Could it be sepsis? New paper to raise awareness among dental professionals

Published in the British Dental Journal, the paper covers the experience of Melissa Mead MBE, who lost her one-year-old son to sepsis
Bachelor of Dental Surgery - Years Three and Four

Every year in the UK 52,000 people die from sepsis 鈥 with 14,000 of these estimated to be preventable. 

Now a new paper has highlighted what dental professionals need to know about sepsis and the importance of communicating these signs to patients.

Led by Dr Cathy Coelho from the 麻豆传媒 and Melissa Mead MBE from the UK Sepsis Trust, the paper in the British Dental Journal details Melissa鈥檚 first-hand experience losing her one-year-old son William to sepsis in 2014, following several missed opportunities to spot the condition. 

Sepsis is a complication that can arise from any infection and signs range from decreased body temperature to a change in mental ability. If caught quickly, it鈥檚 easily treatable with fluids and antibiotics. If not, it can be fatal. 

Melissa Mead MBE and Dr Cathy Coelho explain why there needs to be more awareness of sepsis in dentistry:

Each year, more people will die of sepsis than breast, bowel, prostate cancer, HIV and road traffic accidents combined. Of the 52,000 cases in the UK each year, an estimated 14,000 are preventable through better awareness and treatment.

The signs for dental professionals to look out for are:

  • A patient responds only to voice or pain/unresponsive
  • Acute confusional state
  • Heart rate >130 per minute
  • Respiratory rate 鈮25 per minute
  • Non-blanching rash, mottled/ashen/cyanotic
  • Not passed urine in last 18 hours
  • Systolic blood pressure 鈮 90 mmHg (or drop > 40 from normal)
  • Needs oxygen to keep SpO2 (oxygen in the blood) 鈮92%
  • Lactate 鈮2 mmol/l
  • Recent chemotherapy

Detailing Melissa鈥檚 experience, the paper explains how William had had a sudden drop in temperature, was exhausted and wasn鈥檛 urinating, following a previous diagnosis for a viral bug. Melissa had been advised by doctors that rest was the best course of action.

But in the weeks leading to William鈥檚 death, he in fact had a bacterial chest infection. When the vomiting started this was the early stages of pneumonia. In the last week or so of his life the pleural effusion was developing and in the last couple of days of his life, sepsis took over his body.

Melissa has campaigned since William鈥檚 death to raise awareness of the condition and, after a tooth infection for which she was prescribed antibiotics, she thought about how the condition was addressed in the dental community 鈥 and so the collaboration with Peninsula Dental School at the 麻豆传媒 began.

After meeting with Dr Coelho, Melissa came to the University鈥檚 Dental Education Facility in Truro to address fourth-year students about the signs missed in William鈥檚 case.

Student Neela Venkatasami explained that had it not been for Melissa鈥檚 lecture and leaflet distribution, she would not have been able to spot the signs in a patient who presented them. She too is now raising awareness. 

鈥淭he patient who came in was complaining of pain from an infection. This was treated locally, but as per the current guidelines we didn鈥檛 prescribe antibiotics as they didn't have a temperature. However, due to swelling and the presence of infection there was a potential risk of developing sepsis. I was able to share the leaflet and advise them to go to A&E if their condition deteriorated. There is a chance sepsis can originate from dental infections and the fact that Melissa made us aware of the warning signs meant that I could inform the patient, and in turn they could seek help. The curriculum has taught us about sepsis, but hearing from someone personally affected brought home the importance of our roles and how we can help more people understand the signs."

Neela Venkatasami sepsis in dentistry

The National Institute for Health and Care Excellence (NICE) requires all healthcare professionals, including dental care professionals, to be trained in identifying people who may have sepsis. But the paper highlights how enhancing knowledge about sepsis will help the dental team to educate their patients about sepsis, recognise the pathognomonic warning signs and the need for rapid treatment.

Dr Coelho said: 

鈥淭he more I got to understand sepsis and look at the literature in the dental journals about the condition, I realised there was a gap. So together Melissa and I wrote this paper to raise awareness among dentists 鈥 whether they share the messages with their patients, colleagues or their family, it all helps. I was struck by the number of people who die through sepsis and the fact that it鈥檚 so easily treatable.鈥 

Melissa said: 

鈥淢any of us have had an infection of some description, but how do we know what 鈥榳orse鈥 looks like? I went to the dentist to treat a tooth infection and thought actually, I鈥檝e just been given antibiotics 鈥 there should be some kind of symphony here about what dentists do to help their patients understand signs and symptoms of sepsis.鈥

Since publishing in the BDJ, Melissa has worked with a number of dental organisations to put together a poster called 鈥極pen wide 鈥 just ask, could it be sepsis?鈥, which was distributed to dental practices via NHS England and the Care Quality Commission. 

Melissa, who took her son William鈥檚 ashes as she collected her MBE at Buckingham Palace last month, said: 

鈥淚 don鈥檛 want anyone to go through losing someone they love to sepsis, but knowing that William鈥檚 legacy is carrying on and making a difference in dentistry and beyond already is inspirational.鈥
 The full paper entitled is now available to view in the British Dental Journal.

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