Dentistry

Question 1

Barodontalgia explain and aeromedical disposition

Answer 1

Pain on ascent
Air expands in tooth = pain
Between 5000-35000 ft
Pain better on ground level

Determining area of concern

• pain on ascent - vital pulp disease
• pain on descent - pulp necrosis or facial barotrauma
• pain on ascent and descent - Periapical disease

Question 2

Nature of pain for Barodontalgia classes

Answer 2

Class 1 - non reversible pulpitis= sharp momentary pain on ascent
Class 2 - reversible pulpitis = dull throbbing pain on ascent
Class 3 - Necrotic pulp - Dull throbbing pain on descent
Class 4 - Periapical pathosis= severe persistent pain on ascent and descent

Question 3

Differential diagnosis for barodontalgia

Answer 3

Unerupted or partially erupted 3rd molars
Barotitis media
Maxillary barosinusitis
TMD vs Ear ache
Para function

Question 4

Management of Barodontalgia

Answer 4

Medical assessment
- Barotitis media, barosinusitis
Refer to Dento
- dental ex 
- determine which tooth

Question 5

TMUFF duration for the follow

• routine tx
• Restoration
• Endodontic therapy
• oral/dental infection

Answer 5

• routine tx - only if LA used
• Restoration: large restoration min of 24 hrs and DO review
• Endodontic therapy: 4 days post completion
  — needs to be cleared by DO
  Oral/dental infection - need clearance by DO prior to return

Question 6

TMUFF periods for the following

• exodontia
• Surgical procedure eg flap raised of bone removal
• natural perforation

Answer 6

exodontia: 48hr to 1 week depending on if surgical. DO review prior to return

Surgical procedure eg flap raised of bone removal: min 1 week and DO review

antral perforation: min 2 week and DO to review ( sometime months depending on size)

Question 7

TMUFF periods for the follow

• Secondary infection
• Dry socket

Answer 7

Secondary infection: TMUFF until resolved

Dry socket: until resolved ~ 10 days. Can test with hyperbaric chamber

Question 8

TMUFF periods for the following

• LA
• GA/IV sedation
• sedative/hypnotics
• Nitrous
• analgesia

Answer 8

• LA: min 8 hrs
• GA/IV sedation: min 48 hrs with AVMO RV
• sedative/hypnotics: nov 48hr + AVMO RV
• Nitrous: 8 hr post
• analgesia: 24hours post final dose expect aspirin, paracetamol, ibuprofen(short term)