The Effects of Flying on the Health of Your Teeth

You are all packed up and ready to head off on your summer holiday. The kids are behaving surprisingly well. The airport gate is almost ready for boarding. You can feel the excitement building in your chest. Then, suddenly, you feel a twinge in your tooth. You know, the one which has been sporadically rearing its ugly little head, for the last two weeks? This guide to the most common causes of toothaches whilst flying will help you to identify the problem, find a solution, and rescue your holiday. 

Unfortunately, the combination of flying and toothache is a real killer. It is also a lot more common than you might think. The problem is that aeroplanes are unlike anywhere else on earth (except for deep below the sea). The atmospheric pressure is constantly changing throughout the time between take-off and landing, as the plane climbs, glides, and comes back down again.

Image via Flickr by xlibber 

The Relationship between Flying and Toothache

These fluctuations can play havoc within the ears, nose, and mouth. Whilst frequent flyers are very familiar with the ‘popped ears’ phenomenon, even regular travellers can be taken by surprise when hit with a toothache at high altitudes. The changes in pressure can take a mild twinge or a dull ache – which was perfectly bearable before – and turn it into a serious pain.

If you are yet to experience this kind of toothache, you are probably wondering what all of the fuss is about. However, the issue is common enough to warrant its very own branch of dentistry. Aviation dentistry is an emerging science which studies the impact of flying on the status of teeth. Its main purpose is to understand how flying affects dental health, so that more can be done to prevent disorders associated with changes in atmospheric pressure.


This condition is an important one to know how to spot, because it normally signifies the presence of an underlying problem. Barodontalgia is a type of dental pain (or toothache) which occurs as a result of changes in atmospheric pressure. However, in many cases, the pain results from the stimulation of sensitive nerve endings. This can be an indication of subclinical oral disease.

The pain is characterised by a sharp squeezing sensation. If it is most intense during take-off, it could be related to pulpitis. If it is more of a problem during landing, it could be associated with pulpal necrosis. Or, if the pain is equally bad whilst the plane is climbing and descending, you could be showing signs of periapical disease.


This ailment is also known by the rather frightening moniker of ‘barometric tooth explosion.’ It does not involve any actual explosions, so you need not panic just yet. In this case, the pain is caused by the eruption of gas caught beneath poor quality restorations, crowns, or troublesome cavities.

It is likely to occur if you have holes in your repair work, a dislodged crown, or persistent decay in any of your teeth. The pain can be mild to severe, depending on the amount of gas released. If you experience this kind of pain whilst flying, you are advised to consult a dental professional as soon as possible. You may have developed a fracture in one or more of your teeth.


As the ears, mouth, and nose are all connected, it is common for a pain in one to lead to an ache in the others. This is especially true when flying, as the conditions are so atypical. For example, barotitis occurs during descent and landing, because the pressure change creates a vacuum within the middle ear.

This draws the eardrum further inwards than is normal. The result is a very sharp (often stabbing) pain within one or both ears. In some cases, this might also lead to a dull ache or pain within the teeth. Whilst barotitis is not thought to be linked with underlying dental problems, it is always a good idea to monitor tooth ache and seek advice if it becomes persistent or overly troublesome.


Like barotitis, barosinusitus is caused by flying at high altitudes. The changes in pressure cause negative pressure to build up between the exterior environment and the interior paranasal air sinuses. This leads to inflammation of the sinuses, with the frontal sinus taking most of the strain.

Once again, this is not thought to be linked with underlying dental issues, but it can end up causing barodontalgia. The pain is likely to be moderate to severe and characterised by a contracting and expanding sensation. This will be felt as a kind of squeezing of the affected teeth and gums. If the pain is bearable, it may be controlled or alleviated with painkillers.   

Periorbital Headaches

The periorbital headache is a rather more serious condition which is not always linked to flying. However, the atmospheric changes experienced during a flight are likely to trigger the symptoms. This condition is sometimes called a ‘cluster headache’] and it primarily affects a small amount of young (20-40 years) males. If you are prone to this condition, you probably already know about it or take medication to control the symptoms.  

It can be a problem for females, but the condition seems more prevalent in men. The periorbital headache is extremely painful. It can temporarily impair the eyesight, cause strange behaviour, lead to immense agitation, and facial flushing. If you experience a periorbital headache whilst on board a plane, you are strongly advised to inform an attendant. They may be able to offer you some kind of medical assistance.  

Preventing Toothache While Flying

There are a number of things that you can do to lower the risk of toothache whilst flying. This is important because tooth problems are not only painful, they can very easily become persistent. First and foremost, do not board a plane with an underlying tooth problem. Clearly, this will not always be possible, but it is advisable to consult a dentist before you travel.

If you have recently had work done on your teeth (repairs or restorations), do speak with your dentist about how they are likely to react to the journey. For the most part, modern fillings and other treatments respond perfectly fine to flying. However, it is always best to check so that you do not get confronted with any nasty surprises.

Also, your dentist will be able to make sure that all important follow-up appointments are carried out before you jet off. In fact, if you fly frequently for work, it could be worth discussing specific dental plans with your specialist. It is usually better to opt for cement resin restorations, as opposed to glass ionomers, because they are proven to sustain crowns more securely at high altitudes.

Helpful Tips for Dealing with Persistent Pain

Once again, this will not always be possible, but if it is, avoid flying when you have a cold or flu. Or, if you must get on board, carry a decongestant with you. This will help to minimise pain during landing and take-off. If you usually experience pain in your areas and teeth while flying, try slowly sucking on candy or chewing gum during the flight.

Or, alternatively, keep your ear plugs in during ascent and descent. Some high quality filtered ear plugs are great for gradually balancing out the air pressure against eardrums. The opportunity to listen to music will also minimise the strange sensation associated with loss of hearing, due to altitude changes. If you are on a long flight, do not forget to leave your seat and stretch your legs frequently, even if it is just to go to the bathroom.

The single best thing that you can do if you are a person who is used to experiencing persistent tooth problems is to talk to your dentist. Do not be afraid to ask questions, because it is their job to make sure that your teeth enter and exit the aeroplane in the best condition possible. It is very important not to underestimate the effect which flying can have on the body.

Dental Care in Unique Circumstances

It is an extreme environment and it can impact physical health in a unique manner. As the science of aviation dentistry develops, it will become easier to prevent and treat altitude-related conditions. However, vigilance, care, and a familiarity with your own dental health will always be the best approach. You are the first one to spot the changes, so make sure that dealing with them is first on your agenda.  

If you are planning to head off on holiday in the near future, you might want to download the MyDentist app. This handy program allows you to stay in direct contact with your dentist. So, even if you cannot visit in person, you can share pictures and messages about unexpected tooth pain. Then, your dentist can use this information to make an informal diagnosis and advise you on the next best step.

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