Ludwig’s Angina
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What is Ludwig’s Angina?
Ludwig’s Angina is a rapidly progressing, serious bacterial infection of the floor of the mouth, under the tongue, and neck spaces. It often originates from untreated dental infections in the lower molars. This condition can lead to airway obstruction, making it a medical emergency requiring immediate attention from an oral and maxillofacial surgery team.

When is Ludwig’s Angina Diagnosed?
Ludwig’s Angina may develop due to:
- Untreated dental abscesses (especially in lower molars)
- Injuries to the mouth floor
- Poor oral hygiene or immunocompromised states (e.g., diabetes)
Symptoms of Ludwig’s Angina
- Swelling under the chin and neck
- Difficulty in breathing, speaking, or swallowing
- Pain and stiffness in the neck
- Fever, drooling, elevated tongue
- A “woody” or hard feel under the jaw
What Happens Before Treatment of Ludwig’s Angina
- Immediate hospital admission
- Clinical evaluation and monitoring of airway
- Blood tests and imaging (CT scan) to assess infection spread
- Airway management if breathing is compromised
How Does Ludwig’s Angina Treatment Work?
Treatment includes:
- Airway management (may require intubation or tracheostomy)
- Surgical drainage of infected spaces
- Removal of the source, often an infected tooth
- IV antibiotics and supportive care
How Long Does Ludwig’s Angina Treatment Take?
- Hospital stay typically lasts 5-10 days
- IV antibiotics may continue for 1-2 weeks
- Full recovery can take several weeks, depending on the severity
Risks / Benefits Associated with Ludwig’s Angina
Benefits:
Prevents airway collapse and life-threatening complications
- Controls infection and restores function
Risks:
- Possible need for emergency airway surgery
- Scarring, delayed wound healing
- Risk of infection recurrence if not fully treated
Post-Treatment Care in Ludwig’s Angina
- Oral hygiene maintenance
- Antibiotics as prescribed
- Avoiding smoking or irritants
- Follow-up imaging or wound care
What Can I Expect for Recovery in Ludwig’s Angina?
Recovery is gradual; initial improvement is seen within a few days. Breathing, swallowing, and pain improve steadily. Full recovery may take 2-4 weeks.
When to Consult a Doctor for Ludwig’s Angina
Seek urgent care if you experience:
- Neck/floor-of-mouth swelling
- Difficulty breathing or swallowing
- Fever and facial pain after a dental infection
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FAQs - Ludwig’s Angina
Is Ludwig’s Angina fatal?
Yes, it can be fatal if not treated promptly. It may cause airway blockage and sepsis. Immediate medical attention is critical.
What triggers Ludwig’s Angina?
Most cases arise from untreated infections in the lower molar teeth, which spread to the floor of the mouth and neck spaces.
How is Ludwig’s Angina different from a regular dental infection?
Unlike localized dental abscesses, Ludwig’s Angina spreads quickly across tissues and affects breathing and swallowing.
Can it come back after treatment?
Recurrence is rare if the source infection is fully eliminated and proper aftercare is followed.
What is the role of an oral and maxillofacial surgeon in this condition?
They manage surgical drainage, remove infection sources, and coordinate airway support in emergency settings.
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