A scuba diver or a patient exposed to a hyperbaric environment may develop pain in a tooth as the pressure changes (barodontalgia).
If the pain occurs while during descent or increasing pressure, then the cause is a probably a sealed air pocket which has a relative vacuum to the surrounding tissues.
If the pain occurs during ascent or decreasing pressure, then gas has entered the space at depth (higher pressure) and now is expanding. The risk is greater with Heliox due to the helium gas.
Dental conditions associated with barodontalgia:
(1) dental crown or cap
(2) dental veneer
(3) fillings
(4) caries or fracture with pulpitis
(5) dental root abscess
Consequences:
(1) pain, which may be excruciating
(2) limits on the depth and duration of diving
(3) damage to the tooth or dental restoration, causing it to fracture or fall off
(4) worsening of a dental infection, which can be serious at a remote diving site
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