Ludwig’s angina is a serious inflammatory condition most commonly seen in young men. If left untreated, it can lead to dangerous complications, which is why early diagnosis and prompt treatment are essential. But what exactly is Ludwig’s angina, also known as submandibular space infection or oral floor phlegmon? What causes it, what are its symptoms, and how can it be treated or prevented? And how does it affect oral health? You’ll find all the answers here.
Causes of Ludwig’s angina
Ludwig’s angina is a deep-tissue infection of the floor of the mouth, most often caused by gram-negative and anaerobic bacteria. In many cases, the pathogens involved are part of the body’s natural oral flora, which can become harmful when the immune system is weakened.
Fungi may also play a role. A common trigger for Ludwig’s angina is untreated tooth decay, which creates a breeding ground for harmful bacteria that may spread to the soft tissues or enter the bloodstream. Other potential causes include complications after tooth extraction, periodontitis, tongue injuries, or infections of the salivary glands and tonsils.
Symptoms of Ludwig’s angina
Typical signs include:
- Chills
- Excessive salivation
- Trismus (jaw stiffness)
- Headaches
- Fever
- Speech difficulties
- Trouble swallowing
- Swelling and restricted movement of the tongue
- Tongue protrusion upward and forward
- Breathing difficulties due to swelling
- Submental or sublingual abscess
- Hard swelling under the mouth and redness of the skin
Treatment of Ludwig’s angina
The method of treatment depends on how advanced the infection is when the patient presents for care. However, a confirmed diagnosis is always an indication for immediate hospitalization.
Treatment typically starts with intravenous antibiotics, including penicillin and metronidazole. Any pus pockets must be surgically drained, either through incisions in the oral floor or externally near the submandibular area, depending on where the infection is located. In some cases, intubation may be necessary due to compromised breathing from tissue swelling. Additional supportive measures include IV hydration and parenteral nutrition.
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Preventing Ludwig’s angina
This condition can lead to serious systemic complications, so early intervention is key. If you experience symptoms like swelling, difficulty swallowing, or pain in the floor of the mouth, seek medical attention immediately.
Preventive steps include:
- Treating decayed teeth as soon as possible
- Monitoring wound healing after dental procedures
- Consulting your dentist if you have bleeding gums, gum recession, or tooth sensitivity, as these may be signs of periodontal disease, which increases the risk of deep oral infections
Ludwig’s angina may not be common, but its impact on the body can be severe. Proper oral hygiene, timely dental care, and attention to symptoms can significantly reduce your risk.
