Flying after a tooth extraction

Barodontalgia: tooth pain caused by altitude

It has a name because it is a real thing. Tiny pockets of gas can be trapped inside a tooth — under a filling, in a decayed area, in an incompletely sealed root canal, or in the space after an extraction. As cabin pressure falls that gas expands, and the result can be a sharp, severe toothache that arrives during the climb.

It is more likely where there is recent dental work, active decay or infection, so the period straight after a procedure is exactly when it is most likely to happen. It usually settles on descent, but a few hours of acute toothache at altitude is not a small thing.

The bleeding risk

After an extraction a blood clot forms in the socket, and that clot is what protects the bone underneath while it heals. Two things can go wrong on a flight.

Bleeding restarts. More likely in the first 24 hours, and considerably harder to manage in a cabin than at home.

The clot is lost. If the clot comes away, the socket is left exposed — dry socket — which is intensely painful and needs a dentist to pack and dress. Being somewhere without easy access to dental care makes that considerably worse.

Wisdom teeth and surgical extractions

Surgical removal, particularly of impacted wisdom teeth, involves more trauma, more swelling, sometimes stitches, and a higher risk of both dry socket and infection. Swelling typically peaks around day two or three — frequently when people have booked to fly. Allow longer, and ask the dentist or oral surgeon directly.

If you are flying

• Take pain relief with you and start it before it hurts
• Pack gauze in case of bleeding
• No straws, no smoking, no vigorous rinsing — all dislodge the clot
• Stay upright rather than reclining flat in the first day or so
• Avoid alcohol, which increases bleeding
• Get any known dental problem sorted before a long trip — this is the classic avoidable holiday emergency