By Dr. Manish Pandey, BDS, Dental Surgeon
Tooth pain while scuba diving is often called barodontalgia: dental pain triggered by a change in ambient pressure. It may occur during descent, ascent or after surfacing. Pressure is usually a trigger rather than the original disease. Decay, an inflamed dental pulp, a leaking restoration, a cracked tooth or a sinus problem may be the underlying cause.
Quick answer: why can a tooth hurt during a dive?
As a diver descends and ascends, surrounding pressure changes. Healthy teeth contain solid tissues and normally do not need to equalize. Pain can occur when a tooth already has disease or when gas is trapped in a poorly sealed space beneath a restoration or inside a tooth. The pressure change may stimulate inflamed tissues or stress a weakened restoration. A dental examination is needed because the same symptom can have several causes.
What is barodontalgia?
Barodontalgia means pain in a tooth caused by changes in barometric pressure. It has been reported in scuba divers, aircrew and people receiving hyperbaric oxygen therapy. Reviews describe it as uncommon but potentially important because sudden severe pain underwater can distract a diver and affect decision-making.
Barodontalgia is a symptom, not a complete diagnosis. The dentist still needs to identify the problem responsible for the pain. A 2024 narrative review notes that diagnosis can be difficult because dental clinics cannot routinely reproduce dive conditions. A clear history—depth, whether pain started on descent or ascent, the exact tooth area and recent dental treatment—can therefore be very useful.
Common dental causes of tooth pain while scuba diving
Untreated tooth decay
Decay can irritate the pulp inside a tooth. Pressure change may expose a previously quiet problem, but diving did not create the cavity. Sensitivity to cold, sweets or biting on land also deserves assessment before the next dive.
Inflamed or infected dental pulp
Pulpitis and inflammation around a root tip can cause sharp or persistent pain. Symptoms may be poorly localized, and discomfort from an upper tooth can sometimes be confused with sinus pain. Severe pain, swelling, fever or difficulty swallowing requires prompt dental or urgent medical care.
Defective fillings, crowns or temporary restorations
A restoration with a poor seal may permit a small gas space or fluid movement. Pressure change can then produce pain or, rarely, contribute to restoration damage. An old filling that feels loose, catches floss or causes biting pain should be checked. Do not try to glue a crown or filling back in place.
Cracked teeth
A crack may cause pain on biting, release or temperature change, and symptoms can be intermittent. Read our guide to cracked tooth syndrome. A diver with a suspected crack should avoid further pressure exposure until a dentist has assessed the tooth.
Recent dental treatment
After a filling, root canal treatment, crown, extraction or oral surgery, tissues need time to settle and restorations need to be evaluated. The correct return-to-diving interval depends on the procedure, healing, symptoms and the treating dentist’s advice. Do not use a generic waiting period as a substitute for personal clearance.
Sinus or jaw pain that feels dental
Sinus pressure can be felt in upper back teeth. Clenching a regulator mouthpiece can also fatigue the jaw muscles or temporomandibular joints. Pain that affects several upper teeth, changes with congestion or comes with facial pressure may not originate in a tooth. The distinction matters because treatment is different.
Does pain on descent mean something different from pain on ascent?
The timing can offer a clue, but it cannot diagnose the tooth by itself. Older classifications link certain descent or ascent patterns with pulp disease or trapped gas, yet real cases do not always follow a simple rule. Tell the dentist whether pain began while going down, at depth, while coming up or after the dive, and whether it was sharp, dull, localized or spreading.
What should you do if tooth pain starts underwater?
Use the safety procedures taught by your recognized diving organization. Signal your buddy and end the dive in a controlled way if necessary. Do not make a rapid or uncontrolled ascent because of dental pain. If symptoms are severe, unusual or accompanied by ear, sinus, chest or neurological symptoms, contact an appropriate dive-medicine service or emergency provider after surfacing.
Do not take leftover antibiotics or place aspirin against the tooth. Antibiotics do not repair decay, a crack or a faulty filling, and direct contact with aspirin can injure oral tissues. Learn more in our toothache and antibiotics guide.
How to prevent barodontalgia before a dive trip
- Arrange a dental examination before intensive dive travel, particularly if you have symptoms or extensive restorations.
- Tell the dentist that you scuba dive and describe your expected diving schedule.
- Complete recommended treatment for active decay, pulp disease, infection, cracked teeth and defective restorations.
- Do not dive with unexplained toothache, swelling, a loose crown or a temporary restoration unless your treating dentist has specifically cleared you.
- Follow individualized advice about when to return after local anaesthetic, oral surgery, root canal treatment or a new restoration.
- Brush twice daily with fluoride toothpaste and clean between teeth every day.
- Use a regulator mouthpiece that fits comfortably, and avoid excessive clenching.
Routine preventive care helps identify problems before travel. Our overview of dental prophylaxis and professional cleaning explains what a preventive visit may include.
Can a filling or crown fall out during scuba diving?
It is possible but appears uncommon. Divers Alert Network has documented cases involving defective restorations and pressure-associated pain. Pressure change is not usually the sole cause; decay, poor adaptation, deterioration or an existing gap may make the restoration vulnerable. A sound, well-sealed restoration should not be assumed to contain a harmful air pocket simply because it was recently placed.
When is it safe to dive after dental treatment?
There is no single interval suitable for every procedure and every patient. Healing after an extraction is different from recovery after a small filling, crown preparation or root canal treatment. Some diving organizations publish general waiting periods, but the treating dentist and a dive-medicine clinician should consider wound healing, infection, pain, temporary materials, medication effects and the planned depth or remoteness of the dive.
Before returning, you should be able to bite comfortably, hold the regulator without pain and have no swelling, bleeding, numbness or unresolved postoperative symptoms. Never stop prescribed medication merely to make a dive schedule possible.
When should you see a dentist?
Book a dental assessment after any reproducible tooth pain during diving, even if it disappears at the surface. Seek prompt care for pain on biting, lingering temperature sensitivity, a broken tooth, a lost restoration or gum swelling. Facial swelling, fever, difficulty swallowing or breathing, or rapidly worsening symptoms needs urgent attention.
A dentist may use examination, pulp tests, biting tests and dental radiographs to distinguish decay, pulp inflammation, a crack, a restoration problem and referred sinus pain. Treatment targets the cause rather than pressure alone.
Frequently asked questions
Can healthy teeth hurt while scuba diving?
Occasionally pain may be referred from the sinuses or jaw muscles, but a tooth that hurts predictably with pressure should still be evaluated. Truly healthy, intact teeth generally do not require pressure equalization.
Is barodontalgia a dental emergency?
Not every episode is an emergency, but severe pain underwater is a safety concern and may reveal decay, pulp disease, a crack or a defective restoration. Do not resume diving until the cause has been assessed.
Can scuba diving damage a root canal tooth?
A well-treated and well-restored root canal tooth is not automatically unsafe for diving. Problems may arise if treatment is incomplete, infection persists, the restoration leaks or the tooth is structurally weak. Personal clearance is important after treatment.
Can a regulator mouthpiece cause jaw or tooth pain?
Yes. Prolonged clenching, an ill-fitting mouthpiece or jaw positioning can cause muscle or joint discomfort. Pain from a single tooth, swelling or thermal sensitivity suggests a dental cause and warrants examination.
References
- Dental barotrauma and barodontalgia in divers: comprehensive review
- Barodontalgia and its implications for divers and dentists: narrative review
- Orofacial pain in scuba divers: systematic review
- Barodontalgia among aircrew and divers: systematic review
- Divers Alert Network: unexpected air pockets and dental pain
AI-generated illustration for educational purposes only.
Dental disclaimer: This article provides general education and is not a substitute for an examination, diagnosis, fitness-to-dive assessment or individualized advice from a dentist, physician or dive-medicine professional.