Dental Barotrauma and Barodontalgia in Divers: A Comprehensive Review for Dental Practitioners

Scuba diving exposes teeth, dental restorations and prosthetic devices to substantial hyperbaric mechanical stress. Dental barotrauma (pressure-induced structural injury) and barodontalgia (pressure-induced dental pain) are oral complications that remain underdiagnosed in routine dental practice, despite their capacity to cause acute pain, restoration failure and in-water emergencies. Gas entrapped within defective restorations, incompletely obturated root canals or poorly adapted prostheses responds to pressure change according to Boyle's law, generating forces that can fracture tooth structure or displace restorations, while barodontalgia reflects the activation of pressure-sensitive nociceptors within inflamed pulpal or periapical tissue. This comprehensive review, reported with attention to the SANRA quality criteria, synthesises current evidence on the pathophysiology, clinical manifestations, risk factors, epidemiology and preventive and restorative management of these conditions. Reported barodontalgia prevalence ranges from roughly 10%-19% in civilian and recreational diver surveys to markedly higher rates of dental or orofacial pain in some military naval cohorts. Epidemiological data are sparse, particularly from low- and middle-income countries, and no international dental professional body has issued clinical practice guidelines for divers. Evidence-based management centres on pre-dive dental assessment, durable restorative seals and structured post-procedure diving-restriction protocols. In patients who actively dive, particularly those presenting with unexplained pressure-associated dental pain or recurrent restorative complications, dental practitioners should consider diving exposure as part of the clinical history and apply targeted preventive and restorative measures. Prospective studies and, in due course, consensus guidance would help reduce the burden of diving-related dental complications.