (2024). Barodontalgia and its implications for Navy divers and dentists: A narrative review. Journal of Clinical and Experimental Dentistry, 16(5), e634-e638. https://doi.org/10.4317/jced.61619
6. Gougeon, K., Yasukawa, K., & Baudet, A. (2022). Barodontalgia and dental barotrauma among scuba divers. Aerospace Medicine and Human Performance, 93(5), 421-425. https://doi.org/10.3357/AMHP.6045.2022
7. Gulve, M. N., & Gulve, N. D. (2013a). Provisional crown dislodgement during scuba diving: A case of barotrauma. Case Reports in Dentistry, 2013, 749142. https://doi.org/10.1155/2013/749142
8. Gulve, M. N., & Gulve, N. D. (2013b). The effect of pressure changes during simulated diving on the pull out strength of glass fiber posts. Dental Research Journal, 10(6), 737-743.
9. Gulve, M. N., & Gulve, N. D. (2022). The effect of pressure changes during simulated diving on the shear bond strength of orthodontic brackets. Diving and Hyperbaric Medicine, 52(2), 97-102. https://doi.org/10.28920/dhm52.2.97-102
10. Gunepin, M., Derache, F., Dychter, L., Blatteau, J. E., Nakdimon, I., & Zadik, Y. (2015). Dental barotrauma in French military divers: Results of the POP study. Aerospace Medicine and Human Performance, 86(7), 652-655. https://doi.org/10.3357/AMHP.4197.2015
11. Gunepin, M., Derache, F., Blatteau, J. E., Nakdimon, I., & Zadik, Y. (2016). Incidence and features of barodontalgia among military divers. Aerospace Medicine and Human Performance, 87(2), 137-140. https://doi.org/10.3357/AMHP.4424.2016
12. Hamilton-Farrell, M., & Bhattacharyya, A. (2004). Barotrauma. Injury, 35(4), 359-370. https://doi.org/10.1016/j.injury.2003.08.020
13. Hobson, R. S., & Newton, J. P. (2001). Dental evaluation of scuba diving mouthpieces using a subject assessment index and radiological analysis of jaw position. British Journal of Sports Medicine, 35(2), 84-88. https://doi.org/10.1136/bjsm.35.2.84
14. Jagger, R. G., Shah, C. A., Weerapperuma, I. D., & Jagger, D. C. (2009). The prevalence of orofacial pain and tooth fracture (odontocrexis) associated with SCUBA diving. Primary Dental Care, 16(2), 75-78. https://doi.org/10.1308/135576109787909463
15. Khanna, A. (2010). Crown cementing strategy for naval divers. Medical Journal Armed Forces India, 66(1), 46-49. https://doi.org/10.1016/S0377-1237(10)80092-9
16. Koob, A., Ohlmann, B., Gabbert, O., Klingmann, C., Rammelsberg, P., & Schmitter, M. (2005). Temporomandibular disorders in association with scuba diving. Clinical Journal of Sport Medicine, 15(5), 359-363. https://doi.org/10.1097/01.jsm.0000181435.03151.ab
17. Kovacs, C. R. (2023). Scuba diving and the stress response: Considerations and recommendations for professional and recreational divers. International Maritime Health, 74(3), 186-191. https://doi.org/10.5603/imh.91707
18. Livingstone, D. M., & Lange, B. (2018). Rhinologic and oral-maxillofacial complications from scuba diving: A systematic review with recommendations. Diving and Hyperbaric Medicine, 48(2), 79-83. https://doi.org/10.28920/dhm48.2.79-83
19. Lyons, K. M., Rodda, J. C., & Hood, J. A. (1999). Barodontalgia: A review, and the influence of simulated diving on microleakage and on the retention of full cast crowns. Military Medicine, 164(3), 221-227.
20. Moyaux, P. A., Fernandez de Grado, G., Musset, A. M., & Offner, D. (2022). Orofacial problems in scuba diving: Prevalence and prevention - A large-scale survey among civilian divers in France. Odontology, 110, 814-823. https://doi.org/10.1007/s10266-022-00714-8
21. Onose, Y., Suzuki, S., Yoshino, K., Ishizuka, Y., Satou, R., Kamijyo, H., et al. (2020). Relationship between oral symptoms during diving work and preventative dental visits in Japanese male occupational divers. Industrial Health, 58(3), 238-245. https://doi.org/10.2486/indhealth.2019-0076
22. Oztürk, O., Tek, M., & Seven, H. (2012). Temporomandibular disorders in scuba divers - An increased risk during diving certification training. Journal of Craniofacial Surgery, 23(6), 1825-1829. https://doi.org/10.1097/SCS.0b013e3182710577
23. Ranna, V., Malmstrom, H., Yunker, M., Feng, C., & Gajendra, S. (2016). Prevalence of dental problems in recreational SCUBA divers: A pilot survey. British Dental Journal, 221(9), 577-581. https://doi.org/10.1038/sj.bdj.2016.825
24. Rauch, J. W. (1985). Barodontalgia - Dental pain related to ambient pressure change. General Dentistry, 33(4), 313-315.
25. Robichaud, R., & McNally, M. E. (2005). Barodontalgia as a differential diagnosis: Symptoms and findings. Journal of the Canadian Dental Association, 71(1), 39-42.
26. Safai, P., Farzaneh, B., & Fekrazad, R. (2019). The effects of pressure in vitro on three methods of root canal obturation. Diving and Hyperbaric Medicine, 49(1), 16-20. https://doi.org/10.28920/dhm49.1.16-20
27. Shahnavazi, M., Salari, B., & Fekrazad, R. (2021). The effect of scuba diving on microleakage of a Class II composite restoration: An in-vitro study. Healthcare, 9(6), 768. https://doi.org/10.3390/healthcare9060768
28. Shafigh, E., Fekrazad, R., & Beglou, A. R. (2018). Impact of various pressures on fracture resistance and microleakage of amalgam and composite restorations. Diving and Hyperbaric Medicine, 48(3), 168-172. https://doi.org/10.28920/dhm48.3.168-172
29. Sionek-Wręga, I., & Wręga, J. (2024). Oral health complications of SCUBA diving. Quality in Sport, 33, 55832. https://doi.org/10.12775/QS.2024.33.55832
30. Stoetzer, M., Ruecker, M., Koch, A., Ziebolz, D., Kokemüller, H., Kaempf, C., Gellrich, N. C., & von See, C. (2012). In vitro effects of external pressure changes on the sealing ability under simulated diving conditions. ISRN Dentistry, 2012, 418609. https://doi.org/10.5402/2012/418609
31. Sumen, S. G., Dumlu, A., & Altun, B. D. (2023). Incidence of dental barotrauma and temporomandibular joint problems of divers in Turkey. Undersea and Hyperbaric Medicine, 50(1), 95-104. https://doi.org/10.22462/01.01.2023.39
32. Tsur, N., Arbel, Y., Abuhasira, S., Permut, Y., Lvovsky, A., & Protter, N. (2022). A retrospective study of oral pathoses in Israeli military divers and non-divers: 2011-2020. Dental Traumatology, 38(1), 48-52. https://doi.org/10.1111/edt.12704
33. Vivacqua, A., Fan, K., Gürtler, A., Thieringer, F. M., & Berg, B. I. (2024). An algorithm for jaw pain among divers. Journal of Clinical Medicine, 13(11), 3167. https://doi.org/10.3390/jcm13113167
34. von See, C., Rücker, M., Koch, A., Kokemüller, H., Schumann, P., Ziebolz, D., & Gellrich, N. C. (2012). The influence of pressure changes on endodontically treated teeth during simulated dives. International Endodontic Journal, 45(1), 57-62. https://doi.org/10.1111/j.1365-2591.2011.01947.x
35. Zadik, Y. (2009). Barodontalgia. Journal of Endodontics, 35(4), 481-485. https://doi.org/10.1016/j.joen.2008.12.004
36. Zadik, Y. (2010). Barodontalgia: What have we learned in the past decade? Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 109(4), e65-e69. https://doi.org/10.1016/j.tripleo.2009.12.001
37. Zadik, Y., & Drucker, S. (2011). Diving dentistry: A review of the dental implications of scuba diving. Australian Dental Journal, 56(3), 265-271. https://doi.org/10.1111/j.1834-7819.2011.01340.x
38. Zanotta, C., Dagassan-Berndt, D., Nussberger, P., Waltimo, T., & Filippi, A. (2014). Barodontalgias, dental and orofacial barotraumas: A survey in Swiss divers and caisson workers. Swiss Dental Journal, 124(5), 510-519. https://doi.org/10.61872/sdj-2014-05-01
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Bartosz Litwin, Karolina Ciążkowska , Michalina Nowakowska, Monika Pachcińska, Oliwia Janczak , Wiktoria Biederek , Adrianna Kozak, Julian Juncewicz, Alicja Lubińska , Hana Dadoush
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 16
Number of citations: 0
