<h4>Introduction</h4>Space exploration presents unique challenges to human health due to space radiation, reduced gravity, and prolonged isolation. Astronauts should be prepared to manage medical and dental emergencies. This scoping review maps the evidence on oral health alterations and dental emergencies faced by astronauts during short- and long-term space missions.<h4>Methods</h4>A "Topical Team" assembled by the European Space Agency performed the review described herein. An electronic search was conducted on scientific databases, reference lists of relevant papers, specific textbooks, and space agencies' databases. Inclusion criteria encompassed studies related to dental medicine in microgravity or outer orbital space conditions. Results are presented through narrative format.<h4>Results</h4>Out of 23,686 studies identified, 467 were considered eligible and 80 (54 reviews and 26 human-based studies) were included. The latter were classified into three broad topics: microbiology, space physiology and medicine, and space dentistry. Among the studies involving human subjects, 17 involved individuals who had spent time in space. There are only a few studies about oral health modifications and issues during spaceflight and those have limited evidence. Dental emergencies in space are relatively rare events that tend to increase with mission duration.<h4>Discussion</h4>The impact of microgravity on oral health requires further investigation. Preflight and in-flight measures should focus on prevention and treatment protocols for various dental issues to ensure crew safety and mission success. Understanding and addressing factors affecting oral health in microgravity will enhance the well-being of astronauts and the success of human exploration missions in space. Del Fabbro M, Khijmatgar S, Vandenberghe B, Kijak E, Kulesa-Mrowiecka M, Singhal I, Lorusso F, Xavier BB, Sampson V, Marfia G, Neefs D, Tartaglia GM. Oral health of astronauts in short- and long-term missions in space. Aerosp Med Hum Perform. 2025; 96(2):168-179.

Space dentistry addresses the unique challenges of providing dental care in space, where zero gravity, limited resources, and the vast distance from Earth complicate the maintenance of oral health. Ensuring astronauts' dental health is crucial, as dental issues can adversely affect their overall health and mission performance. Microgravity exacerbates risks for dental problems such as periodontitis, dental caries, bone loss, and potentially, neoplasms. Traditional dental care methods become less effective in microgravity, leading to increased plaque accumulation and worsening of dental diseases. As space missions venture further and last longer, maintaining oral hygiene presents unique challenges that necessitate innovative solutions. These include specialized tools like ergonomic toothbrushes and 3D-printed dental prostheses designed to function effectively in a zero-gravity environment. Preventive measures, such as comprehensive astronaut training programs focusing on oral health, are vital. These programs educate astronauts on maintaining oral hygiene and managing potential dental issues using available resources. Collaborative efforts among dental professionals, engineers, and space agencies are essential to developing comprehensive strategies for space dentistry. Such interdisciplinary collaboration leads to the advancement of dental care technologies and methodologies that can address the unique needs of astronauts. Despite the formidable challenges, these innovative solutions and collaborative efforts offer promising avenues for ensuring the dental health of astronauts during long-duration missions. This review aims to examine the detrimental effects of microgravity on the oral cavity and explore potential solutions to these issues, ensuring that humanity can continue to push the boundaries of space exploration while safeguarding the well-being of those who venture into the cosmos.

dental interventions are found to be essential, these procedures are scheduled and completed three months before take-off to reduce the risk of potential dental issues during the mission [ 6 ]. During flight, remote diagnostic systems perform routine oral health checkups. Photographs of astronauts' oral cavity would be captured with an oral camera and transmitted to the ground control room. For inflight dental emergencies, medical equipment and instruments for various potential medical procedures are available onboard the International Space Station, with detailed instructions. The Dental Pack/manual for astronauts (Table 2 ) in the space environment is composed of handling the following procedures (NASA Medical Checklist 2001): 1) Crown Replacement, 2) Total Avulsion / Complete Tooth Loss, 3) Exposed Pulp, 4) Injection Technique, 5) Temporary Filling, 6) Tooth Extraction, and 7) Toothache. Dental treatment protocols in space are modified to the restrictions of using water and sharpening tools onboard the spacecraft [ 7 ]. Table 2. Space mission dental checklist. Checklist Description Crown replacement Procedures for replacing dental crowns in space, considering limitations in water and tools onboard spacecraft Tooth avulsion Protocol for addressing total tooth loss in the space environment Exposed pulp Guidelines for handling exposed pulp in dental emergencies during space mission Injection technique Procedures for administering dental injections under space constraints Temporary filling Protocol for temporary dental fillings in space, considering available resources Tooth extraction Instructions for tooth extraction in space, where traditional methods may not be feasible Tooth ache Management of toothache and dental pain during space missions according to the manual Open in a new tab Carious lesions that have ceased progression (arrested lesions) pose less threat on earth, as they remain inactive, and the likelihood of reaching pulp is unlikely. However, in an env

ESA - Alexander’s space clinic # Alexander’s space clinic They are skills everyone hopes an astronaut never has to use but they are vital for the International Space Station, where no ambulance can reach. ESA astronaut Alexander Gerst recently boosted his medical skills in a busy hospital setting. Astronauts spend up to six months on the Space Station working on scientific experiments and maintaining the orbital outpost. They need to be able to handle any emergency – after all, hundreds of kilometres and a hard journey separate them from the nearest hospital. At least two Crew Medical Officers are assigned to each mission and these astronauts are taught basic medical procedures, from stitching wounds to filling teeth. Alexander practising on a mannequin Alexander will fly to the Station in 2014 and has already trained to be a Crew Medical Officer. To bolster his expertise, he was sent to the nearby Uniklinik hospital to observe some real-life medical cases – cases he hopes never to see for real during his mission. This three-day medical course was purpose-built in close cooperation between the European Astronaut Centre in Cologne and the Uniklinik Köln. ## Much mor

HRR - Gap - ExMC 4.11: Limited dental care capabilities (Closed) ​ NASA Logo Human Research Roadmap HRP Exploration Data Home| HRP Goals and Objectives| HRP Architecture| HRP Organizational Structure| Acronyms| Reviews| Help {1} ##LOC[OK]## {1} ##LOC[OK]####LOC[Cancel]## {1} ##LOC[OK]####LOC[Cancel]## Evidence MDRP Risks Gaps Tasks Reports Explore Search Risks - Medical Conditions Tasks - Advanced Dental | ExMC 4.11: Limited dental care capabilities (Closed) | | --- | Last Published: 05/13/25 12:40:15 PM (Central) Responsible Element: Exploration Medical Capability (ExMC) Status: Closed Closure Rationale Gap Closure Synopsis Dental care for spaceflight faces challenges of limited crew training, medical resources, evidence-based guidelines and extensive mission duration. There have been two incidences of US pre- and postflight pulpitis and three Russian in-flight dental events--one of which had no reported contingency plan. These events underscore the need for enhancing preventive, diagnostic, and treatment methods for the dental conditions on the Exploration Medical Conditions List (EMCL). A review of Skylab’s oral health data, as well as standard terrestrial tr

NASA/TM–2012-217368 ## Review of Spaceflight Dental Emergencies Anil Menon, MD, MS, MPH The University of Texas Medical Branch NASA/Johnson Space Center Bioastronautics Contract September 2012 The NASA STI Program Office ... in Profile  CONFERENCE PUBLICATION. Collected papers from scientific and technical conferences, symposia, seminars, or other meetings sponsored or co-sponsored by NASA. Since its founding, NASA has been dedicated to the advancement of aeronautics and space science. The NASA Scientific and Technical Information (STI) Program Office plays a key part in helping NASA maintain this important role.  SPECIAL PUBLICATION. Scientific, technical, or historical information from NASA programs, projects, and missions, often concerned with subjects having substantial public interest. The NASA STI Program Office is operated by Langley Research Center, the lead center for NASA’s scientific and technical information. The NASA STI Program Office provides access to the NASA STI Database, the largest collection of aeronautical and space science STI in the world. The Program Office is also NASA’s institutional mechanism for disseminating the results of its research and dev

Aerospace Dentistry: Challenges, Innovations, and a Practical Guide for Space‐Based Oral Healthcare - Sadat Kachouei - 2025 - The FASEB Journal - Wiley Online Library Volume 39, Issue 23 e71284 REVIEW ARTICLE Free Access # Aerospace Dentistry: Challenges, Innovations, and a Practical Guide for Space-Based Oral Healthcare Sara Alsadat Sadat Kachouei, Sayed Soroush Sadat Kachouei, Muhammad Sohail Zafar, Muhammad Amber Fareed, Sara Alsadat Sadat Kachouei, Sayed Soroush Sadat Kachouei, Muhammad Sohail Zafar, Muhammad Amber Fareed, First published: 06 December 2025 view metrics S. A.Sadat Kachouei, F.Heidari, A.Heboyan, et al., “Aerospace Dentistry: Challenges, Innovations, and a Practical Guide for Space-Based Oral Healthcare,” The FASEB Journal39, no. 23 (2025): e71284, https://doi.org/10.1096/fj.202503258R. ## ABSTRACT Human ventures into prolonged spaceflight present unique physiological challenges, making astronaut oral health a critical determinant of mission success. The extraterrestrial environment, characterized by microgravity, radiation, and extreme logistical constraints, induces systemic alterations that significantly increase the risk of debilitating oral