Scuba Diving and Oral Health
Diving with oxygen bottles, so called SCUBA diving (self-contained underwater breathing apparatus), is today’s very popular sport. Number of it’s fans from the mid-20th century is increasing each year. With this increasing number of fans its impact on overall health also expands, thus increasingly engage physicians, dentists, clinicians, and scientists who are involved in the field of sports medicine and study the physiology of scuba diving.
Although the technology that is used in scuba diving is nowadays much progressed and with the proper use is relatively safe, there are still certain risks to health to be taken into account. Proper identification of these risks can prevent and/or reduce the adverse consequences for human life and health. Therefore, training in basic physiology of diving and security is very important for both fans of the sport and for physicians and dentists. Medical conditions and disorders that are associated with scuba diving, which dentists may encounter in their patients, include headache, barosinusitis, barotitis-media, neuropathy of tripartite nerve (trigeminal nerve), facial nerve (facial nerve) neuropathy, baroparesis, dental barotrauma, barodontalgia, herpes infection, heightened gag reflex and temporomandibular joint dysfunction.
The exact epidemiological data on oral health disorders among divers, especially professional ones, unfortunately do not exist since many cases go unreported. Professional divers are often not inclined to report oral and other medical problems from fear of losing a diving license.
Head and facial barotrauma
According to Boyle-Mariotte’s law the volume of gas at a constant temperature depends on the ambient pressure. Changes in volume of gas within the body cavity, associated with a change in water pressure, can cause unwanted side effects called barotrauma. Barotrauma can occur during diving, flying or oxygen therapy in hyperbaric chambers. Barotrauma in head and face regions include barotitis-media, barosinusitis, headache caused by barotrauma, dental barotrauma and barodontalgia.
Barotitis-media, or middle ear barotrauma, is an acute or chronic traumatic inflammation of the middle ear caused by the difference in pressures between the middle ear cavity (tympanic cavity) and the surrounding atmosphere. Symptoms of middle ear barotrauma may vary from mild uneasiness in the ear canal to intense earache, buzzing in the ear, dizziness, nausea and hearing loss. This disorder is usually one-sided and appears during or shortly after a dive.
Already existing inflammation of the upper respiratory system may prevent equalization of pressure through the Eustachian tube (a channel which connects the middle ear and throat) which predispose to the occurrence of barotrauma, and therefore may be a temporary contraindication for diving. Potential complications of middle ear barotrauma is a paralysis of the facial nerve (facial baroparesis) which can be caused by increased pressure in the middle ear. The paralysis of the facial nerve can affect the mobility of mimic muscles and the sense of taste in the front of the tongue.
There are number of cases described where the interference in Eustachian tube and middle ear ventilation were associated with teeth malocclusion (orthodontic anomalies). Correcting of this malocclusion would bring ventilation of the middle ear to the normalization and would prevent health problems after diving. Pain that occurs in the case of middle ear barotrauma can be transferred to the area of the oral cavity (indirect barodontalgia) and may erroneously be recognized as a toothache, especially of the upper teeth. This should be taken into account when it comes to patients who have recently dived.
Barosinusitis (sinus barotrauma) is an acute or chronic inflammation of one or more of the paranasal sinuses that occurs due to the difference in pressure (usually negative) between the sinuses and the surrounding atmosphere. The difference in pressure creates a vacuum which can cause edema of the nasal mucous membranes, increased secretion of saliva from the nose and even submucosal hematoma. All this may be accompanied with pain of varying intensity and bleeding from the nose. Sometimes branches of the tripartite sinus nerve in the upper jaw can be temporarily paralyzed. Sinus barotrauma is more frequent during immersion than during emergence. Pain caused by barosinusitis should be distinguished from orofacial pain caused by other cause.
Headache caused by barotrauma
Headache caused by barotrauma is the headache that occurs during immersion or emergence, and usually lasts 15-20 minutes. It can be one-sided or two-sided, and given the characteristics of the pain many of them are described as migraine, with whom they are often incorrectly replaced during diagnosis.
Dental barotrauma can be defined as tooth fracture (Greek: odontos crexis) and fracture or loosening of dental filling caused by frequent changes of pressure. Separate parts of teeth or fillings will not only cause pain of various intensities, but can be a great danger when diving because they can be inhaled or ingested. Therefore, in such situations, the best solution is to temporary stop diving.
Scientific research has shown that in professional scuba divers, who annually spend more than 200 hours under water, there is an increased risk of dental barotrauma and that their dental fillings and prosthetic replacements have significantly shorter life. As the main causes are cited frequent changes in pressure that occur when diving.
Predisposing factors for the occurrence of dental barotrauma are bigger cracks or hairline cracks on existing fillings, and concealed and/or secondary caries lesions on teeth. In addition, frequent changes in pressure in the microscopic air bubbles in the cement, that was used to cement dental crowns and bridges, can lead to the loss of retention of these prosthetic substitutes, which could result in their loosening and falling out. To this situation are particularly exposed prosthetic restorations cemented with zinc phosphate cement.
Therefore, all divers, and especially professionals, should always have repaired teeth without caries and bad or worn out fillings. Professional divers should alert the dentist about their occupation, especially when cementing crowns and bridges so the dentist can choose the appropriate cement in which the porosity occurs in the smallest percentage. Scuba diving with temporary fillings or temporarily cemented crown and bridge is not recommended because there is a high risk of their unwanted falling out, and thus other unintended consequences.
In edentulous (toothless) divers installation of dental implants has priority over making conventional dentures. Although rare, sometimes for toothless patients dentist can make individual diving inserts for the mouth that are in their form and function complementary with dentures.
Barodontalgia is the intraoral pain caused by changes in atmospheric pressure. Barodontalgia occurs in scuba diving, flying and other situations where there is a significant change in pressure. According to literature data, it occurs in 10 to 20 percent of the divers. The cases are described in which the severe pain caused by barodontalgia leads to dizziness and temporary disability, which may endanger the safety of divers.
Although barodontalgia is more a symptom than a real pathological condition, it’s background almost always conceals some existing subclinical condition or disease of the mouth and teeth. The most common are concealed and/or secondary caries and dilapidated dental fillings. Sometimes the cause may be necrotic pulp, chronic pulpitis and inflammation in the periapical area which may have clinical symptoms. Postoperative barodontalgia may appear immediately after dental procedures. It also can occur as a result of barotrauma caused by diving.
Barodontalgia can be direct (the pain is related to the tooth or teeth) or indirect (the source of pain is not related to the teeth).
Barodontalgia can occur at a depth of 10 meters, although most often occurs at a depth of 18 meters and more. In contrast to aeroplane flight where the upper and lower teeth can be affected with barodontalgia equally, diving barodontalgia is more common in the upper teeth and during immersion, which is explained by the influence of sinus of the upper jaw.
To prevent barodontalgia in divers periodic dental examinations should include recording and analysis of X-rays of the jaw. They also should include testing the vitality of teeth. In these inspections, special attention should be focused to pathological changes in the periapical areas, poor and worn fillings and secondary caries lesions. Setting the protective lining in the cavity when making fillings can reduce the incidence of barodontalgia. As with barotrauma, diving with temporary fillings is not desirable. In repeated endodontic procedures, when patients dive between visits and root canal is not filled, diving may cause subcutaneous emphysema as well as the penetration of infected intracanal content in the apical tissues.
The temporary ban on scuba diving after dental or oral surgery is the best way to prevent the occurrence of barodontalgia. It is recommended to avoid diving 24 hours after dental procedures (eg. tooth fillings, crowns and bridges), a week after oral surgery (including tooth extraction) and at least two weeks if there is suspicion of oroantral communication.
Conditions associated with diving mouthpiece
When scuba diving, divers in the mouth posture mouthpiece with the controller (regulator mouthpiece) that allows them to breathe underwater by bringing oxygen. The mouthpiece is usually made of silicone or soft acrylic resins, and considering the method of preparation can be commercial, semi individual and individual. During scuba diving divers hold mouthpiece firmly between the teeth of the upper and lower jaw, usually between canines and premolars. Therefore, total or partial tooth loss may be a contraindication for this type of diving, and too much compression of mouthpiece can cause damage to the hard dental tissues.
The air that comes through the mouthpiece from the air tank may in presence of oral surgery wounds cause intraoral pain similar to that which occurs in barodontalgia. Therefore, the recommendation is to avoid diving at least one week after the oral surgery to let the wound heals properly. It is also desirable that the dentist examines the wound before diving. In addition, such air coming under pressure can further shorten the lifespan of worn-out fillings.
It is believed that mouthpieces may cause herpes simplex virus infection, especially during their frequent changes among underwater divers. Therefore, it is recommended that everyone uses his own mouthpiece and perform its regular cleaning. Divers need to inform their dentist of any changes in the gums in order to recognize the symptoms of herpetic gingivostomatitis (herpes simplex virus infection) in time.
Although this issue is still a cause of many discussions, it is considered that diving mouthpiece can disrupt the functioning of the temporomandibular joint in divers, especially women. Studies have shown that from 24 to 68 percent of divers feel more or less interferences in the joint that may vary from joint clicking to severe pain. In comparison to the general population in which this joint disturbances occur in approximately 25 percent of cases. Sometimes, with these types of disorders, the name diving mouth syndrome is used which includes symptoms that occur in the temporomandibular joint such as muscle pain, joint pain, painful disc displacement and headaches. The intensity of these symptoms can be different, and can only be shown during the dive, but also can become a long-term and chronic. Temporomandibular joint disorders caused by diving should be diagnostically distinguished from barotrauma of the middle ear. One possible cause of these disorders is protruded position of the lower jaw and enhanced bite force in order to maintain mouthpiece in the position. In order to reduce muscle tension and avoid interference with temporomandibular joint, the use of semi individual or individual mouthpieces which cause smaller fatigue of masticatory muscles. Also the position of the lower jaw is similar to normal when there is no mouthpiece in the mouth.
Scuba diving is sport that is gaining more and more fans. The increased number of fans oblige both dentists and patients to take more care of the impact of this sport on oral health. This impact is multifaceted and can be manifested as dental barotrauma, barodontalgia and diving mouth syndrome with disabilities in the temporomandibular joint. Applying appropriate preventive measures, many of these disorders can be prevented and/or mitigated. Divers should be aware that predisposing factors for the occurrence of dental barotrauma are bigger or hairline cracks on existing fillings and concealed and/or secondary caries lesions.
Oral Thrush From Night Guards
Bruxism is often accompanied by worries about cracked or broken teeth and aching jaws. Unfortunately, oral thrush from night guards is another concern. This infection causes white spots on the inside of the mouth that can cause discomfort and soreness. If you use a mouthguard for teeth grinding, you may wonder if this device is linked to oral thrush. While mouthguards are a great treatment option for bruxism, they must be properly cleaned to avoid bacteria buildup. Fortunately, there are many effective cleaning methods that will keep your mouthguard fresh.
Can Using a Night Guard Increase Your Risk of Oral Thrush?
According to Mayo Clinic, oral thrush, more formally known as oral candidiasis, happens because an overgrowth of yeast causes a fungal infection. The organism, Candida albicans, occurs naturally in the mouth, and it’s normally kept in check by good bacteria that also reside there. When the balance falters, the yeast overgrows and causes raised yellow-white patches throughout the inside of the mouth. The patches may be tender, and they may bleed. Depending on the severity of your case, your mouth may feel cottony or like it’s burning.
Using a night guard doesn’t mean that you’re destined to develop oral thrush from night guards. However, if you are not diligent about cleaning your device, you may be at higher risk of bacterial growth. Yeasts, fungi, and bacteria can grow on mouthguards if they aren’t cleaned properly because they thrive in damp environments. Good hygiene is important. Neglecting the maintenance of your mouthguard can increase your chances of developing cavities, gum disease, dry mouth, oral thrush from night guards and a variety of other illnesses from bacteria buildup.
How Can You Avoid Oral Thrush While Using a Mouthguard?
If you want to avoid oral thrush, bad breath, cavities, gum disease, and other health problems, there’s a simple solution. Make cleaning your mouthguard a regular part of your oral care routine. This will keep it from becoming a breeding ground for bacteria and other biological health threats.
Daily cleaning of an acrylic night guard is straightforward. Rinse the appliance in warm water each morning. Don’t use boiling water. This might cause it to lose its shape. Allow it to dry before storing it in a clean case.
Every two weeks, complete a deep cleaning of your mouthguard. You’ll have several methods to choose from:
- Toothpaste: Select a nonabrasive toothpaste and a toothbrush that is used solely for this purpose. Gently scrub the mouthguard. Then, rinse it with cold water.
- Baking soda: Mix a small measure of baking soda and water to create a paste. Take a toothbrush, and softly scrub the night guard. Finish by rinsing the night guard with cold water.
- Mouthwash: Fill a container that’s large enough to hold the mouthguard with a solution of water and alcohol-free mouthwash. Soak the appliance for 30 minutes. Then, rinse it fully.
- Hydrogen peroxide: Place the night guard in a container. Fill it with hydrogen peroxide. Allow the night guard to soak for 10 minutes or so. Be sure to rinse thoroughly.
- Denture cleaning solution: Products vary, so follow the directions on the package. If you don’t, then you may experience unpleasant side effects or damage to your mouthguard. After cleaning, take care to rinse the device fully.
Do not use bleach to clean your night guard. It may damage the appliance. If your night guard is damaged, worn out, or moldy, it’s time to discontinue use and replace it.
Do make it a point to clean your night guard’s case. After all, storing a clean night guard in a dirty case will quickly undo all your efforts. At a minimum, the case should be cleaned when you deep clean your night guard. In addition, it’s wise to clean it if you drop it, you’ve been sick, or you suspect it would benefit from a cleaning.
What Are Other Causes of Oral Thrush?
Anything that disturbs the balance of Candida albicans and healthy bacteria in the mouth can trigger a bout of oral thrush. As Healthline reports, a weakened immune system is a common culprit. That explains why oral thrush often strikes infants and the elderly, who tend to have weaker immune systems. Some medications, such as antibiotics, have been known to increase the chances of oral thrush as well. Cancer patients are also at risk because treatments like chemotherapy and radiation suppress their immune response.
Some medical conditions also diminish the immune response, leaving the body more vulnerable to infections like oral thrush. Leukemia and HIV both increase a person’s chance of experiencing thrush. Diabetes is a common cause of oral thrush because it weakens the immune response and increases blood sugar.
Anyone who wears a mouthguard or splint needs to practice good oral hygiene and dental care. When you are taking medications or have a medical condition that makes you more susceptible to an oral or bacterial infection, being diligent about your oral care is extra important.
Mouthguards and Teeth Grinding
For people with conditions like bruxism, TMJ disorder, or sleep apnea, night guards can provide amazing relief. Mouthguards can prevent tooth decay, jaw pain, and more. These user-friendly devices are highly effective, but they do require regular cleanings. Without that basic care, they can become a breeding ground for germs that can make users sick. Fortunately, caring for a night guard is simple.
Are you searching for a new custom-fitted mouthguard for bruxism? Check out the selection at Pro Teeth Guard. We offer top-quality mouthguards online for an affordable price. Our night guards are made in a professional dental lab using professional materials and processes. This is effectively the mouthguard you’d receive from a dentist.
- Giorgi, A. (2019). Everything you need to know about oral thrush. Healthline. https://www.healthline.com/health/thrush#diagnosis
- Mayo Clinic Writing Staff. (2017). Bruxism (teeth grinding). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/bruxism/symptoms-causes/syc-20356095
Best Scuba Mouthpieces
It would be easy to take for granted what an important piece of scuba diving equipment and part of your whole diving set up your scuba mouthpiece is. We are firm believers that if you want to have an enjoyable time under the water, you need to be comfortable and if there is one thing that will hinder how good your dive is, it’s jaw fatigue. Talking about being comfortable.. make sure you protect your fingers with the best diving gloves.
Table of Contents
Top 10 Best Scuba Mouthpieces
If you are new to diving or are just looking for a better mouthpiece, you’ve come to the right place. We have scoured the market for the best available and highlighted 10 below.
Click here to find the best hoods to accompany your Mouthpieces.
Before we look at those products, though, we felt it was a good idea to discuss the different types of mouthpieces and what you can expect from each.
Have you ever wondered how to change a mouthpiece but have never had the right guidance? Click here to unlock a bowl full of knowledge.
1. SeaCure X Type Mouthpiece
The first mouthpiece we think you should consider is this option from SeaCure. This features a moldable design that will help it to fit precisely your jaw, teeth gums, and mouth.
Which in turn means it will reduce and even eliminate the problem of jaw fatigue. The X-shape of this model helps to reduce the bulk while improving the feel and fit of the mold and reducing gagging to a bare minimum.
2. Mares Jax Moldable Scuba Mouthpiece
If you have a Mares regulator then it is only natural to choose this Mares Jax scuba regulator mouthpiece. This way you can be sure that it fits perfectly and you are guaranteed the top Mares quality.
Jax is a very special custom scuba mouthpiece. Inspired by dental technology, you can form its personalized shape from a single imprint of your jaws and teeth.
All you have to do is soak the scuba mouthpiece in boiling water for just a few seconds then bite down like you would at the dentist. Voila, in less than 30 seconds you have your very own custom dive mouthpiece.
3. Atomic Aquatics Regulator Mouthpiece
From Atomic Aquatics comes the next product in our guide. The award-winning designers and reputable engineers have come up with a mouthpiece made from two layers of different kinds of silicone.
It is one of the most comfortable to wear on the market while being one of the most durable too.
4. Trident Comfort Bite Mouthpiece
The first thing you will notice about this mouthpiece from Trident is the rolled edges and the roof of the mouth bridge.
These features make it an extremely comfortable mouthpiece to wear and as it’s made from a hypoallergenic material, it is suitable for all. If you are searching an alternative, try this dry snorkel.
5. Edge Moldable Mouthpiece
Next up, from Edge, we have another moldable and customizable mouthpiece. The unique design has been used to avoid it rubbing unnecessarily against your gums.
Another aspect worth noting about it is the fact it has a smaller width than others, making it easier to form a seal between your lips and the mouthpiece.
6. Scubapro Mouthpiece and Hose Protector Sleeve Kit
From the diving accessories and equipment experts, Scubapro comes our next pick.
This vibrantly bright yellow is a second-stage mouthpiece and comes with a first-stage hose protector to allow for easier differentiation between mixes when technical diving.
7. Scuba Choice Silicone Long Bite Mouthpiece
Made from soft and comfortable to bite silicone, this high-quality mouthpiece has a much longer width than standard to fit those of you with bigger mouths.
8. IST Ortho-Conscious Mouthpiece for Scuba Diving
Jaw fatigue is a real issue with scuba divers but you will find some relief with this scuba diver mouthpiece by IST. This bite silicone scuba mouthpiece is specially designed for reducing jaw pain and preventing chafing from the bite tabs.
The IST Ortho-Conscious is one of the better replacement mouthpieces that you can order today. It fits the regulator from almost every diving manufacturer.
9. Maluan 6-Pack Regulator Mouthpieces
A good divers regulator mouthpiece doesn’t have to break the bank, as Maluan proves with this 6-pack. You can also share these with your friends as a snorkel mouthpiece if there are a few non-divers in the group.
This silicone mouthpiece is designed to fit most brands in the diving equipment industry. Just make sure you follow the instructions on how to securely attach this mouthpiece for scuba diving.
10. OMGear Silicone Mouthpiece
To round out our list, the last product we have is this OMGear model made from FDA-approved food-grade silicone. It has been designed to be easy to use and fits most snorkels and regulators.
For a quick recap, Here are our top 3 Best Scuba Mouthpieces:
OUR #1 PICK Octopus Snokel Mouthpiece 2 Pack
- Easy to install
- 2 Available colors
- Soft silicone
- High quality
PROFESSIONAL Seacure X Type Scuba Diving Mouthpiece
- Type SeaCure
- Latex Free
- Great quality
- Durable wear
ON A BUDGET Trident Comfort Bite Scuba Diving Mouthpiece
- Comfort Bite
- long lasting
- Rolled Edges
Different Types of Scuba Mouthpieces
You will find basic and standard sized mouthpieces are the kind that comes with cheaper regulators and rental gear. As they generally feature two very ordinary tabs, you need to bite down a lot harder on them than other options, which means they don’t last nearly as long as others.
If you don’t dive as regularly as you would like, this might be a cost-effective option, though if you are going to be diving regularly, you might want to invest in something a bit better.
As the name suggests, these mouthpieces have soft grips over the tabs you bite down on to increase the level of comfort and protect them against bite-through. Although a tiny bit pricier than standard models, these are extremely comfortable and allow you to concentrate on enjoying your time under the sea.
Long Bite Mouthpieces
Long bite mouthpieces (that often feature textured tabs too) offer you a bit more to bite into. Although many divers swear by them, if you don’t have a particularly long mouth, you may find they are not the most comfortable to use.
As a start mouthpiece, they are ideal because they are not usually very expensive.
Tooth Covering, Winged, and Bridged Mouthpieces
All these mouthpieces, bridged, winged and tooth-covering are designed to help secure your mouthpiece snugly in place. These are ideal for divers who like to or are in the habit of twisting around a lot. One issue with bridged-style mouthpieces is that the tabs are connected and when they rub on the inside of your mouth, they can be uncomfortable.
Similarly, with tooth-covering and winged-style mouthpieces, they grip onto your gums and can rub against the insides of your mouth. However, if you find one that fits you well, then they are worth it.
Finding it tricky to pack away your mouthpiece and other equipment in a timely manner? Click here to read this article to help ease the packing away process.
Custom Fit Mouthpieces
A customized mouthpiece is one that you can trim down easily to the length that suits your mouth best. You then need to place it in boiling water and then bite down on it to form a mold of your bite shape.
It can be a bit fiddly when you are first using one, but when you get it right, you have a mouthpiece almost perfectly molded to fit the size and shape of your mouth, making it incredibly comfortable to use.
Frequently Asked Questions about Scuba Mouthpieces
What is the mouthpiece called scuba diving?
The mouthpiece used in scuba diving is called a diving regulator mouthpiece. Regulator mouthpieces allows scuba diver to breath in air from their tank.
There are di different types of dive regulator mouthpiece. Some are made from basic silicone in a universal shape while others are a moldable scuba mouthpiece that creates a custom fit.
Is it worth buying your own scuba gear?
Buying your own scuba gear is an investment but one that is worth it. Most scuba diving equipment is meant to have a snug fit and can feel quite uncomfortable when it doesn’t suit your face and body just right.
Over time, buying your own gear will prove more affordable if you are a frequent diver. On the other hand, if you only occasionally dive then it might make more financial sense to rent the equipment.
Why do scuba divers wear snorkels?
Scuba divers mainly wear snorkels to be able to breathe at the surface level without using their air supply. This saves more of the air supply for when they are deeper underwater.
How do you change a regulator on a mouthpiece?
- Carefully cut off the zip tie on the old mouthpiece using a side cutter. Slide the cutter under the zip tie and then snip without damaging the mouthpiece or regulator.
- Pull off the old mouthpiece from the regulator.
- Slide the new dive mouthpiece into the same position.
- Take a zip tie and secure it exactly where the mouthpiece ends and the rest of the regulator tube starts.
- Pull the piece where the zip tie feeds through to left or right side of the mouthpiece so that it doesn’t bother your field of vision.
- Secure the zip tie tightly but it should not be so tight that the mouthpiece shape changes.
- Using the side cutter, cut off as much of the excess zip tie as you can.
- If the part where the zip tie feeds through feels too large, you can cut off a small piece using a box cutter. Make sure you are not loosening the zip tie by doing this.
Scuba diving is more than a passion to me, it’s a part of who I am. Now, I travel and dive as much as I can, exploring the world, trying new dive gear, discovering dive destinations and reviewing them here for you. All while educating people of the threats our marine life and oceans face every day and what we can do to help defend it.