Short answer
- Mike Williams was Michael Anthony Williams, the former Syracuse wide receiver who played for the Tampa Bay Buccaneers and the Buffalo Bills. He died in Tampa, Florida, on September 12, 2023, aged 36, after a hospital course that followed a work related construction accident on August 21, 2023. In December 2023, the Hillsborough County Medical Examiner's Office released an initial case summary. It gave his cause of death as "bacterial sepsis with cerebral abscesses and necrotizing lobar pneumonia due to multiple dental caries and retained dental roots," and it listed arteriosclerotic cardiovascular disease as a contributing factor. The death was ruled natural, with no indication of foul play. ESPN and the Associated Press both reported those findings at the time. That is the verified record, and this article keeps it in full. The construction accident is part of the record. So is the dental finding. The medical examiner did not list the head injury as the cause of death, and the Associated Press noted that this was the first time in Hillsborough County that a death had been attributed to this specific type of dental sepsis. The general lesson is narrower than the headline version. An untreated tooth infection can, in rare cases, spread to the jaw, the neck, the bloodstream, and distant organs, and become a medical emergency. Most dental infections are treated long before that point. This article is general information only, not a diagnosis or a treatment plan for any individual. If you have tooth pain with swelling, fever, or any difficulty breathing, swallowing, speaking, or opening your mouth, treat that as urgent and follow the emergency guidance below.
Who Mike Williams Was
Several public figures share the name Mike Williams, so the identity is worth stating plainly. The man in this article is the football player. Michael Anthony Williams was born in Buffalo, New York, in 1987. He played at Syracuse, and the Tampa Bay Buccaneers selected him in the fourth round of the 2010 NFL draft, 101st overall. He played for Tampa Bay from 2010 to 2013, and in his rookie season he caught 11 touchdown passes, a then franchise record. He was traded to his hometown Buffalo Bills in 2014, missed the 2015 season, and had a stint with the Kansas City Chiefs in 2016 before retiring.
By 2023 he was working in Tampa as an electrician, for a contractor ESPN named as Exodus Electric Corp. That working life, not his playing career, is the setting for the accident that put him in hospital. Nothing in the medical examiner’s reporting connects his death to football or to any other person with the same name.
What Happened in August and September 2023
The timeline below comes from the medical examiner’s initial case summary as reported by ESPN and by Tampa Bay 28, the local ABC affiliate, in December 2023.
- August 21, 2023: Williams was working on a construction site when heavy supplies fell on his head. He sustained head trauma.
- August 22, 2023: Emergency services were called from his home the following day, and he was taken to hospital. A CT scan showed multifocal intracranial masses, meaning several areas of abnormal tissue within the skull, with a worsening shift of the brain’s midline measured at 8 millimeters. He was admitted to intensive care with acute hypoxic respiratory failure, cardiac arrest, and sepsis due to multiple brain abscesses.
- September 1, 2023: He suffered a further cardiac arrest, received CPR, and was intubated and sedated.
- September 7, 2023: He was transferred to Suncoast Hospice with a diagnosis of respiratory failure.
- September 12, 2023: He underwent palliative ventilator withdrawal and died at 8:20 a.m. local time. He was 36.
Note that the brain abscesses and the sepsis were present during his hospital admission, not only in the final days, in a three week hospital course in which infection and its complications were central.
What the Medical Examiner Reported
In December 2023, the Hillsborough County Medical Examiner’s Office released an initial case summary report. Its central findings, as reported by ESPN, the Associated Press, and Tampa Bay 28, were:
- Cause of death: “Bacterial sepsis with cerebral abscesses and necrotizing lobar pneumonia due to multiple dental caries and retained dental roots.”
- Contributing factor: Arteriosclerotic cardiovascular disease, which is hardening and narrowing of the arteries.
- Manner of death: Natural. ESPN reported that there was no indication of foul play.
- Status of the report: Initial and preliminary. The Associated Press reported that a full autopsy would be released later, including toxicology. ESPN likewise reported that full autopsy and toxicology results were still pending.
- Rarity: The Associated Press reported that, according to the medical examiner’s office, this was the first time in Hillsborough County that a death had been attributed to this specific type of dental sepsis. Tampa Bay 28 reported the same point in similar terms.
Read that line in the order it is written, because the order carries the meaning. In a medical examiner’s formulation, the condition after the word “due to” is the underlying source. Here, the chain runs from multiple dental caries and retained dental roots, to bacterial sepsis with abscesses in the brain and a destructive pneumonia in a lobe of the lung. The dental problems are named as the origin of the fatal infection; the cardiovascular disease is listed separately, as a contributing factor rather than as the cause.
What the report does not say
The report does not say that the construction accident caused the dental infection, and it does not list the head injury as the cause of death. The accident and the hospitalization are the context in which Williams was treated, and honest reporting keeps them visible: it would be just as wrong to erase the accident as to erase the dental finding.
Nor does the report say that dental infection commonly kills people. The county’s record points the other way: a death of this specific type had not previously been attributed there. This case is evidence that a rare outcome is possible, not that it is likely for any given person with toothache or decay. And because the summary was described as initial and preliminary, this article reports it as the official finding released in December 2023, not as a later final report.
The Terms in the Cause of Death, Explained
Dental caries is tooth decay. Bacteria in plaque produce acid that dissolves the minerals in enamel, and untreated decay can progress through the tooth until it reaches the soft pulp at the center. Our full guide to cavities and tooth decay, what they are and how to protect your teeth works through that progression.
Retained dental roots are tooth roots, or root fragments, that remain in the jaw after the visible crown of a tooth has broken down or after a tooth has been partly removed. The peer reviewed literature lists leftover root fragments among the possible starting points for oral infection, because a retained root can harbor bacteria in tissue that is no longer a working tooth and may cause no pain for a long time.
Bacterial sepsis is the body’s overwhelming, life threatening response to a bacterial infection. The Centers for Disease Control and Prevention defines sepsis as the body’s extreme response to an infection, a medical emergency that can rapidly lead to tissue damage, organ failure, and death.
Cerebral abscesses are collections of pus within the brain. MedlinePlus lists brain abscess among the complications that can follow when infection spreads from a tooth to other areas of the body.
Necrotizing lobar pneumonia is a severe pneumonia affecting a lobe of the lung in which infected lung tissue dies. It is part of the sepsis picture here, alongside the brain abscesses, not a separate unrelated illness. Arteriosclerotic cardiovascular disease, the contributing factor, is cardiovascular disease driven by hardening and narrowing of the arteries: a condition that played a part in the death without being the underlying cause the examiner named.
How an Untreated Tooth Infection Can Spread
A dental infection usually starts in one of three ways: decay that reaches the pulp, a cracked or broken tooth that lets bacteria in, or gum disease around the tooth. The American Dental Association’s MouthHealthy resource explains that these problems can let bacteria enter the pulp, the soft tissue inside the tooth. MedlinePlus describes the same route: openings in the enamel allow bacteria to infect the pulp, and infection may then spread from the root to the supporting bone.
Stage one: infection inside the tooth
Once bacteria reach the pulp, the pulp can die and pus can collect at the tip of the root, in the jawbone. That pocket of pus is a periapical abscess. A peer reviewed review of severe odontogenic (tooth origin) infections in the journal Biology describes the usual progression in three phases: inoculation, when bacteria gain access to the pulp chamber; cellulitis, a spreading inflammation of surrounding tissue; and abscess formation. At this stage the problem is still local, and routine dental treatment most often resolves it. Our explainer on how cavities turn into root canals covers this stage step by step.
Stage two: spread into the face, jaw, and neck
Untreated, the infection can break out of the bone around the root tip and enter the soft tissue spaces of the face, jaw, and neck. These spaces are connected compartments, so infection can move from one space to the next. MedlinePlus lists the results plainly: spread to soft tissue, including facial cellulitis; spread to the jawbone; and loss of the tooth. The Biology review notes that infections in these spaces are classed as severe, require hospital admission and operating room drainage, and can threaten the airway, because swelling in the floor of the mouth and neck can push the tongue up and back. Difficulty opening the mouth, difficulty swallowing, a changed voice, and drooling are the outward signs, and they are emergency signs.
Stage three: spread through the bloodstream to distant organs
Bacteria can also enter the bloodstream, which is how a problem in a tooth can produce infection far from the mouth. MedlinePlus lists the distant complications of an untreated tooth abscess as blood infection, brain abscess, inflammation of the heart (endocarditis), and pneumonia. The Biology review lists a similar set, including airway obstruction, cerebral abscess, and sepsis. A 2023 literature review in Medicine likewise records that odontogenic infections are usually limited locally but can spread rapidly under certain conditions, and lists sepsis, meningitis, and abscesses within the central nervous system among the documented severe complications.
Williams’s reported cause of death sits at this third stage. The examiner’s chain describes a dental infection that had spread through the body, not one that stayed in a tooth.
Severe complications have become exceedingly rare with modern treatment, but the risk is not evenly shared. The Biology review identifies immune suppressing conditions as a setting in which odontogenic infection can spread more rapidly, with diabetes, especially poorly controlled diabetes, the most common example it discusses. MedlinePlus warns likewise that a weakened immune system raises the risk of spread from an untreated abscess. That does not turn an ordinary toothache into an emergency by itself. It does mean a person with such a condition has less margin for waiting.
Why Most Tooth Infections Do Not End This Way
It would be easy, and wrong, to read this case as a warning that tooth decay is usually deadly. Dental infections are common; deaths attributed to dental sepsis are rare enough that a county medical examiner’s office could identify this one as the first attribution of its specific type on its record. Most infections stay local, and pain usually brings a person to a dentist while the infection is still confined to the tooth and the bone around it. Local infection also has effective treatment: removing the source and draining any pus deals with the cause, not only the symptoms. And the warning signs of spread usually appear before the most serious stage: enlarging swelling, fever, difficulty opening the mouth, difficulty swallowing. Those signs are a prompt to act the same day, not a reason for panic.
Warning Signs of a Dental Infection
The NHS, the American Dental Association, and MedlinePlus describe a consistent picture of a dental abscess or tooth infection. Signs include:
- Intense, throbbing, or continuous toothache, or pain in the gums, which may spread to the jaw, neck, or ear on the same side.
- Pain when chewing or biting, and sensitivity to hot or cold food and drink.
- Redness inside the mouth, or on the face or jaw outside it.
- Swelling of the gum over the infected tooth, which may look like a pimple or a small bubble on the gum.
- A swollen face or jaw.
- A bad or bitter taste in the mouth, or bad breath, which can happen when pus drains.
- Swollen glands in the neck.
- Fever, or feeling generally unwell, uneasy, or feverish.
- Difficulty opening the mouth or chewing.
Any of these signs is a reason to contact a dentist promptly rather than to wait and see. The NHS is direct that a dental abscess needs urgent treatment by a dentist and will not go away on its own. MedlinePlus adds a point that catches people out: the toothache may stop if pressure is relieved, for example if the abscess drains or the pulp dies, but the infection remains active and continues to spread. A tooth that stops hurting has not necessarily healed, and the Sepsis Alliance dental infections guide makes the same point: feeling better does not necessarily mean an infection has gone away.
Gum symptoms belong in this picture too, because gum disease is one of the routes into dental infection. Our guides to the 5 signs of gum disease and to healthy gums versus unhealthy gums set out which gum changes deserve an appointment.
Signs an Infection Is Spreading
Treat the following as signs that infection is moving beyond the tooth:
- Facial or jaw swelling that is enlarging, or spreading toward the eye or down the neck.
- Fever together with tooth pain or facial swelling.
- Increasing difficulty opening the mouth.
- Difficulty or pain when swallowing, or difficulty speaking.
- Swelling inside the mouth, including under the tongue.
- A swollen or painful eye, or any sudden change in eyesight.
- Pain that is severe and getting worse despite painkillers.
- Feeling seriously unwell alongside any of the above.
Swelling after dental treatment deserves the same attention. Our guide to the signs of a jaw infection after a root canal covers what to watch for after treatment.
Sepsis Warning Signs
Sepsis is not the infection itself. It is the body’s extreme response to an infection, and it can develop from an infection anywhere in the body, including the mouth. The Centers for Disease Control and Prevention lists the signs and symptoms a person with sepsis might have, in any combination: clammy or sweaty skin; confusion or disorientation; extreme pain or discomfort; fever, shivering, or feeling very cold; high heart rate or weak pulse; and shortness of breath.
Sepsis Alliance, the United States sepsis advocacy organization, teaches the same pattern through its TIME reminder: Temperature higher or lower than normal; Infection, signs or symptoms of an infection; Mental decline, confused, sleepy, or difficult to rouse; Extremely ill, severe pain or discomfort, or shortness of breath. Its dental infections guide adds that there is no single sign of sepsis; a combination of symptoms is what matters.
Two implications follow. New confusion or difficulty waking a person who has an infection is a warning sign, not something to sleep off. And you do not need every sign before acting: the CDC’s instruction is to act fast when an infection is getting worse, and to ask the clinician, “Could this infection be leading to sepsis?”
When It Is an Emergency: Call 911
Some dental symptoms should not wait for a dental appointment at all. In the United States, call 911 or go to the nearest emergency department now if tooth pain, a dental abscess, or facial swelling comes with any of the following:
- Difficulty breathing, speaking, or swallowing, or drooling because you cannot swallow.
- A swollen or painful eye, or a sudden problem with your eyesight.
- A lot of swelling inside your mouth, or swelling that is spreading quickly.
- Great difficulty opening your mouth.
- New confusion, extreme sleepiness, difficulty waking, or a feeling of being seriously and unusually ill.
- Shortness of breath, a racing or weak pulse, or clammy or sweaty skin alongside an infection.
Those thresholds follow the NHS dental abscess emergency list, adapted here to the United States emergency number, together with the CDC sepsis signs above. Do not drive yourself if you have breathing or swallowing difficulty: ask someone to take you, or call 911, and tell the responders you are concerned about a spreading dental infection or about sepsis.
Below that threshold, the rule is same day urgency. If you think you have a dental abscess, ask for an urgent dental appointment the same day. If you cannot reach a dentist and symptoms are worsening, use urgent care or an emergency department for assessment, while understanding that definitive treatment of an abscess is dental treatment: a medical clinician can assess spread, treat sepsis, and protect an airway, but the tooth still needs a dentist.
What Treatment Usually Involves
Treatment has one goal that matters more than any single medicine: remove the source of the infection and drain any pus that has collected. The elements, as the NHS, the American Dental Association, and MedlinePlus describe them, are:
- Examination and imaging. The dentist examines the teeth, mouth, and gums, and dental X rays and other tests can show which tooth is causing the problem and how far infection has spread.
- Drainage. A collection of pus is drained. MedlinePlus notes that a severe infection may need surgery to drain the abscess, and that some people need hospital admission.
- Treating or removing the tooth. Root canal treatment may be recommended to try to save a tooth whose pulp is infected; if the tooth cannot be saved, it is removed. The ADA lists root canal treatment among the treatments for an abscess caused by decay or a cracked tooth, alongside drainage and cleaning the space between tooth and gum where gum disease is the cause.
- Antibiotics. A dentist or doctor may prescribe antibiotics, particularly where infection is spreading or severe. Antibiotics support source control; they do not replace it. The peer reviewed review of severe odontogenic infections states the principle plainly: treating with antibiotics without intervening to remove the odontogenic cause and drain the abscess is a mistake. Antibiotics that ease pain while a decayed tooth or a retained root stays in place leave the source in place.
- Pain relief and aftercare. Painkillers may be offered for a few days after treatment. While waiting to be seen, the NHS suggests painkillers such as ibuprofen or acetaminophen as directed on the label, soft foods, a soft toothbrush, and avoiding food and drink that is very hot or very cold. Never place aspirin directly on a tooth or gum, and never try to drain a swelling yourself.
Hospital treatment of a severe, spreading infection is a different level of care, involving urgent assessment, imaging, operating room drainage where needed, airway protection, and intensive care for sepsis. That is the setting in which Williams was treated, and the aim of urgent dental care earlier is to keep an infection from ever reaching it.
Prevention: The Routine Care That Interrupts This Chain
Nothing in this section is exotic, and that is the point. The chain that ended in a medical examiner’s report began with decay and retained roots, the two most ordinary dental problems there are. The NHS prevention advice for dental abscesses is to brush with fluoride toothpaste at least twice a day, spitting after brushing rather than rinsing; to clean between your teeth every day; to replace your toothbrush every 2 to 3 months; to keep regular dental checkups so problems can be spotted early; and not to use mouthwash straight after brushing, and not to smoke.
Add the items that speak directly to this case. Have decay treated while it is still a filling sized problem, because prompt treatment of dental decay reduces the risk of a tooth abscess, as MedlinePlus puts it. Have broken or chipped teeth examined right away, because a break is an entry route for bacteria. If a tooth has broken down to the root, or a root fragment has been left behind, raise it at a checkup even if it does not hurt, and ask whether it should be removed. Our article on 5 tips for healthy teeth and gums brings the daily habits together.
If cost or access stands between you and a dentist, solve that before pain forces the issue. Ask a local clinic, a dental school, or a community health service what low cost options exist in your area, and what urgent care route they advise for facial swelling or fever with tooth pain, so you know the route before you need it. Waiting is the one option this case argues against.
Frequently Asked Questions
Did Mike Williams die from an infected tooth?
According to the Hillsborough County Medical Examiner’s initial case summary, reported by ESPN and the Associated Press in December 2023, his cause of death was bacterial sepsis with cerebral abscesses and necrotizing lobar pneumonia due to multiple dental caries and retained dental roots, with arteriosclerotic cardiovascular disease as a contributing factor, and the manner of death was natural. In plain terms, the examiner traced the fatal infection to dental decay and retained tooth roots. The summary was described at the time as initial, with a full autopsy still to follow.
Did the construction accident cause his death?
The accident is part of the verified record: heavy supplies fell on his head at a work site, he was taken to hospital the next day, and he spent three weeks in hospital and then hospice before he died. The medical examiner, however, did not list the head injury as the cause of death. The cause given was bacterial sepsis due to dental caries and retained dental roots, with cardiovascular disease contributing, and the manner of death was ruled natural. Honest reporting keeps both facts together: the accident as context, and the dental sourced sepsis as the examiner’s stated cause.
Is death from a tooth infection common?
No. It is rare. The Associated Press reported that this was the first time in Hillsborough County that a death had been attributed to this specific type of dental sepsis, and peer reviewed reviews describe severe complications of dental infection as exceedingly rare with modern treatment. The lesson is not that tooth infections are usually fatal. It is that they should not be ignored, because rare serious spread is possible and early treatment is effective.
Can antibiotics alone cure a tooth abscess?
Not reliably, because antibiotics do not remove the source. The NHS treats a dental abscess by draining the pus and then treating or removing the tooth that caused it, with antibiotics offered alongside in some cases. Reviews of severe dental infection make the same point more strongly: antibiotics without removing the dental cause and draining the abscess is not adequate treatment. If you are given antibiotics, you still need the dental appointment.
When should I call 911 for a tooth problem?
Call 911 or go to the nearest emergency department if a tooth problem comes with difficulty breathing, speaking, or swallowing; a swollen or painful eye or a sudden change in eyesight; a lot of swelling inside the mouth; great difficulty opening your mouth; or sepsis signs such as new confusion, extreme sleepiness, shortness of breath, a racing or weak pulse, or clammy skin. Below that threshold, a suspected abscess still needs an urgent dental appointment the same day.
Sources & references
- ESPN, Jenna Laine, Coroner: Ex-Bucs star Williams' death was from rare bacterial sepsis, December 22, 2023. https://www.espn.ph/nfl/story/_/id/39164580/coroner-ex-bucs-star-williams-death-was-rare-bacterial-sepsis
- Associated Press, Former NFL player Mike Williams cause of death revealed, December 22, 2023, via NBC Sports Bay Area. https://www.nbcsportsbayarea.com/news/former-nfl-player-mike-williams-died-of-dental-related-sepsis-medical-examiner-says/1684000/
- Tampa Bay 28 (WFTS), Former NFL player Mike Williams' cause of death released by officials, December 21, 2023, updated December 22, 2023. https://www.tampabay28.com/sports/former-nfl-player-mike-williams-cause-of-death-released-by-officials
- NHS, Dental abscess. https://www.nhs.uk/conditions/dental-abscess/
- MedlinePlus Medical Encyclopedia, Tooth abscess, US National Library of Medicine. https://medlineplus.gov/ency/article/001060.htm?ref=b13as9
- American Dental Association, MouthHealthy, Abscess. https://www.mouthhealthy.org/en/az-topics/a/abscess
- Centers for Disease Control and Prevention, Preventing Infections That Can Lead to Sepsis. https://www.cdc.gov/sepsis/prevention/?s_cid=GAOS-CON-OY1Q2-MT-EN-009
- Sepsis Alliance, Sepsis Information Guide: Sepsis and Dental Infections. https://www.sepsis.org/files/sig/sepsisanddentalinfections.pdf
- Neal TW, Schlieve T, Complications of Severe Odontogenic Infections: A Review, Biology, 2022, via PubMed Central. https://pmc.ncbi.nlm.nih.gov/articles/PMC9775288/
- Abed K, Paciorek M, Bursa D, Potential infection foci in the oral cavity and their impact on the formation of central nervous system abscesses: A literature review, Medicine, 2023, via PubMed Central. https://pmc.ncbi.nlm.nih.gov/articles/PMC10659677/
- Zawiślak E, Nowak R, Odontogenic Head and Neck Region Infections Requiring Hospitalization: An 18-Month Retrospective Analysis, BioMed Research International, 2021, via PubMed Central. https://pmc.ncbi.nlm.nih.gov/articles/PMC7834778/
