Elsevier

Dental Abstracts

Volume 62, Issue 2, March–April 2017, Pages 99-100
Dental Abstracts

Hands On
Diver’s mouth syndrome

https://doi.org/10.1016/j.denabs.2016.09.030Get rights and content

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Background

Scuba divers wear a mouthpiece to permit them to breathe underwater. They tend to continuously clench their jaws to maintain the position of the mouthpiece with the mandible displaced anteriorly and/or molar occlusal support lost. Such anterior displacement of the mandible and/or loss of molar occlusal support can stress the stomatognathic system, causing pain and/or disturbed function. Diving in cold water may have add the stress of reducing the activity of the orbicularis oris muscle, further

Methods

A literature search of PubMed identified 32 articles that addressed various factors possibly related to stomatognathic problems caused by or exacerbated by wearing a diving mouthpiece. DMS was defined as a range of symptoms related to the stomatognathic system related to or exacerbated by scuba diving (Table 1). The various parts of the mouthpiece considered were the connector, the labial flange, the platform, and the occlusal lug.

Factors Contributing to DMS

Among the factors that contribute to DMS were the forward movement of the mandible, the loss of molar occlusal support, and the continuous jaw clenching.

The forward movement of the mandible while wearing a diving mouthpiece is more closely related to the design of the standard commercially available mouthpiece than to any physiological requirement for breathing underwater. Moving the jaw forward also moves the base of the tongue forward, opening the respiratory tract and facilitating breathing.

Design Considerations

In addition to the specifics noted, it was proposed that custom-made mouthpieces are a better choice for scuba divers. These can relieve and prevent DMS if they are correctly fabricated (Table 2).

The fabrication procedures that can be used include various lost-wax techniques and the thermo-forming technique. Adding silicone material to a commercially available mouthpiece may achieve customization. A wax pattern can be fabricated on a stone cast, invested, dewaxed, and then cured by polymeric

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Hirose T, Ono T, Maeda Y: Influence of wearing a scuba diving mouthpiece on the stomatognathic system—considerations for mouthpiece design. Dent Trauma 32:219-224, 2016

Reprints available from T Hirose, Toyohara Dental Clinic, 169-1 Toyohara, Nago, Okinawa 905-2172, Japan; fax: +81 980 55 3905; e-mail: [email protected]

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