Bacteria from an abscessed tooth or a mouth injury can cause Ludwig’s angina. This rare type of cellulitis can spread quickly to your tongue and neck. Swelling can occur that cuts off breathing. This is a life-threatening emergency. Most people recover with antibiotics and surgery to drain the abscess. Rarely, the condition is fatal.
Ludwig’s angina is a bacterial infection (cellulitis) that affects your neck and the floor of your mouth. It is not contagious. It typically starts from a tooth infection (abscessed tooth). This rare type of cellulitis can spread rapidly, causing life-threatening swelling that can affect your ability to breathe.
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The condition gets its name from German physician Wilhelm Friedrich von Ludwig who first described it in 1836. It goes by both Ludwig’s angina and Ludgwig angina. Healthcare providers also call it “sublingual space infection” and “submandibular space infection.” These terms all refer to the same condition.
The infection affects the:
An abscessed tooth (tooth infection) causes Ludwig’s angina. In 9 of 10 cases, the infection starts in the second or third molar in your lower jaw.
You may be more prone to Ludwig’s angina if you have:
Symptoms of Ludwig’s angina include:
An untreated infection can lead to life-threatening sepsis. As swelling worsens and breathing becomes more difficult, these complications may also occur:
These symptoms indicate a medical emergency, requiring immediate care. Call 911.
Your healthcare provider can diagnose Ludwig’s angina based on your symptoms. You may also get a CT scan.
For initial symptoms like toothache, you may see a dentist. In an emergency situation, you need to go to a hospital emergency department.
When detected early, IV antibiotics can clear up the infection. When swelling becomes life-threatening and affects your ability to breathe, you’ll need:
Good oral hygiene and regular dental check-ups can prevent the tooth infections that cause Ludwig’s angina. Don’t delay in seeking treatment for toothaches, mouth sores and other oral problems.
With fast treatments of antibiotics and surgery, most people survive Ludwig’s angina. About 8% of people who develop the infection die from the swelling and lack of oxygen (asphyxiation).
If you have trouble breathing or swallowing, call 911 to get immediate medical care. You should call your healthcare provider if you have:
You may want to ask your healthcare provider:
A note from Cleveland Clinic
Bacteria from a tooth infection can spread quickly when you have Ludwig’s angina. Proper brushing and flossing can help prevent this rare type of cellulitis. You should see your healthcare provider anytime you have a toothache, oral injury or facial swelling. If you find yourself struggling to breathe or swallow, seek medical attention immediately. With antibiotics and surgery to drain the abscess, most people recover. Without fast treatment, Ludwig’s angina can be fatal.
Last reviewed by a Cleveland Clinic medical professional on 07/01/2022.
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