Sinus/tooth squeeze and still have numb teeth, Neon yellow Mucus

[Mark2189]

Hi everyone!
We got our advance open water last week. As we were ascending from our deep water portion my wife began to experience pain in her jaw and cheek area. The pain started to really bother her. After some questionable advice she decided to go back under for the second dive. The pain immediately went away until she surfaced again. While waiting for the boat to pick us up, pressure shot out of a tooth and she had immediate relief. Then when she stepped on the dive boat pressure and liquid shot out of her nose. After that she felt great. All was good.

Now, a week later, her teeth are still numb. Yesterday she blew her nose and some neon yellow mucus/liquid came out. This is the second time that’s happen. I’m worried that it’s cerebral spinal fluid. Other than that she feels great. Should we be worried. She already went to the dentist and they were clueless. Should we go to a ENT doctor next?

 

[RyanT]

Unlikely to be CSF, but I would say go see a dentist for starters. If she had sudden relief in the tooth, it may have been damaged as the gas escaped. Continuing numbness is also a concern she should discuss with the dentist.

 

[rsingler]

Pure speculation, but the mechanism you describe indeed suggests a sinus pressurization, that then was explosively relieved. The numbness is called neuropraxia, or a nerve bruise, and should should resolve in six weeks. It is unlikely to be permanent, as there was nothing described that would have cut the nerves.
Of concern is the cause. Was it simple sinusitis, where temporary inflammation blocked the opening and made it into a one way valve? Or instead something like nasal polyps which blocked the opening? The "neon" you describe may imply a chronic process, and an ENT can indeed get you situated.
Make sure to note the relation to diving to your doctor, and contact DAN, @Duke Dive Medicine or @doctormike for help finding an ENT with dive medicine experience if the advice you get doesn't square with what you've learned about pressurization at depth.

Diving Doc

 

[Duke Dive Medicine]

Thanks for the add @rsingler . @Mark2189 , neon yellow mucus is suggestive of a sinus infection. CSF is clear and a very pale straw color, and if she was leaking CSF (especially that much) she would likely be symptomatic. Sometimes the sockets of the upper molars can communicate with the maxillary sinus, which could explain why there was explosive discharge in the area of a tooth. The nerves that innervate the upper molars also run in the area of the maxillary sinus so extreme pressure there could have resulted in the neuropraxia that @rsingler mentioned.

I can only imagine what kind of pain she must have been in before the pressure relieved itself. Needless to say, she should not dive until this is resolved. A timely visit with an ENT physician would be a very good idea. If you PM your location I can check on an ENT in your area. DAN is also a resource.

Best regards,
DDM

 

[Mark2189]

Thanks for the add @rsingler . @Mark2189 , neon yellow mucus is suggestive of a sinus infection. CSF is clear and a very pale straw color, and if she was leaking CSF (especially that much) she would likely be symptomatic. Sometimes the sockets of the upper molars can communicate with the maxillary sinus, which could explain why there was explosive discharge in the area of a tooth. The nerves that innervate the upper molars also run in the area of the maxillary sinus so extreme pressure there could have resulted in the neuropraxia that @rsingler mentioned.

I can only imagine what kind of pain she must have been in before the pressure relieved itself. Needless to say, she should not dive until this is resolved. A timely visit with an ENT physician would be a very good idea. If you PM your location I can check on an ENT in your area. DAN is also a resource.

Best regards,
DDM

Awesome info. Thanks!

 

[Mark2189]

Unlikely to be CSF, but I would say go see a dentist for starters. If she had sudden relief in the tooth, it may have been damaged as the gas escaped. Continuing numbness is also a concern she should discuss with the dentist.

Awesome. Thanks!

 

[Mark2189]

Thanks for the add @rsingler . @Mark2189 , neon yellow mucus is suggestive of a sinus infection. CSF is clear and a very pale straw color, and if she was leaking CSF (especially that much) she would likely be symptomatic. Sometimes the sockets of the upper molars can communicate with the maxillary sinus, which could explain why there was explosive discharge in the area of a tooth. The nerves that innervate the upper molars also run in the area of the maxillary sinus so extreme pressure there could have resulted in the neuropraxia that @rsingler mentioned.

I can only imagine what kind of pain she must have been in before the pressure relieved itself. Needless to say, she should not dive until this is resolved. A timely visit with an ENT physician would be a very good idea. If you PM your location I can check on an ENT in your area. DAN is also a resource.

Best regards,
DDM

Thanks for the great info. Unfortunately I can’t message you direct yet since I’m new to the website. I’m in New Braunfels,Texas though.

 

[Capt Jim Wyatt]

I had a tooth do this one time. 70 foot dive, no deco but at 15-20 feet the tooth started hurting. At the surface it hurt like hell. I had the dentist pull that tooth out.


On a pain scale of 1-10 I gave it an 8-9.

 

[MarkA]

I had a tooth do this one time. 70 foot dive, no deco but at 15-20 feet the tooth started hurting. At the surface it hurt like hell. I had the dentist pull that tooth out.


On a pain scale of 1-10 I gave it an 8-9.

Had a very similar dive with a similar outcome. Spent a good 5 minutes at 5m chewing on the mouth piece trying to relieve the pressure in the tooth to no avail. It took about 4 hours for the pain to start reducing. The following dentist visit meant redoing half my fillings.

It was in the lower jaw so unlikely to be a sinus issue.

 

[Waterwulf]

I had something like that happen on a dive. I was surfacing and at about forty feet, when a tooth starting hurting. I tried going back down and then up again but nothing helped. Since I was running low on air, I just went for it and forced myself to surface past the pain. That hurt a LOT!! Then, at about ten feet from the surface, there was a loud pop in my mouth and something burst loose. But, the pain was all gone. On the surface, I found a broken filling in my mouth. The Dentist said some debris must have acted like a one way valve inside a damaged tooth and kept the pressure in. At least it popped the filling out instead of braking the tooth.