Steven P. Hughes
Graham’s Age: 55
Experience: Advanced Open Water Diver with 70-Plus Dives
Medical History: Fit; In Good Health
Graham always enjoyed diving wrecks, seeing history and human ingenuity resting at the bottom of the ocean, being slowly grown over by coral and tunicates. He had been to this wreck a number of times, as it was fairly close to his home on the coast of South Carolina, but he was excited for a good day of diving with friends.
Four divers performed a giant stride off the back of their boat and descended to the wreck with no issues. Graham and his buddy explored the bow of the ship, peeking through portholes and watching a seahorse sway with the swells, staying between 70 and 100 feet deep. At the end of the dive, Graham signaled to his buddy and the other group to start their ascent, happy to have had great visibility and overall good conditions.
Related Reading: Best Destinations for Wreck Diving
After climbing a few dozen feet, Graham started to feel discomfort and pressure around his ears and jaw. He also noticed some vertigo as he tried to get his bearings partway up the water column.
Graham knew that divers sometimes experienced a “reverse block,” which happens when the expanding air in your ear canals during ascent causes the eardrums to bend outward. Thinking this must be what was happening, he slowed his ascent and grabbed onto their guide line to let his ear equalize. However, even after waiting for five minutes, the discomfort and pain did not go away. Graham decided to keep ascending and get back to the boat.
Once on the boat, Graham still felt pain in his jaw, but he had no other concerning symptoms. His buddies kept an eye on him as they rode to shore and drove him home. Graham kept wondering what could be wrong. He had never heard of a reverse block being sustained for so long, and it was mostly his jaw that hurt—not his ears. After taking a hot shower to relax, Graham used his mirror to look in his mouth to see what might be causing the pain. He suddenly realized that the dark spots on his molars weren’t from a post-dive cookie—two of his cavity fillings had popped out!
When a diver experiences tooth pain or injury due to changes in pressure, it is termed barodontalgia, or tooth squeeze. While rare, a few incidents are reported each year. The most common cause is an improperly applied filling that leaves a gap within the tooth. Air can fill this gap before ascent, then expand within the tooth, causing pain, discomfort and, sometimes, dislodging the filling. An incident can occur any time after obtaining a filling, up to months or years in the future.
The largest safety risks from barodontalgia are rapid ascent and impaired judgment stemming from severe pain.
Related Reading: A Sudden Lionfish Sting Tests a Diver's First-Aid Skills
Lessons for Life
1 If you experience tooth pain or discomfort during a dive, remain calm and do not dive any deeper. Signal to your buddy to end the dive, ascend safely and plan to visit the dentist before another dive.
2 Overall maintenance of your dental health is an important component of remaining fit to dive. That means keeping up with brushing, flossing and annual trips to a reputable dentist for cleanings and check-ups.
3 After any dental procedure or surgery, wait to dive until all healing is complete. Wait a minimum of 24 hours after a local anesthetic procedure and up to four to six weeks after surgery. You may want to do a test dive in a deep pool to make sure you are comfortable with pressure changes during ascent and descent before returning to open water.
