ISSUE 16 ARCHIVE - DIVING DENTIST

Celehte Fortuin

Yes, it’s true. Every single word of it. Believe it. I have a copy of the coveted FAQ Dive Medicine book, fresh off the printing press. Yes, it’s signed... and I’ve realised I left the launch without paying
for it. So, I have a signed, stolen copy of a newly released book by the visionary of Tanked Up, co-written and signed by the guy who has to pass my dive medicals and a blogger (Hi Rob!) who can rip me apart verbally. I’m doing well. And as long as we’re sharing – I also didn’t floss last night. Shock, horror, gasp. Only joking, I did no such thing, now back to flossing everyone.

As a city-bound diver emerging blinkingly into a splendid summer, I will be joining the rest of my fellow divers in the long queues on the motorways and country lanes, heading to our favourite dive sites. My final and probably most shocking confession to complete this trilogy of awful truths is that I am still the driest diver out there.
I have even considered a session in the pot to remind me of how to clear my ears, until the owner of my local dive club piped up and offered me a Scuba Review. Great! So please form an orderly queue at the deep end of the pool, pass me my snorkel and mind the giant stride before my big humiliation.

Q: On my last few dive trips I have had general tooth and face ache during the dives and even some pain after diving. I went to my dentist and after a few tests and much knocking around on the teeth, was given the all clear and assured I didn’t need any fillings. However, after thinking I was imagining it and trying to get on with diving again, I had the same face ache on my last dive and my teeth felt really ‘jangly’.
Lola

DD: Looking at your symptoms it seems
that there may be a few reasons behind your jangly teeth and achy face post dives. In
the absence of any tooth problems the next step will be to look into your facial sinuses. The frontal and maxillary sinuses of the face and upper jaw are often related to atypical facial pain and discomfort in the upper teeth, as we have all experienced during a head cold – or in the unfortunate sufferers of hay fever/allergies – these sinuses often become inflamed, blocked and fill up with a thick mucus, difficult to shift. This has many times been the cause of toothache and, in the case of long time sufferers of sinusitis, a frustrating problem.

In certain circumstances a Panoral x-ray (an image showing your upper and lower jaws, including the teeth and sinus areas) taken
at your dental surgery may show a cloudy appearance of the affected sinus. More often than not we start treatment with an over-the- counter medication and sinus sprays to see if this thins out and loosens the mucus, making it easier to clear up. Following a bacterial infection and a suspicious looking colour to the mucus (I know, lovely thought) we can treat with antibiotics and sinus rinses. Diving on medication, and especially sinus clearing sprays should really be avoided. Most of these medications have a short term working action of 6-8hours. Should you be diving whilst under their effect, you run the risk of a reverse sinus block when their effect wears off during the dive. Besides being painful, the added distraction under water is an unwelcome occurrence and dangerous when, upon ascent, concentration is required and
a safety/deco stop needs to be performed.

Should these simpler treatments not bring any relief, you may have to be referred to an Ear, Nose and Throat Specialist and more complex tests like CT scans. Deviated and narrowed septums (the bridge of the nose), sinus polyps (mucus-filled growths in the sinuses), foreign objects (don’t ask), unusually placed tooth-related infections are all treatable and will hopefully not take away too much from your bottom time.

Q: I met a lovely lady on holiday in Fiji last year and am happy to say we are now “going steady”. Doing lots of diving, she has noticed a lot of jaw pain and episodes of locked jaw, especially when opening her mouth really wide, like when yawning. Besides resting
 her jaw, is there anything else we can
 do to alleviate the symptoms?
 Regards, Kevin

DD: It appears your lady has a case of
an unfortunate slippery disk in her jaw
joint causing her the lock jaw. This disk
is responsible for allowing the ball-and- socket joint to glide smoothly over each other during movement. In some cases, the ligaments from the muscles supporting the disk become slack and/or the joint itself develops growths and uneven surface areas. When the joint opens, the disk is pulled too far forward in the socket, upon closing the ligaments lack the strength or uneven surfaces stop the disk slipping back into it’s natural resting place, locking the jaw in a painful open position. Some people develop an uncanny knack to unlock the jaw or develop habits stopping this occurring. Other than being careful and taking pain relief as needed, there is unfortunately no surgery or treatment to stop this happening. A night guard may be indicated if the joint and muscles are also under strain from clenching or grinding at night.

Have a happy summer everyone and remember... flossing saves teeth.