How dangerous are toothaches?

EXTREMELY rarely, if ever, will a death certificate indicate that a toothache was the cause of death. The blame is usually placed on the effects of a secondary infection somewhere else in the body. Now, a twelve-year-old, let me call him Tommy, as it is obviously unethical to publish the actual name of private patients, ignored the pain in one of his teeth. His mother had five children to support and at the time was unemployed. So, visiting a private dentist would have to wait. Before long, the toothache was no longer noticeable. The pain seemed to have migrated into his head. The resulting headache became so unbearable that Tommy’s mother took him into the emergency room at the Public Hospital.

In most cases, dental problems such as cavities or toothaches are viewed as trivial. Many people do not consider these as ”a big deal.” This is so, although there may be pain. A visit to the dentist can quickly bring relief.

Tommy’s headache was caused by a brain abscess – a bacterial infection in the brain. The infection had come from the infected tooth he had complained about previously. The tooth became abscessed and the bacteria spread, causing a secondary infection in the child’s brain. Some species of Streptococcus bacteria that cause tooth decay and gum disease tend to accumulate in nerve tissue. From an infected tooth, they can migrate up through the nerves and into the brain or spinal column, where they can cause a secondary infection. This is what happened to Tommy.

Tommy underwent two surgeries and the removal of the infected tooth. For several weeks afterwards, he seemed to be on the mend, working with a physiotherapist to regain full use of his right arm and leg, which the brain infection and surgeries had impaired. But despite thoroughly disinfecting the tooth socket and taking antibiotics, some of the infection remained and continued to spread. Within a few weeks the infection inside Tommy’s brain returned, and this time with a vengeance. Again, he was rushed to the hospital, but it was too late. Tommy died before doctors could help. The cause of his death was attributed to a brain abscess, but the real culprit was an infected tooth.

In another case, I am aware that a 57-year-old man was admitted to a hospital complaining of a toothache accompanied by a fever and swelling in his right cheek and neck. The man was a diabetic and suffered from liver cirrhosis due to excessive alcohol consumption. His immune system was obviously overworked, dealing with the consequences of poor lifestyle choices. His symptoms worsened despite antibiotic therapy. Infection from the tooth eventually spread to his lungs (pneumonia), kidneys and liver. After 35 days in the hospital, the patient died of multi-organ failure. Antibiotics were useless. The infection in his mouth continued to feed the systemic infections until it killed him. Although weakened by other health problems, his death, like that of Tommy’s, was literally caused by an infected tooth.

Relatively young and otherwise healthy individuals and those who are older and in poor health are affected. A 19-yearold woman with no serious health problems had an infected tooth extracted. Soon after, she developed chest pain. Even though she was treated with antibiotics before and after the dental procedure, bacteria from the infected tooth spread to her heart. Thirteen days after the tooth extraction, she died of a heart attack brought on by the infection.

While deaths due to tooth infections are uncommon, they happen more often than we suspect. In most cases they go unreported or unrecognised, with the secondary infection getting all the blame. In most cases the patients suffered from poor nutrition, low immunity ( especially HIV infection), or other health conditions which exacerbated the situation. If a tooth infection can cause death, it can certainly cause other health problems. Even people who can eat well and care for their health can be affected by the health of their teeth.