Warning Signs Of Ludwig's Angina

February 7, 2024

Ludwig's angina, which is considered to be a form of cellulitis, or severe diffuse irritation or inflammation of the sublingual space or the sub-mandibular space, can be life-threatening. Ludwig's angina primarily affects the soft tissues of the floor of the mouth and the neck. Usually, the infection that causes Ludwig's angina begins in the lower second and third molars. The majority of Ludwig's angina cases are caused by Bacteroides bacteria, Staphylococcus bacteria, and Streptococcus bacteria. The main dangers that present with Ludwig's angina are the whole or partial obstruction of the airways. Before there were significant findings of antibiotic infection control, about half of all patients who had Ludwig's angina died from the blockage of the airway. Reveal the warning signs of this condition now.

Swollen Tongue

A swollen tongue is a common occurrence with Ludwig's angina, because the infection origin is within close proximity to the tongue itself. The progression from the mandibular molars or rearmost molars to the hypopharyngeal and sublingual regions will cause the swelling of the tongue. Usually, a swollen tongue can be felt easily, but sometimes the way an individual's voice sounds can indicate swelling. When an infection has spread to the base of the tongue, the area usually becomes very inflamed and makes it hard to eat and swallow due to swelling. Swelling occurs in body tissues because of the inflammatory response the body has. The dilation of blood vessels and the increase in permeability of the vessels allows for better blood flow and a supply of white blood cells, fluid, and proteins to the infected tissues. This is why with Ludwig's angina, the tongue can increase in general size and occupy more of the mouth as the infection moves into and past that area of the lower oral cavity.

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Neck Swelling Or Redness

When an infection of the lower back molars travels down into the gums and past the base of the mouth, it can continue to spread into the tissues of the neck. The same swelling process that happens to the tongue will also happen with the neck, but on a much bigger scale. The blood vessels involved in the inflammatory response to the infection in the sublingual, submandibular, and sub-maxillary spaces are larger and have more surface area. This means when they dilate and allow increased permeability, there is going to be more fluids or more edema, white blood cells, and proteins moving out of the vessels and into the infected tissues of the neck. Neck swelling or redness is almost always physically noticeable, and often will be the symptom that will push individuals to seek medical treatment. Swelling of the neck causes problems with jaw movement, chewing, swallowing, and breathing. Untreated Ludwig's angina can lead to a life-threatening airway obstruction that can cause death from the lack of oxygen delivery to the brain and heart.

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Speech Difficulties

Speech difficulties are a common occurrence in individuals who have Ludwig's angina. There are several reasons why speaking would be difficult or even impaired as a result of Ludwig's angina. The first would be the displacement of the vocal cords and pathway of which sound travels out of the throat and mouth due to excessive swelling in the mouth, jaw, throat, and neck. Often times the sound that comes out is very abnormal and mumble-like or garbled. If the infection has spread into the area where the vocal cords are contained, paralysis of the vocal muscles can occur, resulting in major problems with speaking function. There are also complications with speech that occur because of an indirect effect on the mechanism of physical speech. The swelling of the neck, throat, tongue, and mouth can cause significantly reduced airflow to the lungs, which ultimately will result in reduced oxygen levels in the blood. With reduced oxygen, the blood being pumped to the brain does not provide sufficient oxygen to the vital brain tissues. This results in hypoxia, causing disorientation and confusion. This confusion often times can cause an individual to say things that don't make logical sense, making verbal communication a challenge.

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Infections of the back molars can cause very intense pain. The pain from the infection and the swelling of the area around the infected molar can radiate, or work its way up, to the ear area. This might cause an individual to think they actually have an ear infection when the infection has not yet spread into the ear. On the other hand, Ludwig's angina can also produce earache pain from the inflammatory swelling response the body has to the infected areas of the head and neck. The excessive swelling puts significant pressure on parts of the inner ear, and this alone can cause pain in and around the ear. The increased pressure from the swelling also has the potential to partially or fully obstruct some of the inner ear canals, and fluids or water can get trapped in the obstructed canal. While Ludwig's angina is caused by a tooth infection itself, it can also result in the development of an inner ear infection due to the combination of excessive swelling and anatomical location relativity. As a result of an inner ear infection that has developed from these mechanisms, an individual will experience pain in the ear.

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Fever Or Chills

A fever is characterized by a body temperature exceeding 98.6 degrees Fahrenheit. Most of the time a fever or chills are attributed to the immune system's response to bacteria and viruses. When the body detects an infection, one of its first defense mechanisms is to raise its overall temperature in an attempt to kill the invading virus or bacteria. The viruses and bacteria that cause infections tend to be sensitive to temperature, making a fever the ideal immune response to inhibit further growth of them. Allowing a fever to be present can help the body fight off the infection causing Ludwig's angina, however, sometimes the body produces a fever that is high enough to damage its own functions. In addition, a high temperature can cause different reactions in each individual that can be uncomfortable and lead to further complication, such as excessive vomiting. The chills associated with Ludwig's angina happen because an individual with a high temperature is going to feel like everything around them is very cold because the individual is very hot. Chills are a physical reaction to this type of temperature sensitivity.

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