What is Ludwig's angina?

 Ludwig's angina is a serious and potentially life-threatening infection that affects the tissues of the floor of the mouth. It is a type of cellulitis, which is a spreading infection of the skin and subcutaneous tissues. The condition is named after Carl Friedrich Wilhelm Ludwig, a German physician who described the condition in 1836.

The infection usually starts with inflammation and infection of the submandibular salivary glands, which are located just below the jawbone but can quickly spread to the surrounding tissues, including the tongue, the floor of the mouth, and the neck.

Symptoms of Ludwig's angina can include:

  • severe pain and swelling in the jaw, tongue, and neck
  • difficulty swallowing and speaking
  • drooling
  • fever and chills
  • swollen lymph nodes in the neck
  • difficulty breathing (due to the swelling in the neck)
Ludwig's angina is considered a medical emergency, and prompt treatment is essential to prevent potentially life-threatening complications, such as airway obstruction or sepsis. Treatment typically includes antibiotics to fight the infection, along with surgical drainage of any abscesses that may have formed.

Ludwig's angina typically starts as an infection in the submandibular salivary glands, which are located just below the jawbone. However, it can also be caused by an infection in the teeth, gums, or other oral structures that spreads to the floor of the mouth.

A common cause of Ludwig's angina is a dental abscess, which is a pocket of pus that forms at the tip of a tooth's root due to a bacterial infection. Dental abscesses can be caused by untreated tooth decay, a broken or cracked tooth, or gum disease. The bacteria can spread through the bone and soft tissues of the jaw and into the submandibular space, leading to Ludwig's angina.

Another oral infection that can cause Ludwig's angina is a peritonsillar abscess (quinsy) which is a collection of pus in the tonsils caused by a bacterial infection. This abscess may spread to the floor of the mouth and also cause Ludwig's angina.

In general, Ludwig's angina is considered a rare but serious condition, and if left untreated, it can be life-threatening due to the potential for airway obstruction and sepsis (systemic infection).

The mortality rate associated with Ludwig's angina varies depending on the studies, but it ranges between 2-15%. Early recognition and intervention are critical to improve the outcome. Early identification and appropriate intervention along with the necessary care, will lower the mortality rate.

It's essential to seek professional dental help if you suspect you have a tooth infection or an abscess, or if you experience any of the symptoms associated with Ludwig's angina, such as severe pain and swelling in the jaw, tongue, and neck, difficulty swallowing and speaking, fever, and difficulty breathing.

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