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Forget sharks, barracudas or the bends. A big worry of scuba diving may be the dental bill.

A new survey of recreational scuba divers finds that 41 percent report dental problems related to diving. Most of the problems had to do with pain from the increased pressure underwater or from clutching the air regulator too tightly in their mouths, but a few people experienced loosened crowns or cracked fillings.

The survey was limited, but suggests that people should make sure their teeth are in good shape before they go deep.  An unhealthy tooth underwater would be much more obvious than on the surface.  One hundred feet underwater is the last place you want to be with a fractured tooth.

Barodontalgia is a toothache caused by the increase in pressure felt underwater (it can also happen at high altitudes because of low pressure). The condition, which occurs while the person is in the high- or low-pressure environment, is most common in people who have some sort of underlying dental condition, like a cavity or poorly completed filling. 

A small online surey of 100 divers showed, forty-one percent of respondents said they'd experienced dental symptoms while diving. Of those, 42 percent said they'd had barodontalgia. The second-most common symptom was pain from holding the air regulator too tightly (24 percent of those who'd had a dental symptom), and the third-most common problem was jaw pain (22 percent of those who'd had a dental symptom).

Five people reported that a crown — a cap that fits over a broken or damaged tooth — had loosened during a dive. One person reported a broken filling.  Possible causes are the dry air and awkward position of the jaw while clenching down on the regulator. Dive instructors reported more pain and problems than casual divers,

The small online survey is only a first step. A study group of more than 1,000 divers is being looked into. Dental safety should get more attention from scuba certification groups once this survey is completed. Divers are required to meet a standard of medical fitness before certification, but there are no dental health prerequisites.

In the meantime, divers can protect themselves by visiting the dentist before scuba diving to check for decay and other problems.

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