Abidin, Sulhi and Sim Siang Lin, Galvin and Mat Daud, Muhd Sharifuddin and Mohd Nazri, Sofia Azreena and Mazlan, Nurhidayu and Haron, Mohammed Haizar and Abu Muslim, Munawarah Silam
(2025)
Occupational health in aviation: a crosssectional study of barodontalgia among Malaysian air force pilots.
BMC Oral Health, 25.
pp. 1-8.
ISSN 1472-6831
Abstract
Background Barodontalgia, or pressure-induced dental pain, poses a significant occupational risk to pilots,
potentially impairing flight performance and safety. The present study aimed to determine the prevalence of
barodontalgia among Malaysian military pilots, identify the associated risk factors, and examine its relationship with
flight performance.
Methods A cross-sectional study employing a census approach was conducted among active Malaysian military
pilots between 2021 and 2022 using a modified questionnaire. The questionnaire underwent content validation
by five experts and was pre-tested on 10 pilots. Data collection was performed through an online survey. Statistical
analyses included descriptive and inferential statistics (Chi-square, t-tests, ANOVA, logistic regression, and ANCOVA),
with results considered significant at p < 0.05.
Results The questionnaire demonstrated excellent content validity. Among the 190 pilots surveyed (63% response
rate), 12.1% experienced barodontalgia, most commonly at altitudes of 6,000–10,000 feet, with worsening
symptoms at 0–5,000 and 11,000–15,000 feet. Transport pilots reported the highest prevalence (43.5%), and the
most common symptoms were headaches (43.5%) and loss of concentration (34.8%). Age was negatively associated
with barodontalgia (β=-0.1505, p = 0.023), with younger pilots more likely to be affected. Meanwhile, years of service,
aircraft type, smoking, dental awareness, and brushing frequency showed no statistically significant associations
(p > 0.05). Gender was a significant predictor when controlling for service years (p = 0.048) but not when controlling
for age (p = 0.067).
Conclusion Barodontalgia is an occupational concern for Malaysian military pilots, particularly among younger
pilots. Preventive dental care, targeted treatment, and regular check-ups are essential to mitigate risks and maintain
operational readiness.
Keywords Altitude sickness, Dental care, Military personnel, Occupational health, Pilots
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