Diving – your dental team


Copyright Michael Ennenkel

As a diver you come in direct contact with us dentists in the following problems:

1. fillings / root canal treatment = barotrauma + reverse blocking

2. Surgery and implants

4. Musculoskeletal problems and periodontitis

Not only a good dive planning and maintaining physical fitness is important in diving, also the care of the teeth plays a big role.

Prophylaxis means here the keyword and prophylaxis usually does not mean to go to the normal provision twice a year, but regularly take care of his teeth and his dental and overall health. This can e.g. in the context of a prophylaxis program (private service, but which is covered by some insurances, so that part of the invested money goes directly back to you as a health service). Further information s. dental insurance

1. fillings / root canal treatment and barotrauma

Cavities can lead to problems when descending and emerging. Such cavities may be hidden under defective, carious fillings (but also in crowns, bridges, inflammation of the jawbone and gums) or hide under not optimally filled plastic or amalgam fillings. The air that is compressed when you descend and expands when it emerges can cause toothache or even break off parts of the filling or the tooth. This can lead to a barotrauma or a reverse blocking.
We advise our diving patients to gradually say goodbye to old fillings and exchange them for gold or ceramic inlays. In this type of filling an air storage is excluded.

filling alternatives

Also root canal treatments can lead to air pockets. This is not only to be considered during an ongoing root canal treatment – here is our recommendation to stop the dive for the treatment period – but v.a. for the closure of the roots with (heated) gutta-percha, the actual root filling material (s.u.). This must be done very carefully so as not to guarantee trapped air. Therefore, seek out a certified endodontist who will perform this treatment. A later crowning in the posterior region (in other areas a so-called multi-layered hyrid filling) is a prerequisite for avoiding a later fracture of the tooth due to barotrauma or mouth overload.

How is a modern root canal treatment performed??
With a local anesthetic it can first be ensured that the treatment is completely painless.

Step 1:

We provide access to the tooth interior.

The channel inputs are carefully scanned.

The length of the root canals is determined with an X-ray or an electronic measuring device.

2nd step:

The channels are cleaned with state-of-the-art, flexible nickel-titanium alloy instruments.

The instruments can even handle very curved and very fine channels.

Ultrasonic rinsing additionally cleanses and kills bacteria. Then we dry the channels and fill a drug with very acid pH, which kills the invading bacteria.

3rd step:

There are different filling methods. In the modern “Thermafil” method, the gutta-percha (elastic natural material), which adheres to a tissue-compatible pen, is heated. This makes them flowable and distributes well throughout the root canal, even in the fine side channels. After a control recording, the tooth is closed with a ceramic plastic.

Blue spotted photo shredder

2. Surgery

After each surgical procedure, at least one dive pause should be taken until removal of the sutures (typically 8 days) so as not to interfere with wound healing by infected water or gagging of the wound edges by mouthpiece or snorkel. For major surgery such as surgical wisdom tooth removal or bone augmentation, this dive may extend to 6 to 8 weeks. Ask your treating dentist or maxillofacial surgeon in each individual case; a general assessment is not possible because of the individually different course of the surgery.

3rd dentures:

Divers with partial or full dentures have two problems: Firstly, it can be difficult to securely hold the mouthpiece (full dentures with toothless dive colleagues) or there is a danger of aspiration (= swallowing) of partial dentures.
The affected persons should therefore always pay attention to a – as far as possible – good fit of their prostheses; i.e. Regular visits to the dentist and the prostheses can also be regularly checked and relined. Full dentures are much looser in the mouth than prostheses anchored to residual teeth. Therefore, these persons are correspondingly more at risk, because in dangerous situations could lead to loss or in the worst case swallowed the prosthesis.

Example of a simple bridge restoration in the lower jaw, to which the prosthesis is attached

Therefore, I would always advise in this case to a supply of implants. Here “dowels” are placed in the jawbone and on this – after a healing period – can then in a second step, the prostheses or even re-fixed dentures (crowns and bridges) attached with appropriate counterparts. An optimal solution – not only for diving (and now also the statutory health insurance company)!

4. Musculoskeletal problems and periodontitis

A normal dive by us scuba divers takes about 40 – 60 minutes. With technical divers, this time can even extend to several hours. This constant tension of the masticatory muscles when holding the mouthpiece can lead to headache, jaw and temporomandibular joint pain.

This may be because:

  • the standard mouthpieces do not cover the posterior molars
  • Medium pressure hose on the right of the regulator hangs (= overload)
  • it thus to an activation of the masticatory muscles and load of the Kiefergelenks logo CNRS logo INIST> Overload possible
  • Joint gap compression when crunching on the mouthpiece is possible.

All this can lead to unphysiological stress in the very complex muscular and skeletal oral / facial system.

For smaller problems, the following procedure may lead to relief:

  • Change of right and left lung valve
  • Medium pressure hose horizontally lead (joint, attention achievement restriction!)
  • Use high-pressure tubing that is not as inflexible as the previous tubing
  • lighter 2nd stage (?)
  • Orthopedic mouthpiece (covers the entire tooth area), if necessary adaptation by dentist or orthodontist possible
  • Self-massage (ask the appropriate techniques with the physiotherapist).

Due to my own problems, I have helped me with the preparation of an individual mouthpiece made of silicone. In dive shops or online you can get a corresponding mouthpiece or the high-pressure hoses (thin and very flexible). The customization is usually straightforward. In difficult cases, however, it may be necessary to have the dentist adapt a professionally manufactured mouthpiece.

In the context of periodontal disease may also cause problems with the mouthpiece and the associated muscular overload. The problems arise when teeth are inflamed or loose and are no longer “right” in the bone.

This is an urgent need to intervene, as periodontal disease not only affects the teeth and periodontal ligaments (bones, teeth and gums) but also has a significant impact on your overall health.

Soft coral egypt photo dr. Reißmann

I hope to have done with this info page “first aid“.

For further inquiries, I am happy to be available by e-mail.

Instructor training in Alanya Turkey

Despite the medical evidence diving is one of the most fascinating sports that I know.
If you are interested, you can book everything from the taster course, the OWD to special courses all about the Dive Center Tauchbar Dusseldorf, where I work as a certified diving instructor.
I also like to refer to a new article about me as a diving instructor, s. link

Book your appointment online now:
The link leads you directly to Doctolib


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