When Untreated Tooth Decay Turns Deadly
A fatal case of sepsis linked to untreated dental caries underscores how oral disease can rapidly escalate into life-threatening systemic infection. The case highlights the critical role of early dental intervention in preventing deep neck infections.
Despite decades of progress in preventive dentistry, untreated dental caries remains the most prevalent oral disease worldwide and a persistent driver of serious medical complications. A recent fatal case illustrates how neglected dental caries can evolve beyond the oral cavity, culminating in widespread infection, organ failure, and death.
A 65-year-old man with poor oral hygiene was admitted to the hospital with nonspecific symptoms, including malaise and neck stiffness. Initial laboratory findings showed leukocytosis and elevated inflammatory markers, prompting consideration of conditions such as meningitis and cervical spine inflammation. Empiric broad-spectrum antibiotics were initiated while diagnostic imaging was pursued.
Advanced imaging of the head and neck revealed an extensive retropharyngeal abscess with surrounding soft-tissue inflammation. The patient underwent urgent surgical drainage and a tracheostomy was placed to secure the airway. Despite aggressive intervention, his clinical status deteriorated, and blood cultures later identified methicillin-sensitive Staphylococcus aureus, requiring escalation of antimicrobial therapy.
The source of infection remained elusive until airway evaluation raised concern for a possible odontogenic origin. A subsequent dental consultation revealed extensive untreated caries and advanced oral disease. Multiple teeth were extracted, and the dental infection was identified as the most likely primary source of the deep neck infection and subsequent sepsis.
The infection progressed rapidly, spreading to adjacent anatomical spaces, and triggering systemic inflammatory response. Despite maximal medical and surgical management, the patient developed heart failure secondary to septicemia and died.
Odontogenic infections can extend into deep neck spaces, the mediastinum, or epidural regions, leading to airway compromise, neurologic injury, and death. Early recognition of dental disease, timely intervention, and collaboration between medical and dental teams are essential, particularly when patients present with systemic infection of unclear origin. While this patient lived in Poland, many Americans face significant barriers to accessing the dental care necessary to address such an infection. Click here to read more.
