Appeal over son struck down by visit to dentist

Until recently dentists were advised to give antibiotics to patients with heart problems to prevent infections because of their higher risks from illness.

But following a directive from the National Institute for Clinical Excellence (Nice), Kristian Adey was not given medication after a visit to the dentist, even though he had suffered bleeding from his gums when his teeth were cleaned.

Ten days later he fell ill with unexplained seizures and scans revealed he was suffering from a brain abscess.

Doctors in Leeds operated on him immediately and for six weeks there were grave fears that he might not survive.

His mother Maralyn, of Shipley, near Bradford, said it was the first time he had undergone a dental procedure without antibiotics.

She was reluctant for the dentist to continue after he told them he could not give him the medication because of the Nice guidance but had eventually agreed.

“Because of this directive, it has caused so much needless suffering, heartache, and distress,” she said.

“Our son is very precious to us and we have fought all his life to give him the best we could and so far it has worked.

“If Kristian had been given the usual antibiotic, which costs nothing in relation to a life, all the heartache would not have happened.”

It had been a “horrendous” time last October as doctors at Leeds General Infirmary battled to save Kristian who despite his complex health problems had only been in hospital twice before and never for more than a week and otherwise had a good quality of life which he “enjoys to the full”, she said.

Tests showed he had been infected with two kinds of bacteria and it would take as much as a year for him to recover fully.

“I am angry, bitter and desperately sad that this has happened,” she said.

“One whole year out of Kristian’s life that a stupid directive has taken away and cannot be replaced.”

She had spoken to the family’s GPs who had assured her they would give Kristian antibiotics if he required further dental treatment.

Mrs Adey wrote to Nice to complain about their “inappropriate and unreasonable” guidance and urged them to withdraw it.

She told the watchdog: “I am sure if you add up the cost of giving one single dose of antibiotic to everyone with a heart condition, against the cost of eight weeks stay in hospital, 20 different drugs, at least six CT scans and priceless heartache, you will see that my request makes sense.”

But she had been disappointed with replies from Nice and separately in a complaint to Health Secretary Andrew Lansley which were both confined only to the risks of infective endocarditis – a serious condition in which the lining of the heart becomes inflamed following an infection – and not to the other potential complaints.

She was also warning other families of the potential risks via social networking websites and urging others similarly affected to come forward to put pressure on for change.

A spokesman for Nice said the guidance was issued in March 2008 concerning only infective endocarditis.

“This guideline does not make any recommendations on prophylaxis against infections in other parts of the body, for example, the brain.

“This is outside the scope of this particular guideline.

“The 2008 guideline does not recommend antibiotic prophylaxis against infective endocarditis for people at risk when they are undergoing dental or certain non-dental procedures.

“This is because medical and dental procedures are no longer thought to be the main cause of endocarditis and taking antibiotics carries its own risk.

“Healthcare professionals are expected to take our clinical guidelines fully into account when exercising their clinical judgment.

“However, the guidance does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of each patient.

“Therefore dentists will need to make decisions which reflect the risk in each patient.

“These decisions should be made in consultation with, and with the agreement of, the patient and/or their guardian or carer.”