Temporomandibular disorders in scuba divers during diving certification training programme

Objective: The design of a diving regulator's mouth-piece is known to increase the risk of a temporomandibular disorder (TMD) in SCUBA divers. The total weight of a diving regulator is reflected directly on the temporomandibular joint (TMJ) causing articular and periarticular problems. In this study, the prevalence of TMD in SCUBA divers having a training for diving certification is investigated. We also aimed to determine the factors that lead to TMD, and clarify the observation that there is an increased incidence of TMD in inexperienced divers with an anxiety of diving training. Material and methods: The study was held in a period of 5.5 years, between 2006 and 2011. Ninety-seven divers were referred with the complaint of pain around the temporomandibular area. The divers were classified according to their experince levels. Symptoms and signs of TMD were noted and graded. Results: 14 divers were diagnosed with TMD. It was found that TMD was seen more frequently in inexperienced divers than in experienced divers (p=0.0434). The most prevalent symptom was an increased effort spent for holding the mouth-piece during a dive. TMJ tenderness and trigger point activation were the mostly seen physical signs. 13 divers had an improvement with therapy. Conclusion: The effort for stabilizing the mouth-piece of the second stage of a diving regulator is a recognized factor in TMD development. The training for diving certification causes an increase in the prevalence of TMD.