Thomas R. Flynn, DMD



The incidence, severity, morbidity, and mortality of odontogenic infections have declined dramatically over the past 60 years. In 1940 Ashbel Williams published a series of 31 cases of Ludwig’s angina in which 54% of the subjects died. Only 3 years later, he and Dr. Walter Guralnick published the first prospective case series in the field of head and neck infections, in which the mortality rate of Ludwig’s angina was reduced to 10%.2 This dramatic reduction in mortality from 54 to 10% was not due to the first use of penicillin in the treatment of these infections. Rather, Dr. Guralnick applied the principles of the initial establishment of airway security, followed by early and aggressive surgical drainage of all anatomic spaces affected by cellulitis or abscess. Since then, with the use of antibiotics and advanced medical supportive care, the mortality of Ludwig’s angina has been further reduced to 4%.

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