Roughly one in nine military aircrew report having had tooth pain brought on by flying, according to a review by Zadik in Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics (2010), which put the figure at 11.0%. The condition is called barodontalgia. The change in cabin pressure is the trigger, but the tooth that hurts almost always has a problem already, such as decay, a failing filling or an inflamed nerve. A sound, healthy tooth rarely reacts.
Pressure finds the weak spot in a tooth
Passenger cabins are pressurised, but not to sea level, so the air pressure around you falls as the plane climbs and rises again as it comes down. A healthy tooth is a solid, sealed structure and is not bothered by this. A tooth with a defect is different. A small pocket of air trapped under a leaking filling or within decay can expand and contract with the pressure change, and a nerve that is already inflamed can react painfully to the shift. Researchers still debate the exact mechanism in each case, but the common thread is an existing problem.
For that reason, pain on a plane is best treated as an early warning rather than a flying problem. The tooth may feel fine on the ground for weeks before it starts to ache there too.
Faulty fillings and decay are the usual culprits
Zadik's review pooled a decade of reports on in-flight dental pain and found the most common causes were faulty fillings and decay that had not yet reached the nerve (29.2% of cases), followed by a dead nerve or inflammation around the root tip (27.8%), an inflamed but still living nerve (13.9%), recent dental treatment (11.1%) and sinus pressure (9.7%).
In everyday terms, that means a tooth with an old filling that has started to leak, a cavity you have not noticed, or a tooth that has been niggling on and off. Our guide to toothache from an abscess or inflamed nerve covers the infection side. A cracked tooth is another possibility worth ruling out.
Sinus pressure deserves its own mention. The roots of the upper back teeth sit just below the maxillary sinus, so a blocked sinus during a cold or hay fever can make several of those teeth ache on the descent, even when the teeth are healthy. Our article on sinus toothache explains how to tell the difference.
Descent is when many people notice it
A 2026 systematic review of aircrew studies by Duarte and colleagues in the British Dental Journal found that episodes happened mostly during descent, with some on the climb. The pain is usually felt in one tooth and is often described as sharp. It tends to settle once the aircraft is cruising or on the ground, but the cause remains. If the same tooth hurts on every flight, it needs examining.
If a tooth starts to ache in the air
Over-the-counter pain relief taken as directed on the pack can help. Swallowing, sipping water or chewing sugar-free gum helps the ears equalise, and while it will not reach the tooth directly, it can ease the general pressure discomfort that often comes with sinus congestion. Avoid icy drinks if the tooth is sensitive to cold. Then book a dental appointment once you land. If you develop facial swelling or a fever, seek care promptly wherever you are.
Planning dental work around a trip
The simplest prevention is a dental check before a long trip, particularly if a tooth has been bothering you or it has been a while since your last visit. The Duarte review suggested routine pre-flight dental check-ups may help reduce in-flight episodes among aircrew, and the same logic applies to travellers. A check can pick up decay, a failing filling or an infection before you are a long way from home. Our guide to a dental check-up explains what the visit involves.
Timing matters too. A tooth that has just been filled or has started root canal treatment can be tender while it settles, and recent treatment featured in the causes above. Try not to schedule non-urgent work in the days right before a flight, and if treatment is unavoidable, tell your dentist your travel dates so the plan can allow for them. If you are flying in specifically for treatment, our article on travelling interstate for dental treatment covers how to plan the visits.
Questions travellers ask
Why does my tooth only hurt when I fly?
The pressure change stresses a tooth that already has a weak point. On the ground the problem may not be causing symptoms yet, so flying brings it to light earlier.
Can a healthy tooth hurt on a plane?
It is uncommon. A sound, well-sealed tooth does not react to cabin pressure changes. When a tooth hurts, there is usually an underlying cause, although sinus pressure can make healthy upper back teeth ache.
Is it safe to fly after a filling or extraction?
There is no fixed rule for most passengers. A newly treated tooth can be sensitive for a short time, so ask your dentist about timing if you have a trip coming up, especially after surgery or an extraction.
A tooth that hurts at altitude is worth having checked before your next trip. The team at Lumi Dental can examine it and explain what is going on. See our current offers or book with a general dentist in Melrose Park.
This article is general information and not a substitute for personal dental advice.
