Ludwigs Angina

[AnginaJoe]

I have just had a root canal on monday. I was in severe pain with #18 molar that had a deep filling performed last April. I also had severe ear pain. After the root canal was done and the pain medication wore off again I was in severe pain. My tounge started to swell on the side of the root canal.Upon waking my tounge had swollen enough to affect my speach.  I went to see my endodontist on Tuesday. He examined me said facinating I've never seen this before and prescribed Amoxicillen. Last night I again experienced pain in my ear, falling asleep between 12am & 2am. I awoke with no pain in my ear but a bitter burning in my mouth. the burning sensation was so strong it took 4 tums to neutralize it. I also beleave that # 19 may also be compromised. I have researched Ludwigs Angina and appear to have many of the symptoms. elevated tounge, some neck swelling, pain under my chin adjacent to the root canal & sore throat. Now this burning sensation. I have a call into my endodontist. Any insight is appreciated.

[DrMichael]

Hello.
The bitterness and yucky taste sounds like you had a little gastrointestinal reflux issue that night, which is not directly related to your dental work.

The swelling and tenderness is normal after a root canal.  I have had three root canal proceedures myself, and swelled up (including the tongue) with all of them.

If you are experiencing very sharp, intense pain that comes and goes, you may have an air bubble in one of the roots.  It will go away, but it is bothersome until it does.  

If you have abnormal redness inside the mouth, or a noticable red or dark area on the gums, you probably have an infection, possibly released by the root canal proceedure, as many such proceedures are the result of an abcess.

It seems prudent to me that a good dentist or endodontist would have put you on Ciprofloxacin or some other broad spectrum antibiotic as a prophylactic measure, concurrent with or in advance of the root canal proceedure.

As far as Ludwig's goes ... it's pretty rare.  If it's NOT Ludwig's, the Amox. and a little time should resolve your issues.  If it is, a few days of careful patience will not make things worse.

I expect yor comfort will greatly improve over the next 72 hours.

[mike1105]

i'd see an oral surgeon in this case-- no doubt. ask for a referal from your dentist.

[Jerome Bogin, D.D.S.]

Any swelling is serious and should be monitored closely--Ludwigs Angina is very serious and you need to be seen by your dentist or an oral surgeon.