Q: I am off travelling and have done a lot of diving but my girlfriend has a fake tooth which is attached to the teeth either side with metal/glue. Although this is very well fixed she is worried about the pressure – any advice?
A: Firstly, I would suggest a quick dental check up for hidden vials of potassium cyanide or other suicide pills hidden within the fake tooth. Next, blindfold your girlfriend, take her down into the basement, tie her to a chair and administer intensive interrogation with the aid of a feather duster, a riding crop and a sordid imagination. If she still won’t talk, I think we’re okay to go diving. A tooth like this is going to be solid and therefore not susceptible to pressure effects. As long as the glue holds tight, there’s now’t to worry about.
There are occasional tales of exploding teeth and ballooning gums that make the scientific dive literature, but I think more as exceptional cases than as common problems. The term ‘aerodontalgia’ has been coined for this, mainly to confuse the layman – it literally means ‘air tooth pain’. You can get gas spaces forming around the roots of infected teeth or where old fillings cause little gaps to appear between the tooth and gum. During a descent the contracting gas spaces can suck in blood or make the gum swell, causing pain, or in the worst case scenario, a particularly fragile tooth can collapse. Naturally, the gas expands again on ascent, again causing pain, or the occasional ‘blow out’, where the tooth literally explodes. Some older divers with lots of fillings can actually gauge their depth quite reliably on the basis of how much pain they’re in. But before anyone with fillings panics, cases like this are unusual. A dental check once a year should show up any problems. Pain in the teeth on a dive can sometimes be referred from a sinus squeeze, but if it persists a trip to the ‘drawer-tooth’ is probably a good idea.
Do you have a question for Dr Firth? Email divingdoctor@scubadivermag. com with your query and we will pass it on to the team at London Diving Chamber.