Odontogenic Infections & Fascial Spaces
Dental infections can spread along fascial planes; knowing the dangerous spaces is high-yield.
Key Entities
- Ludwig's angina — bilateral cellulitis of the submandibular, sublingual and submental spaces; firm 'woody' floor of mouth, raised tongue; the dreaded complication is airway obstruction.
- Canine space infection — can spread via the angular vein to the cavernous sinus (cavernous sinus thrombosis — a danger zone of the face).
- Buccal, masticator, pterygomandibular, lateral pharyngeal spaces also involved depending on source tooth.
Management
Secure airway, incision & drainage, remove the source, and appropriate antibiotics (amoxicillin ± metronidazole, clindamycin if penicillin-allergic).
Exam Tips ⭐
Ludwig's angina = bilateral submandibular+sublingual+submental; airway is the priority; canine space → cavernous sinus.