1
|
Vivacqua A, Fan K, Gürtler A, Thieringer FM, Berg BI. An Algorithm for Jaw Pain among Divers. J Clin Med 2024; 13:3167. [PMID: 38892877 PMCID: PMC11173261 DOI: 10.3390/jcm13113167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 05/15/2024] [Accepted: 05/18/2024] [Indexed: 06/21/2024] Open
Abstract
Background: Temporomandibular disease (TMD) is commonly seen, and divers also experience pain in the temporomandibular joint (TMJ) or masticatory muscles. This article aims to provide a tool for diving physicians or medical professionals involved in diving medicine since jaw pain among divers is a pertinent subject and can be challenging to evaluate without some background in dentistry or maxillofacial surgery. Method: A basic algorithm was developed to provide a tool to differentiate jaw pains experienced by divers. Three brief case studies were developed, and five diving physicians were tasked with diagnosing the cases using the algorithm. Additionally, simple exercises and massage techniques that can benefit patients with TMD, particularly immediately after diving, are outlined. Results: All five diving physicians successfully diagnosed the cases using the algorithm. However, three of them were unable to diagnose the first case (disc luxation) without consulting the algorithm. Nevertheless, all physicians acknowledged the utility of the algorithm. Conclusions: Jaw pain in divers can stem from diverse causes, but effective treatment options exist. Our study findings provide valuable insights to assist diving physicians in making accurate diagnoses and guiding appropriate patient management, which may include referrals to specialists such as dentists, maxillofacial surgeons, or orthodontists.
Collapse
Affiliation(s)
- Angelo Vivacqua
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 4031 Basel, Switzerland; (A.V.); (F.M.T.)
| | - Kathleen Fan
- Oral and Maxillofacial Surgery Department, King’s College Hospital NHS Foundation Trust, London SE5 9RS, UK;
| | | | - Florian M. Thieringer
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 4031 Basel, Switzerland; (A.V.); (F.M.T.)
- Faculty of Medicine, University Hospital Basel, 4031 Basel, Switzerland
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University Basel, 4001 Basel, Switzerland
| | - Britt-Isabelle Berg
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 4031 Basel, Switzerland; (A.V.); (F.M.T.)
- Faculty of Medicine, University Hospital Basel, 4031 Basel, Switzerland
| |
Collapse
|
2
|
Altunan B. Primary headaches in scuba divers and the effect of temporomandibular dysfunction. Cranio 2024; 42:18-24. [PMID: 33794749 DOI: 10.1080/08869634.2021.1909457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE This study aimed to evaluate the frequency of episodic primary headaches (EPH) and temporomandibular dysfunction's (TMD) effect in experienced scuba divers. METHODS A form consisting of the Fonseca Anamnestic Index and a structured headache questionnaire was sent to individuals using social media platforms. RESULTS A total of 132 divers and 104 non-divers were included the study. In male divers, EPH and TMD were not different from the non-diver group (p = 0.1, p = 0.1), and TMD had an effect on increasing the possibility of migraine (OR = 2.5, p = 0.04). In female divers, the possibility of EPH and TMD were also lower (OR = 0.1, p < 0.001, OR = 0.2, p = 0.01). CONCLUSION Scuba diving does not pose a risk for EPH or TMD in either gender. TMD treatment in male divers is important for uncontrolled migraine attacks.
Collapse
Affiliation(s)
- Bengü Altunan
- Faculty of Medicine, Department of Neurology, Tekirdag Namik Kemal University, Tekırdag, Turkey
| |
Collapse
|
3
|
Orofacial problems in scuba diving: prevalence and prevention—a large-scale survey among civilian divers in France. Odontology 2022; 110:814-823. [DOI: 10.1007/s10266-022-00714-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 03/22/2022] [Indexed: 10/18/2022]
|
4
|
Anderson W, Murray P, Hertweck K. Dive Medicine: Current Perspectives and Future Directions. Curr Sports Med Rep 2019; 18:129-135. [PMID: 30969238 DOI: 10.1249/jsr.0000000000000583] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
As SCUBA diving continues to rapidly grow in the United States and worldwide, physicians should have a fundamental working knowledge to provide care for an injured diver. SCUBA divers are faced with many hazards at depths that are normally well compensated for at sea level. Pressure gradients, changes in the partial pressure of inhaled gases and gas solubility can have disastrous effects to the diver if not managed properly. Many safety measures in SCUBA diving are governed by the laws of physics, but some have come under scrutiny. This has prompted increased research concerning in water recompression and flying after diving. This article will give physicians an understanding of the dangers divers encounter and the current treatment recommendations. We will also explore some controversies in diving medicine.
Collapse
Affiliation(s)
- Wayne Anderson
- Morton Plant Mease Family Medicine Residency Program, Department of Family Medicine, University of South Florida College of Medicine, Tampa, FL
| | | | | |
Collapse
|
5
|
Livingstone DM, Lange B. Rhinologic and oral-maxillofacial complications from scuba diving: a systematic review with recommendations. Diving Hyperb Med 2019; 48:79-83. [PMID: 29888379 DOI: 10.28920/dhm48.2.79-83] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Accepted: 04/28/2018] [Indexed: 12/13/2022]
Abstract
Rhinologic and oral maxillofacial complications from scuba diving are common, representing approximately 35% of head and neck pathology related to diving. We performed a systematic and comprehensive literature review on the pathophysiology, diagnosis, and treatment of rhinologic and oral maxillofacial pathology related to diving. This included complications due to sinus barotrauma, barodontalgia, odontocrexis, temporomandibular joint dysfunction, partially dentulous patients, and considerations for patients following major head and neck surgery. Of 113 papers accessed, 32 were included in the final synthesis. We created a succinct summary on each topic that should inform clinical decision making by otolaryngologists, dive medicine specialists and primary care providers when faced with pathology of these anatomic sub-sites.
Collapse
Affiliation(s)
- Devon M Livingstone
- Corresponding author: Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, University of Calgary, 7th floor, 4448 Front Street SE, Calgary, Alberta, Canada, T3M 1M4.
| | - Beth Lange
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery; University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
6
|
Cabral RP, Moiolli-Rodrigues ME, Motta FLK, de Souza Motta FCK, da Silva JR, Malheiros L, Martins N, Trepte L, Abrão ALG, Maiworm A, Oliveira LC, Cardoso RL, Arnóbio A, Presta GA, de Sá Caputo DDC, Filho SDS, Frederico ÉHFF, Bernardo-Filho M, de Paoli S. Temporomandibular Disorder in University Students of the <i>Parque das Rosas Campus, Universidade Estácio de Sá</i> That Practice Sports. Health (London) 2016. [DOI: 10.4236/health.2016.81003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
7
|
Hirose T, Ono T, Maeda Y. Influence of wearing a scuba diving mouthpiece on the stomatognathic system - considerations for mouthpiece design. Dent Traumatol 2015; 32:219-24. [PMID: 26486490 DOI: 10.1111/edt.12239] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2015] [Indexed: 10/22/2022]
Abstract
Although diver's mouth syndrome (DMS) has long been recognized by scuba divers, little attention has been paid to the influence of wearing a scuba diving mouthpiece on the stomatognathic system. In this review, DMS-related stomatognathic events (DMS-SE) while wearing a mouthpiece, the relationship between components of the mouthpiece and those events, and design considerations to reduce the risk of those events are discussed based on evidence from 32 articles concerning scuba diving mouthpieces. Forward movement of the mandible, loss of molar occlusal support, and continuous jaw clenching while wearing a mouthpiece are considered to be pathogenic for DMS-SE. Several experimental studies have suggested a relationship between incidence of those events and the design of mouthpiece components such as the connector, labial flange, platform, and occlusal rug, and the possibility of reducing risk of those events through design customization of these components. Improvement of the shape of commercially available mouthpieces and creation of custom-made mouthpieces may thus contribute to the prevention and treatment of DMS-SE and the provision of a comfortable diving environment.
Collapse
Affiliation(s)
- Toshiaki Hirose
- Toyohara Dental Clinic, Nago, Okinawa, Japan.,Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Takahiro Ono
- Division of Comprehensive Prosthodontics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Niigata, Japan
| | - Yoshinobu Maeda
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| |
Collapse
|
8
|
Lobbezoo F, van Wijk AJ, Klingler MC, Ruiz Vicente E, van Dijk CJ, Eijkman MAJ. Predictors for the development of temporomandibular disorders in scuba divers. J Oral Rehabil 2014; 41:573-80. [PMID: 24766672 DOI: 10.1111/joor.12178] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2014] [Indexed: 11/28/2022]
Abstract
The aim was to determine predictors for the development of complaints of temporomandibular disorders (TMD) in a large sample of Dutch scuba divers who were free of any TMD complaints before they started diving actively. Five-hundred and thirty-six scuba divers (mean ± SD age = 40.4 ± 11.9 years; 34.1% women) completed a specifically developed questionnaire, either online or on paper. Stepwise forward logistic regression analysis was performed to predict the presence of TMD pain, with several potential risk factors as predictors. Four hundred and eighty-five of the 536 respondents were free of any TMD pain before they started diving actively. In this sample, TMD pain was present in 214 persons (44.1%). Four predictors contributed significantly to the presence of TMD pain, viz., clenching (OR = 2.466), warm water (OR = 1.685), biting on the mouthpiece (OR = 1.598), and the quality rating of the mouthpiece (OR = 0.887, that is, a higher rating means a smaller odds of having TMD pain). TMD pain is a common complaint among scuba divers who were free of such complaints before they started diving actively. Clenching, biting on the mouthpiece, and a low rating of the mouthpiece are predictors for the presence of TMD pain in scuba divers, while diving in cold water serves as a protective factor for TMD pain.
Collapse
Affiliation(s)
- F Lobbezoo
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, MOVE Research Institute Amsterdam, Amsterdam, The Netherlands
| | | | | | | | | | | |
Collapse
|