DOI: 10.26650/hfaa.2026.1984786 ISSN: 3023-8439

Barodontalgia and Flight Safety: A Critical Narrative Review of Pressure Physiology, Acute Pain, and Human Factors

Esra Bihter Gürler
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Barodontalgia is dental or orofacial pain brought on by a change in barometric pressure, and it usually points to an underlying dental or maxillofacial problem rather than standing as a disease on its own. This narrative review looks at the condition through five lenses: pressure physiology, clinical presentation, epidemiology, occupational stress, and human factors relevant to flight safety. A literature search was conducted using PubMed/MEDLINE, Web of Science, Scopus, Google Scholar, and DergiPark between 22 April and 7 June 2026. One systematic review covering 4,894 aircrew members and divers reported an overall experience rate of 8.2%, with divers at 9.8% and aircrew at 5.8%. Divers may be more exposed simply because pressure changes more rapidly over a short vertical distance underwater and because descent-ascent cycles occur more often, though differences in study design across the diving and aviation literature make a direct comparison difficult. A Turkish pilot survey found that 81% of those who had experienced barodontalgia placed the pain below 2,000 ft. That is a striking figure, but it comes from self-report: it points to a plausible overlap with low-altitude, pressure-changing flight segments without actually confirming the flight phase or an operational safety effect. Bruxism, occupational stress, and barodontalgia appear together in the literature, but the association is observational and says nothing about causality. General pain research backs the idea that pain can pull attention away from a task, yet no study has measured pilot performance during an actual barodontalgia episode. Taken as a whole, the evidence makes barodontalgia a biologically credible and operationally worth-watching problem, potentially preventable in principle, even if its real performance cost has not yet been quantified.

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