How Your Dentist Can Save Your Life (page 2 of 4)

An Oral Epidemic

Americans have brighter smiles than ever before, thanks to ubiquitous teeth-whitening systems. But behind those gleaming smiles, all is not well. Oral health has improved some in recent decades: More kids are being treated with dental sealants; the incidence of mild gum disease (gingivitis) has decreased about 40 percent since the 1960s; and untreated tooth decay in permanent teeth has decreased slightly since the late 1980s, according to an August report from the Centers for Disease Control and Prevention. But here's the bad news: One in three Americans over age 30 still have more advanced gum disease known as periodontitis; more than nine in ten Americans have at least some tooth decay; and nearly three in ten adults over 65 have no teeth at all.

Not getting enough fluoride may be part of the problem. One in three Americans live in communities with insufficient fluoride in their drinking water, and bottled and filtered water often contain little fluoride. Also, 108 million Americans don't have dental insurance. In fact, one in five low-income children and adolescents have untreated tooth decay, a level twice that of their more affluent peers. Oral disease is still widespread in this country because the will and the money to reduce it have not been there. The result, according to a 2000 Surgeon General's report, is a "silent epidemic" of oral disease that threatens the health of Americans.

Runaway Infections
In the operating room at Loyola University Medical Center, oral surgeon Mark Steinberg and two residents made two small incisions inside Michener's cheek and three on his neck; then they installed flat rubber tubes in each to drain pus. They made a slice the width of a nickel through Michener's neck into his windpipe, and inserted a six-inch-long curved plastic tracheostomy tube that allowed him to breathe.

Michener remained in intensive care for two more days and in the hospital for the rest of the week. His massive infection began receding. "It was lonely," Michener remembers. "You couldn't talk. You couldn't move. You couldn't sleep." Nurses suctioned mucus from his windpipe for four days so he could breathe. "You didn't want to fall asleep and gag to death, so you had little catnaps and that was it."

Infections like Michener's are rare, but not exceedingly so. Between 1996 and 2001, physicians at San Francisco General Hospital, a large public hospital, treated 157 patients with runaway tooth infections that had eaten into their jaws, faces and necks. All the patients recovered. Still, "patients who get a big dental abscess -- well, they can die from it," cautions M. Anthony Pogrel, DDS, MD, co-author of the study and chairman of the oral and maxillofacial surgery department at the University of California, San Francisco.

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