In-flight sudden incapacitation could jeopardise the flight's safety thus, an individual's health status is an important part of the aircrew's operative fitness. Principles of prevention, periodic examination, dental-related flight restriction (grounding) and dental documentation (for forensic purposes) are described as well.ĭuring flight, the aircrew is responsible for the lives of the aircrew members and passengers, for successfully completing the flight, and for maintaining the aircraft in good condition. This article supplies the dental practitioner with some diagnostic tools as well as treatment guidelines. Results and conclusions Special considerations have to be made when planning restorative, endodontic, prosthodontic and surgical treatment to an aircrew patient. Methods Data were gathered to cover the following issues: head and facial barotraumas (barotrauma-related headache, external otitic barotrauma, barosinusitis and barotitis-media), dental barotrauma (barometric pressure-related tooth injury), barodontalgia (barometric pressure-related oro-dental pain), and dental care for aircrews. The aim of this article is to introduce the concepts of aviation (aerospace) medicine and dentistry. Moreover, dentists should prevent the creation of in-flight hazards when treating aircrew members. The investigators plan to perform a randomized double blind placebo control trial to determine if pseudoephedrine is effective in decreasing the rate of MEB during HBOT.Background With the growing number of air passengers, flight attendants, leisure pilots as well as military and airline pilots, dentists may increasingly encounter flight-related oral conditions requiring treatment. However, the use of pseudoephedrine for patients undergoing HBOT has not been studied. Other studies involving scuba divers and airplane travelers showed that oral pseudoephedrine is effective in decreasing MEB. This is despite two negative studies showing that this medication does not work any better than placebo. At our facility, oxymetazoline, a topical nasal decongestant, is the standard rescue medication administered for patients that have symptoms of MEB during HBOT. Currently there is no objective criteria for predicting which patients will experience these complications, nor is there consensus on effective prevention measures. Last year 27/991 treatments at our Center for Hyperbaric and Dive Medicine were aborted due to MEB. The severe discomfort associated with MEB sometimes causes HBOT to be postponed or abandoned. The incidence of MEB, depending on the definition used is between 2-45%. The spectrum of symptoms ranges from sensation of ear fullness and muffled hearing to severe pain, vertigo and tympanic membrane rupture. Patients experiencing MEB usually feel pressure or pain in their ear(s). The most commonly associated complication of HBOT is middle ear barotrauma (MEB) which occurs when the eustachian tube does not allow air to enter the middle ear space to equalize the pressure between the ambient environment and the inner ear. Hyperbaric oxygen therapy (HBOT) utilizes 100% oxygen delivery at a pressure greater than 1 atm for the treatment of various emergent medical conditions including carbon monoxide poisoning. Why Should I Register and Submit Results?.
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