Sir, we read with interest your recent article regarding a death following an odontogenic infection in a patient immunocompromised with chronic lymphocytic leukaemia (BDJ 2007; 203: 241–242). We wish to relay that it is our experience that deaths can still arise from odontogenic infections in Britain in the twenty-first century. Furthermore, patients need not be immunocomprised to succumb to airway obstruction or overwhelming sepsis.

We have had two deaths due to overwhelming dental sepsis in the last ten years, and up to 15 cases which we would regard as 'near misses'.1 The conditions arising from dental sepsis have included septic shock, necrotising fasciitis and airway obstruction. Common denominators included previous antibiotic use for dental infection without definitive dental treatment.

All dentists and doctors must be aware that antibiotic prescription is not a substitute for dental surgical control of infection, adhering to the principles of eliminating the source of infection, and drainage of pus.

In our experience, these patients often have at least minor abnormalities in liver function, often as consequence of excess alcohol consumption.2 We wonder if the patient reported by Carter and Lowis had any such biochemical abnormality.