Man Who Almost Died After Tooth Extraction Calls For Change

UK: Greg Hutton (pictured), a 62-year-old former IT technician from Swansea, has called for changes to the National Institute for Health and Care Excellence (NICE) guidelines after surviving two near-fatal bouts of endocarditis. This severe heart infection, which has a 30% mortality rate within a year, developed following a tooth extraction during which he was not prescribed preventive antibiotics despite his history of heart disease.

The issue stems from NICE guidance, updated in 2008, which advises against routine antibiotic prophylaxis for invasive dental procedures. Hutton believes this approach contributed to his condition. “It was horrendous, absolutely horrendous, not just for me but for my family as well,” he told the PA news agency.

A Preventable Medical Crisis

Mr. Hutton, born with a bicuspid valve—a congenital heart defect—underwent a valve replacement in 2014. Three years later, a dental procedure led to his first battle with endocarditis. His dentist declined to provide antibiotics, citing NICE guidelines. “The dentist said he couldn’t give me antibiotics because it goes against the NICE guidelines, and he would get into trouble,” Hutton recalled.

Two weeks after the tooth extraction, he became gravely ill. Initially misdiagnosed, he endured months of worsening symptoms, including organ failure, before being hospitalized for four months. The treatment, which involved gentamicin, left him deaf in one ear.

Despite recovering, Hutton suffered a second bout of endocarditis shortly afterward, requiring another lengthy hospital stay. This time, he was treated for fungal endocarditis, a particularly dangerous form of the infection. A subsequent heart attack further underscored the severity of his health struggles.

Financial and Emotional Impact

The financial burden on the National Health Service (NHS) to treat Hutton’s condition is estimated at around £400,000. By contrast, the cost of a preventive antibiotic prescription is only a few pounds. Hutton received a substantial legal settlement through Wolferstans Solicitors, which he believes is one of the largest of its kind.

Holly Bowditch, a solicitor at Wolferstans, highlighted the broader implications: “Since the NICE guidelines were changed in 2008, advising against the prescription of antibiotics prior to an invasive dental procedure, around 6,700 people have contracted endocarditis when it could have been avoided. It is estimated that around 2,000 deaths have occurred which could have been prevented.”

Calls for Change

Hutton has written to NICE to urge revisions to their guidelines, arguing that current policies leave both patients and dentists at risk. While NICE updated its guidance in October to reference advice from the Scottish Dental Clinical Effectiveness Programme (SDCEP), Hutton believes this does not adequately address the issue.

NICE maintains that routine antibiotic use is not warranted but acknowledges limited evidence supporting its use for high-risk individuals. A NICE spokesperson noted, “While there is some new evidence about the benefits of preventive use of antibiotics for people at higher risk of [infective endocarditis], this remains insufficient to change the overall recommendations in the NICE guideline, which seeks to balance the potential benefits of antibiotics with the risks of increasing anaphylaxis and antibiotic resistance.”

The Road Ahead

For Hutton, fitness and determination have been key to his survival. “According to statistics I should be dead, I put that down to my fitness,” he remarked. Yet, his ordeal has driven him to campaign for clearer, more protective guidelines.

His story highlights the need for a careful reassessment of NICE policies to balance antibiotic stewardship with patient safety, ensuring no one else endures the hardships he has faced.