Ludwig’s angina is a serious infection under the tongue caused by untreated infected teeth or mouth lesions. Swelling can cause breathing difficulties, and treatment may include antibiotics or surgery to support the airways. Proper dental care can help prevent it, and immediate medical attention is necessary.
Ludwig’s angina is an infection under the tongue in the lower part of the mouth, which can get quite serious if not treated properly. It is most often caused by not treating infected teeth in the mouth. As a result, the bacteria can spread to the tissue under the tongue. Alternatively, this area of the mouth can become infected if a lesion occurs in the mouth and is not treated with antibiotics.
The biggest danger with Ludwig’s angina is that the affected tissues will start to swell and cause the airways to become dark. This can mean that breathing is inhibited rapidly. Other symptoms that are noted with Ludwig’s angina include excessive salivation, known swelling and/or redness around the neck, neck pain, and earache. People may have a fever and some appear to be confused or have rapid mood changes. The infection can also cause flu-like symptoms and, in particular, people may feel weak, tired or very sleepy. Before swelling blocks the airways, people usually feel that breathing is more difficult and they may have difficulty getting air.
Caught in very early stages, the only treatment that may be needed is antibiotics to cure the infection, with a follow-up to treat any dental problems that may be present. Some people will need much more surgery if the swelling in the airways is so severe that breathing is labored or inhibited. There are several potential choices for airway support. A person may require intubation, the breathing tube down the throat through the mouth, or may need oxygen support with a mask or through the nose. In very severe cases, tracheostomy is needed because the swelling is too large to intubate or allow air from the mouth or nose into the lungs; tracheostomy is typically a last resort treatment and is usually removed once the infection has cleared.
Prevention of Ludwig’s angina is not always possible. It seems more common in people who have serious illnesses such as diabetes or HIV. Getting proper dental care can help minimize your risk, as it is most often due to tooth abscesses or infections. Regular dental cleanings and exams may therefore prove to be the best prevention.
Some people may wonder why Ludwig’s angina is so called, since angina is typically associated with chest pain. Angina can also mean squeezing or strangling. In the case of this disease, continuous swelling can literally strangle the patient, cutting off all the air. Those who suspect that they have this disease should definitely see a doctor immediately.
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