Tuesday, June 13, 2017

Death from a Tooth Infection--How That Can Happen

Recently, two different new patients came to see me with long-standing tooth infections.  One of them will probably lose the tooth because it is too diseased to save, and the other will need a root-canal—but I am convinced they would not have needed one if the tooth was treated earlier.  But these patients are lucky.  
Untreated tooth infections can lead to systemic disease, and every year untreated tooth infections cause many people to actually die.  Earlier this year, there was a story that had made national news about a 26 year-old truck driver and father of two after he suddenly died as the result of complications from a toothache.
Vadim Anatoliyevich first complained of a toothache in January of this year, when he was on a routine work trip to New York. He stopped in Oklahoma and was seen by a dentist, who looked at the infection, cleaned it, and gave him antibiotics. He continued driving and felt better, but when he arrived in New York, he was in pain again and his mouth became swollen.
Anatoliyevich’s brother Miroslav met up with him to help him drive home faster, and noticed at one point that Vadim was having trouble breathing and couldn’t stand up. Then in Utah, Miroslav drove his brother to the nearest hospital, where doctors said they “made it just in time.” However, the infection from Anatoliyevich’s tooth had progressed and spread to the rest of his body. His lungs had fluid in them, and he couldn’t breathe on his own.  The infection could not be stopped and in early February, he died.
The story is tragic and scary, but calls attention to the fact that dental infections can lead to serious health complications more often than you might think. Every year there are cases where the patient did not receive appropriate and timely treatment of an infected tooth. In most cases, the infected tooth starts as a localized site with pain and infection.
Obviously you’re not going to die of the physical pain, but these problems can start from some form of periodontal issue or, as is most often the case, cavities. The decay leads to abscesses, which are usually infections between the tooth and the gums.  Not treated, the problem progresses and the patient becomes septic, which can lead to multiple organ failure and death.
Unlike your mouth, your lungs are a sterile cavity. When bacteria from your mouth get into your lungs, they can replicate quickly and cause a serious infection like pneumonia — and this can happen as a result of a tooth infection or gum disease. People can actually breathe in pathogenic biofilms from their mouth into their lungs, where they can create an infection. I have seen people get lung issues because of an untreated infection in their mouth.  Periodontal disease is a big deal.
It’s not just lungs that are a concern.  Bacteria from dental infections can get into your bloodstream and affect various organs, including your heart.  Dental infections can even affect your brain and cause abscesses there. It’s important for people to recognize that it’s not just a tooth — there are a lot of risks of the infection spreading elsewhere.
This is not a new phenomenon, of course. Dental infections and other tooth-related problems were listed as the fifth-leading cause of death in London back in the early 1600s. But it certainly happens today, too.  And although the number of people who die from an untreated tooth problem is not at epidemic levels, the details can be disturbing.

One famous case is the 2007 death of Deamonte Driver, a 12-year-old Maryland boy who died when bacteria from an abscess infected his brain. He had two brain operations totaling $250,000 before he died, but he could have been saved with a timely tooth extraction that would have cost $80.  Kyle Willis, a 24-year-old unemployed father from Cincinnati, died in 2009 after putting off a tooth extraction and prescription antibiotics for an infection.  John Schneider of Mt. Orab, Ohio, was 31 when he died in 2014 after what he thought was a sinus infection but was actually an untreated abscess that eventually led to multiple organ failure.

The scope of the danger was highlighted a few years ago by the Pew Charitable Trusts, which found preventable dental conditions made up more than 830,000 emergency room visits in 2009. That was up 16 percent from 2006.  While the number of deaths aren’t regularly examined, a 2013 study published in the Journal of Endodontics offered a quick cross-section of the issue based on one kind of condition. Researchers found that between 2000 and 2008, there were more than 61,000 hospitalizations nationally for periapical abscesses, an infection at the tip of a tooth’s root that is a common symptom of untreated tooth decay.  More than 1 in 1,000 of those patients actually died.

I strongly recommend that people see a dentist ASAP if they notice they have any swelling in their mouth.  Anything that hurts when you press your finger on the outside of your gums, see the dentist right away.
It’s also crucial to regularly brush your teeth, floss, and follow good dental hygiene.  Most gum disease and periodontal infections, including cavities, don’t hurt, which is why it’s so important to routinely see your doctor.  Your dentist is able to find these problems before they get out of hand and treat them as needed.
Of course, most people can develop a tooth or gum infection and won’t die from it.  But if your immune system is compromised, it could develop into a more serious problem.  These complications can happen, and when they do, it’s both creepy and tragic—and almost always preventable.
Keep smiling,




Dr.Elzbieta W. Basil, DMD is a private practice dentist with offices in West Hartford Center and Downtown New Britain, Connecticut.  She is a Clinical Instructor at the UConn School of Dental Medicine, and has won several awards naming her regional “Best Dentist” and “Top Dentist.” She is an active member of the Connecticut State Dental Association and the American Dental Association. Tel: 860-561-2121

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