Incidence and Etiology of Barodontalgia in the Israeli Air Force

Objective: Dental pain caused by barometric pressure change in an otherwise asymptomatic tooth, known as Barodontalgia, is nowadays of a minor concern for the aviation surgeon and dentist. During World War II, 9.5% of the American military aircrews had reported of at least one episode of barodontalgia. Publications regarding the 1960s to 1990s have reported a prevalence of 0.23% to 0.3% in hypobaric chamber simulations. However, in-flight environmental conditions are different from hypobaric chamber conditions. Moreover, aviation platforms have dramatically changed in recent decades. The purpose of this study is to assess the current in-flight incidence of barodontalgia and to find out the various dental pathologies as etiologic factors. Methods: 450 questionnaires had e-mailed to fighter-, helicopter- and transport aircrews of the Israeli Air Force, in which they were asked to report whether they had ever suffered from a toothache during flight. In case of a positive answer, the subject was interviewed and his dental file was checked to reveal details about the incidence. Results: 331 (73.6%) aircrew members (29.7±7.3yrs old) responded the questionnaire. Of them, 27 (8.2%) reported at least one event of barodontalgia: 6.5% of the fighter, 6.6% of the transport and 8.6% of the helicopter aircrews. Dental diseases were the major causative pathology, responsible to 67% of the cases: pulpitis (40.7%), pulp necrosis/apical periodontitis (18.5%), vertical root fracture (3.7%) and impacted tooth (3.7%). 18.5% of the barodontalgia cases were due to barosinusitis. None of subjects has reported of premature mission cessation because of dental pain. Conclusions: A considerable number of military aircrews, from all the aviation platforms, have reported barodontalgia events. Pulp diseases are the major causative pathology of barodontalgia. Aviation surgeons and dentists must be aware of this phenomenon, and use preventive measures among aircrew members.