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Dental Problems - Pain

Dr Jules Eden, dive medicine specialist and founder of e-med, answers divers' questions - as published in Sport Diver magazine:
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Q - The last few times I've been diving I start to get headaches during my first dive. After the dive the headaches persist and if I dive a second dive the headaches intensify, on the last occasion quite severely and for several hours afterwards. They are always left-sided. At first I put it down to a number of contributing factors; too much exposure to the Red Sea sun, general dehydration, a bit of sea sickness etc. Unfortunately my last dive was 2 weeks ago at Capenwray, a million miles from Egypt so I can't really find a link. A friend who dives thought I might be biting too hard on my regulator, and I remember my dentist saying I had a small bite - could this be anything to do with it? Any advice would be gratefully received.

A - Agreed - I would guess this is something to do with your bite. The joint that connects the jaw to the skull is called the temporomandibular joint (TMJ). Like any other joint, it can be affected by dislocation, arthritis and other injuries. Symptoms include all sorts of things – difficulties with biting and chewing, clicking or popping sounds when opening or closing the mouth, pain in the ear or head, migraines, and neck or shoulder pain. Biting the mouthpiece for long periods on dives can cause facial muscle fatigue and bring on the symptoms of TMJ dysfunction. So first step here is to see your dentist again to check you out for any signs of this. It’s a complex disorder and may require some experimentation to fix things, but may I suggest a change of mouthpiece, to a Comfobite or similar – much easier to hold onto throughout a dive without clenching for Britain.

Q - My daughter (9) has recently taken up scuba diving. She started complaining of toothache on her back molars about a week before her first dive. She seemed to have a few problems equalizing, but has since solved that issue. For the last two weeks her tooth pain got worse and then she started to complain about headaches and earaches. The dentist couldn't find any cause for her pain and our GP was at a complete loss, since there didn't seem to be anything wrong with the ears. She prescribed a course of antibiotics anyway which I am reluctant to give to my daughter, since there is no obvious infection. My guess would be a sinus problem, but who do I consult, if the GP can't give me an answer? Please help!

A - Hmmm, this ain’t anything to do with diving. I know this ‘cos it started before she even dived. And she equalized OK too. And the problem has gotten worse since then. So pain in the back of the molar mouth area? Could it be wisdom teeth, an early eruption? Where there X-rays taken?

I used to get minor inflammation of my gums there and yes it does cause ear pain, and that doesn’t half give you a headache. Sinal pain is mostly associated with colds and green gunk in that area too.

Or stress, was she anxious about the diving? So many questions, but in a 9 year old there’s often only one answer. Buy them more toys, they soon get better. If you do want another opinion though I am happy to see her.

(other dive medical questions)


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