Diving after dental procedures - recommendations for the waiting period

Diving places special demands on the body, particularly with regard to the pressure conditions in the body cavities. An appropriate waiting period should be observed after dental procedures in order to avoid complications. The fact that the teeth in the upper jaw are in close proximity to the maxillary sinus makes them an important part of smooth pressure equalization. A stable row of teeth is also of crucial importance when holding the regulator. This means that considerable forces act on the teeth and jaw over the duration of the dive. For these reasons, surgical procedures in particular, some of which require more complex bone augmentation techniques in the tooth-bearing area, are associated with long waiting times.

Dekoblog is delighted about the guest article and the expertise of M. med. dent. Moritz Jonasch, dentist and recently an enthusiastic sidemount diver.

Sidemount diving is relaxing. For the jaw joint too? Photo: Simone Golling

These recommendations are based on the necessary healing time and not solely on the type of procedure. In addition, the planned diving depth plays a decisive role - the risk increases with increasing depth or more demanding diving profiles. These recommendations reflect the personal opinion of the author. After an operation, individual consultation with the treating doctor is always recommended.

 

1. No waiting period required

No waiting period is required for the following dental procedures:

• Teeth cleaning

• Teeth whitening (bleaching)

• Fillings without local anesthesia

For fillings with local anesthesia, it is recommended to wait until the anesthesia has completely worn off. To be on the safe side, a waiting time of 12 hours is recommended.

Common sense applies. These recommendations are not an invitation to dive straight in after your dental appointment.

2. Waiting period of approx. two weeks

A waiting period of at least two weeks is recommended after the following procedures:

• Non-surgical periodontal therapy (treatment of gum disease)

• Simple tooth extractions (tooth removal)

Diving should only take place after removal of the stitches and a final follow-up check by the dentist.

3. Waiting time of approx. one month

More complex procedures require a longer healing time. These include:

• Simple apicoectomies (removal of the root tip of a tooth)

• Complex tooth extractions (e.g. several teeth, complicated surgical techniques)

• Simple implantations with closed healing

• Surgical periodontal therapy (treatment of gum disease)

• Small mouth-antrum connections (MAV, connection between the oral cavity and maxillary sinus)

The mouth-antrum connection can occur during various procedures (tooth extraction, sinus floor elevation, root tip resection, implantation) and must be completely healed before diving. The standard waiting time for small openings is at least one month, but can be longer in the case of complications or larger openings.

4. Waiting time of more than one month

Some surgical procedures involve more complex surgical techniques, which entail a longer healing period of three to six months. However, as these procedures are very individual, the treating dentist/surgeon should decide on the final waiting time. Examples of this are:

• Surgical interventions with complex bone augmentation procedures, e.g.

  • Sinus floor elevation for implantation (elevation of the maxillary sinus floor)

  • Iliac crest transplantation

  • Bone augmentation with the help of membranes

• Creation of an oral-antrum connection (connection between the mouth and maxillary sinus) and its closure

• Large bone defects, e.g. after tooth extraction or cyst removal. Depending on the size of the defect, the risk of a jaw fracture may be increased

5. Cases with a general diving ban

If there is pain or swelling in the tooth or jaw area, diving should be avoided under all circumstances. A general diving ban is recommended in the following situations:

• Ongoing root canal treatment:

  • The insertion of medication can cause air pockets, which can lead to pressure-related complications.

• Ongoing crown or bridge restoration with temporary crowns:

  • Due to the risk of aspiration (inhalation of dissolved parts), diving is not advisable.

6. Individual decision

The following situations must be assessed on a case-by-case basis:

• Dentures, partial dentures, temporary wire clasp dentures and the like:

  • Some divers have no problems with them, while others have difficulties. The decisive factor is the stability with which the mouthpiece is held in place, and it may be advisable to have it adjusted by a dentist.

• Fixed orthodontic appliances:

  • Here, too, there is a risk of individual parts or wires coming loose. In addition, biting down on the mouthpiece can be uncomfortable. A general recommendation cannot be made due to the many different appliances.

Swelling impairs desaturation and can promote local decompression symptoms.

7. Wisdom teeth - considerations

Wisdom teeth, also known as third molars, often erupt in the late teens or early twenties. In some people they are retained without problems, but often these teeth cause problems due to difficulty erupting, lack of space or displacement and therefore need to be removed.

Guidelines for diving after a wisdom tooth extraction:

• After uncomplicated extractions, wait at least four to six weeks before diving. For very large defects, however, this waiting period may be considerably longer.

• Consult your dentist or oral surgeon before diving again.

• Make sure you can hold a regulator for the duration of a dive without pain or discomfort.

• Avoid diving if you are taking pain medication that may impair judgment or interact with nitrogen narcosis.

• If swelling persists, be aware that nitrogen desaturation may be impaired and localized decompression symptoms may occur.

8. Temporomandibular joint and chewing muscle problems

Problems in the area of the temporomandibular joint or muscular problems of the chewing apparatus can make diving difficult or even impossible and are a well-known problem when diving.

The following medical conditions can contribute to problems:

• Bruxism (teeth grinding)

• Dislocations in the temporomandibular joint (displacement of the joint disk)

• Muscular tension

• Temporomandibular joint luxation (dislocation of the temporomandibular joint)

In addition to consultation with the attending physician, it is crucial that the regulator can be held without problems for the duration of the dive. In some cases, the symptoms can be exacerbated by long dives. A suitable, individually adapted mouthpiece can help.

The setup also plays a major role when diving. Think of a long dive with poorly fitted equipment, where the short hose exerts continuously one-sided pressure on the mregulator. This can put a lot of strain on the jaw, the temporomandibular joint and the chewing muscles.

In special cases, it might even be worth checking whether a dental splint could help.

9. Further considerations

What has been said about wisdom teeth naturally applies to swellings of any kind. Therefore, diving should not be performed in the case of larger swellings.

Stronger painkillers (e.g. codeine, oxycodone) can interact with nitrogen and increase the risk of deep intoxication or impaired judgment.

If other medications are taken, e.g. blood thinners, the risk of complications after dental procedures should be assessed individually, if necessary in a diving medical consultation.

Conclusion

The waiting time after dental procedures depends on the complexity of the procedure and the individual recovery times. While simple treatments involve only minimal risks, more invasive procedures such as extractions, implants and bone augmentation require longer recovery times. The extraction of wisdom teeth in particular should be planned well in advance of a diving trip to avoid any complications. Be sure to consult with your dentist to ensure safe diving.