>A diver myself, I understand their concerns.
>To better help divers choose a proper course of action, I will discuss what causes a tooth to need a root canal and explain the treatment. I’ll also explain when it’s safe to dive after a root canal and whether it is preferable to have the treatment before or after diving.
>Pulp, the vascular tissue made up of blood and nerve tissue in the interior of the tooth, supplies nutrients to the tooth during its development. Once the tooth matures, it can function without nerve tissue. Sometimes the nerve tissue inside the pulp chamber becomes inflamed or infected. This can cause a sharp pain when the tooth is subjected to hot or cold, and the infection and/or inflammation may also cause sensitivity to pressure.
>Sometimes the pain diminishes, but the absence of pain does not mean the problem is gone. Not treating the tooth can lead to a more serious condition and sometimes even a patient’s death. This is due to an expansion of air pockets within the tooth. Airplane flights can aggravate the problem.
>Root canals don’t have to hurt much anymore
>Based on stories they’ve heard, some patients fear a root canal treatment. A skilled endodontist using state-of-the-art techniques and technology should be able to perform the procedure with little or no discomfort to the patient.
>A root canal involves several steps. First, an endodontist opens the tooth and locates the canals in the roots. Using special files, the endodontist then shapes the canals and irrigates them with several different antibacterial agents. Next, the endodontist removes the bacteria and diseased nerve tissue and thoroughly cleans the inside of the tooth. Many endodontists use a dental operating microscope, which is designed to aid in locating difficult-to-find canals.
>The number of canals in the roots of a tooth vary, depending on the tooth and its structure. Most molars have three to four canals. Based on cases referred to our practice, I’ve noticed a pattern when a patient still suffers symptoms after a root canal treatment: Not all canals are always located during treatment, and the tissue in the missed canal may be a source of pain. Because of missed canals, my two partners and I have re-treated several thousand root canal cases.
>Filling the gaps
>Most endodontists fill the tooth with a material called guttapercha, a natural latex-like material that is compatible with the tooth. Choosing a filling material that is compatible with the patient is important to avoid an allergic reaction to a foreign substance.
>Guttapercha is used to fill the space created by the removal of the diseased tissue. For the most part, diving with the newer, resilient temporary materials in the tooth doesn’t pose a problem; however, it would be a good idea to see a dentist and have the final restoration completed before diving.
>If a temporary filling leaks, that indicates the inside of the tooth is contaminated with bacteria from saliva. In that case, the tooth will need to be retreated. Because the fill material is difficult to remove, the retreatments cost more than the original procedure.
>If, as described here, the endodontist removes unhealthy tissue, diving should not be a problem. Waiting a week is probably a good idea to ensure there are no complications after treatment. There are exceptions, however. Before having a root canal, some patients have swelling, and that usually lasts several days after the procedure. The swelling is caused by the infection spreading to the surrounding tissue. Undertaking a dive trip while experiencing infection would not be advised.
>When to have a root canal
>If you need a root canal, should you have the procedure before you leave on a dive trip or when you return? It’s advisable to have the procedure before your trip. Why? Sometimes that subtle ache-heat and/or cold sensation can quickly worsen into a very painful condition during a vacation. Plus, as we mentioned before, flying can aggravate the symptoms. It’s generally OK to have the treatment started before the trip and have it finished on returning; however, if you have swelling or extreme pain after the procedure, delay the trip until you are symptom-free.
>In short, don’t gamble with your teeth. This can ultimately ruin a dream vacation. Take care of any pain and swelling by seeing your dentist right away — and especially before a dive trip. If you have an extraction or are recovering from an infection, allow yourself plenty of time for healing and rest before you travel. You’ll want to be 100 percent ready to enjoy your diving.
>Sink Your Teeth Into This Advice
>Dental pain not only ruins the vacation, but it can also be dangerous. The infection can spread, and proper dental care is often difficult to find if you’re diving in a remote area. Also, a medical doctor needs to know about dental infections to prescribe the correct antibiotic. I have often seen patients whose conditions worsened after they saw medical doctors who had prescribed the wrong medication.
>When planning a dive vacation, see a dentist beforehand if you’re experiencing hot, cold or pressure sensitivity in the teeth.
>ABOUT the AUTHORS
>Linda Bascom, D.D.S., graduated from the University of Missouri at Kansas City in 1985. She served in the U.S. Navy for 22 years, including six months (1990-1991) stationed with the U.S. Marines in Saudi Arabia during Operation Desert Storm. She has practiced endodontics for 15 years in Kennewick, Wash.
>John Monk, M.S., is a retired math and science teacher who completed his master’s degree in environmental studies in 1988. A certified diver since 1977 and an avid underwater photographer, he has been the office manager in Dr. Bascom’s practice for seven years.