Barodontalgia: what have we learned in the past decade?

This article reviews the current knowledge regarding barodontalgia, a barometric pressure-related oral (dental and other) pain. Contemporary classification, prevalence, and incidence, features, etiology, and diagnosis of this entity are presented regarding flight and diving conditions. Summarizing the past decade data, three-fourths of episodes were described as severe, sharp, and localized pain. Barodontalgia affects 11.9% of divers and 11.0% of military aircrews with a rate of 5 episodes/1,000 flight-years. Upper and lower dentitions were affected equally in flight, but more upper than lower dentition were affected in diving. The most prevalent etiologic pathologies for in-flight dental pain were faulty dental restorations (including dental barotrauma) and dental caries without pulp involvement (29.2%), necrotic pulp/periapical inflammation (27.8%), vital pulp pathology (13.9%), recent dental treatment (11.1%), and barosinusitis (9.7%). This review refutes 3 generally accepted conventions: According to the results, the current in-flight barodontalgia incidence is similar to the incidence in the first half of the 20th century, the weighted incidence of barodontalgia among aircrews are similar to the weighted incidence among divers, and the role of facial barotrauma in the etiology of in-flight barodontalgia is minor.