A very scary tale

A recent article in the British Dental Journal (BDJ 2007) highlighted an alarming case of how poor dental care lead to a near fatal incident.

The case involved a 25-year-old woman living in London who experienced severe toothache over a period of several weeks, but was unable to get an adequate diagnosis or treatment for her condition. During the time of her extreme pain she visited 3 separate dentists, none of whom diagnosed her condition correctly (she had a large cavity under an old filling and a clearly inflamed nerve) or gave appropriate care. Left to her own devices the lady discovered that holding cold water against the tooth gave her some relief, albeit short lived. Unfortunately the lady swallowed the water after resting it against the tooth, which lead to a consumption of 10 litres or more per day. Such high levels of water consumption can, and in this case did, lead to dangerously low sodium levels in the body, which in turn resulted in a coma. The lady in question was admitted to hospital and stayed in a coma for 3 days, from which she made a full recovery. Her waking words from the coma were “I’ve got tooth ache” and this time, at last, they did not fall on deaf ears. She was transferred to the dental department of the hospital where her dental condition was treated quickly and painlessly.

This story, as well as painting a very poor picture of my profession, highlights an important diagnostic point that all patients should be aware of. The symptoms of this lady’s condition are very characteristic and should be well noted. Any one suffering from toothache with the following symptoms should seek urgent treatment, which will need to involve direct treatment of the affected tooth (usually removing the inflamed nerve under strong local anaesthetic). Antibiotics will not work in these cases.

• Spontaneous and severe pain often described as an agonising throb
• Pain worse on contact with heat (often cold in early stages, progressing to heat later on)
• Prolonged pain after the heat has been taken away
• Pain that wakes you in the night
• A previous history of milder sensitivity to hot and cold drinks
• Pain relieved by presence of cold liquid

If you would like to know more about this condition or the treatment of it then please do not hesitate to call the surgery and we will he happy to help you.