EAR, NOSE, THROAT, AND DENTAL DISORDERS - Medicine for Mountaineering and Other Wilderness Activities - page 212

swollen. Overt trauma can produce such symptoms, but the most common cause is an in-
fection of the pulp, which should be detected and treated before an outing.
Theinflammationcausesthetoothtobeextrudedslightly,whichintensifiesthepressure
on the tooth during biting and increases the pain. Treatment in a wilderness situation con-
sists of an analgesic and a soft diet. Placing a piece of gauze or similar material between
the teeth on the opposite side prevents the involved tooth from striking opposing teeth and
reduces the pain. Dental care should be obtained promptly.
Cracked Tooth Syndrome
Individuals with a cracked tooth may complain of pain when chewing certain foods
or when releasing the bite. They may complain that the pain is felt only when biting
something hard “in just the right way.” No pain is felt when chewing soft foods because
the crack in the tooth is not opened. The condition usually progresses slowly and can be
controlled by not chewing on the affected side. Dental care should be obtained promptly,
but evacuation from an extended expedition is rarely necessary.
Open Cavity
An open cavity in a tooth may be painful, particularly when it becomes packed with
food. Such abnormalities should be corrected before major expeditions—but may result
from fillings lost during an outing—and can be expected in locals hired as porters or for
similar tasks. Removing food from the cavity often relieves the pain.
A well-equipped expedition could carry a temporary filling material such as Cavit®.
Care must be taken not to fill the cavity with so much of the material that it extends above
the tooth surface, which would cause pain from the increased pressure on that tooth. If
nothingelseisavailable,thecavitycanbefilledwithasmallamountofsugar-freechewing
gum for a brief time.
Maxillary Sinusitis
Sinus infections in the maxillary sinuses sometimes produce pain in the teeth. Such in-
fections typically are accompanied by fever and discomfort. Indications that the pain is
from this source include the normal appearance of the teeth and the involvement of more
thanonetooth.Suchinfectionsshouldbetreatedinthesamemannerasallsinusinfections.
Abscesses
Abscesses are quite rare among individuals who obtain regular dental care. On outings
to developing countries, such abnormalities would be much more common among locals
employedfortheexpedition whodonothaveaccess tosuchcare.Theoriginofsuchinfec-