Barodontalgia is a rarely reported condition involving changes in ambient pressure resulting in tooth pain. According to Ferjentsik and Aker, Class II barodontalgia is observed in teeth that have pre-existing pulpal disease and an ultimate diagnosis of irreversible pulpitis. This article describes a case of Class II barodontalgia that was experienced on a commercial airline flight and reviews current knowledge regarding this phenomenon, including proposed etiologic mechanisms.