A case is presented of severe anterior mandibular pain, which first appeared during descent of a long commercial flight, and lasted 3 d for a 28-yr-old military helicopter pilot. Apical periodontitis due to pulpal necrosis of the #31 tooth was diagnosed as the causative pathology of the pain. This pain was not ever felt in his daily routine helicopter flights, up to 6000 ft, only in the pressurized chamber of a commercial flight to 7000-ft conditions. Although barodontalgia, dental pain evoked by barometric pressure change in an otherwise asymptomatic tooth, has relatively low prevalence nowadays, it seems that periodic dental vitality tests and panoramic imaging of the jaws are worthwhile for aircrew members.