Many people may have suffered the excruciating pain that a dental infection can cause. Swelling, bad taste in the mouth, lost days at school or work can be consequences of an infection related to a decayed tooth or infected gums. It may be assumed that this is a minor health issue that can be cured with a short course of antibiotics. Some individuals may not even consider making an appointment with the dentist right away due to having to take off work or other obligations. While a dental infection may seem minor, it is actually potentially deadly.
How dental decay becomes dangerous
When asked if tooth decay can cause death, Dr. M. Kent stated in Tooth Talk the way many individuals may have felt at one time or another when experiencing a terrible toothache. You may “wish you would die when you have a tooth infection, only to get rid of the pain.”
Dr. Kent then points out that teeth are “portals” to the rest of the body. When an individual has a dental infection, there is undoubtedly drainage or discharge. An infection can also be inside the gums or even the bone. The infection and surrounding inflammation causes swelling. Swelling can become severe enough that the airway is affected. Pus can be swallowed. When the drainage from a tooth infection is swallowed, it does not just magically dissolve. It has the potential danger of settling near or in a vital organ, which can lead to a life-threatening situation.
Actual cases of death related to tooth infections
While it may seem far-fetched to some, there are people who have actually died from dental-related infections. It was about 15 years ago that I read in the local newspaper where a man in his early 40s had died. An autopsy was conducted because the seemingly healthy man just suddenly collapsed and died. His family knew of no serious medical conditions in his family tree that may have contributed to his untimely death.
But the autopsy revealed the terrible cause of his death. The autopsy revealed the man had an abscessed tooth. Some of the drainage from the abscessed tooth was swallowed. The infection then settled around his heart causing a massive infection in the lining of his heart, which caused his death.
More recently, ABC News reported that a Cincinnati man and father, just 24 years old, died of a tooth infection. The man was unemployed with no dental or prescription insurance. He finally went to the emergency room, where he was given prescriptions for pain medication and antibiotics to cure the infection. Kyle Willis could not afford both prescriptions, so he only got the pain medication filled. Within a few days, Willis died after the infection caused swelling in his brain.
ABC also gave details of a case where a 12 year old boy died after the family had lost their Medicaid coverage and the family could not afford to have their son’s tooth extracted.
Risks of death may be particularly high for poor, disabled and elderly
While many jobs offer dental benefits, those benefits are largely available to full-time employees and executives. Part-time employees and those in businesses such as retail or fast-food may not have dental health benefits.
For individuals on Medicaid, dental benefits do exist, but there are restrictions. The Medicaid website indicates that states have the “flexibility” to design their own program under the Children’s Health Insurance Program (CHIP). The program must meet federal guidelines, however. But this means that not all benefits available in one state may be available in another. The website explains that dental coverage under CHIP includes dental coverage “necessary to prevent disease and promote oral health,” and to treat emergency conditions.
Each state has the flexibility to decide what benefits are available to adults who are on Medicaid. The Medicaid website clarifies adult coverage by stating “less than half of the states currently provide comprehensive dental care.” So adults with dental health problems get limited dental care. Care such as a root canal or other advanced dental procedures may need “prior authorization.” This may take weeks.
Medicare recipients have even less coverage. While it may be assumed that older individuals may be in more need of dental services, Medicare does not provide any dental care coverage (nor vision) at all for recipients. The only exception is if an individual has to have some type of facial reconstruction or has had another type of severe injury. In addition to dental services during reconstruction of the jaw due to injury, if a tumor must be removed from the jaw or mouth, or in preparation for radiation treatment, Medicare may pay for dental services then. The Centers for Medicare & Medicaid Services (CMS) gives details of the “blanket exclusion” of dental services from Medicare.
Medicare will not cover any other dental care. This blanket exclusion includes those who receive Medicare due to disability as well as elderly Medicare recipients.
Minimal assistance is available even when teeth are infected
While there are free or reduced dental care services in many communities, accessing those services may be a major issue. For instance, Columbus Ohio has a few dental clinics that offers dental care for reduced fees starting at $40, based on income. But the more services or more advanced type of services needed, the cost rises. An individual who needs a tooth pulled will pay a minimum of $80 to have a single tooth extracted. If a person has a dental infection and is unemployed or under-employed, that $80 fee may not be possible.
I made a call to a couple of the clinics to determine the wait time if an individual needed an appointment. One said that appointments are not given over the phone; the person must come in and complete an application in person, bring picture identification, several weeks pay stubs or other proof of income and proof of current residency. A future appointment is then set up. The other clinic advised that they were booking 2 months in advance. Limited services are provided at all the reduced clinics. No root canals, dentures or partial plates or repairs are provided. Services are basically limited to cleanings, fillings or extractions. For each tooth that needs care, a fee is charged.
Some communities have completely free dental clinics. But as Dr. Glenn Stream, then-President-elect of the Academy of Family Physicians was quoted by ABC, “The wait is often months at these clinics.” He pointed out that Willis died in less than 2 weeks of developing his dental infection. The end result of these long wait times may be the same as what happened to Kyle Willis.
Dental infections may not be considered to be serious by some people. Many individuals may choose getting a pain medication prescription filled when faced with a decision of which prescription to get when the individual or family has limited resources. Those who are unaware of the seriousness of dental infections may not realize that death can occur and in a very short time.
Raising awareness of the seriousness of dental infections to children and adults of all economic levels, as well as to appropriate government agencies and insurance providers, the medical, dental and social services community is critical. Increasing the availability of free dental care without extensive wait times and complicated application procedures, as well as filling antibiotic prescriptions for the unemployed, under-employed, elderly and disabled may possibly save lives.