tooth or sinus squeeze?

[mtnredhed]

My son and I just returned from Coz where he had some odd symptoms during two of his dives.

He's a new diver, had no problems during his checkout dives, has braces, and no known untreated dental problems. He typically has no problem clearing his ears. He didn't report any congestion problems, but we live in a very dry climate (front range colorado), and there's always some adjusting to that level of humidity change.

Our first dive (shallower palancar area, about 60fsw) went w/o problem. We had a 45 minute surface interval, and started our next dive. within the first 10-14 ft., he experienced severe pain. He describes it as feeling like it was above his upper right rear molars, like it was in the bone. We immeadiately surfaced, and the pain went away as quickly.

We did another 5 dives to various depths w/o problems. On the first dive of our last diving day, he again experienced some pain around 20fsw. It wasn't as intense, and we hung there for about a minute. He moved his head around and worked his jaw, then he said he heard/felt a sound and the pain went away completely. we finished out that dive and another w/o problem.

I'm leaning to a sinus squeez, but I'm a bit concerned since it was so close to his teeth.

ideas?

thanks!

[mtnredhed]

no repsonse? Hints on how to avoid sinus squeeze?

[mweitz]

I am a newbie so my experience can't help, but if I were you I would get a family membership to DAN (http://diversalertnetwork.org/). You can call them for advise, and probably get a referral to a doctor that specializes in dive medicine. I personally wouldn't let him go down again until it is resolved. Better safe than sorry.

Mark

[mtnredhed]

We have a family membership. I would guess that a very high percentage of people posting here from North America have DAN cards. I'm trying to set up an appt. although it's out of coverage for my health insurer.

[Green_Manelishi]

then he said he heard/felt a sound and the pain went away completely.

If the sound he heard/felt was a "squeek" it was likely a middle ear equalization. Mine do the same thing ... SOMETIMES. Other times I have 'no problem'. It cannot be over stressed that squeeze can happen 'just like that' and a diver needs to stay ahead of the curve.

[Laurence Stein DDS]

We have a family membership. I would guess that a very high percentage of people posting here from North America have DAN cards. I'm trying to set up an appt. although it's out of coverage for my health insurer.

Hi mtnredhed,

Sorry, I was away.

It sounds like a sinus squeeze...especially if there are no dental problems. Upper molar pain referral is typical and depending on the length of exposure, it may clear immediately or slowly over a few hours.

I have typically seen this type of squeeze in patients who call from the airport on arrival. They had pain on the flight...especially descent...and by the time they get to the office the pain is gone and nothing can be found.

You didn't say how old your son was but if he is about 14-16, he may have wisdom teeth that are not visible but may be beginning to erupt.

At some point in the eruption cycle, the sac surrounding the wisdom tooth may communicate with the oral cavity without the tooth being visible. If so, it is possible for air to get into this space and could possibly cause the problem. This is about the only dental problem I can think of in an otherwise healthy mouth that might cause a barodontalgia other than the sinuses.

You might want to check with you dentist about the wisdom teeth.

Hope this helps.

Laurence Stein, DDS