Monday, November 15, 2010

"Mortality associated with dental caries and dental intervention.

The case of Deamonte Driver probably is the best-known case of caries-related mortality. Lesser known are the cases of Alexander Callender, a 6-year-old Mississippi boy who died of sepsis, and Jackie Martinez, a 7-year-old California girl who choked on a crown during a dental visit.2 Unknown to but a few involved in their care are the names of many other children who have died as a result of sedation mishaps or an overdose of local anesthetic during treatment for ECC [early childhood caries]. ECC-associated mortality secondary to infection and treatment likely never will be known owing to inadequate surveillance, lack of an ECC registry, issues of confidentiality, the terms of some legal settlements, missing or incorrect diagnoses, and even inconsistent diagnostic coding choices by hospitals and physicians. Among brain abscesses alone, 15 percent result from infections of unknown source, some or many of which may be of dental origin. It is likely that mortality related to ECC and its treatment is underreported. Coté and colleagues,in an attempt to identify pediatric deaths related to sedation during an almost 30-year period, commented that their study sample represented a gross underreporting while also stating that dental specialists were disproportionately represented among all pediatric health providers."