Prognosis
Prognosis
Localized dental abscesses treated promptly with drainage and source control have an excellent prognosis — complete resolution within 1–2 weeks. Failure to drain is the most common reason for treatment failure; antibiotics alone without drainage rarely resolve an established abscess.
Spreading infections managed in hospital have good outcomes when diagnosed early. Predictors of poor outcome: delayed presentation (>72 hours of swelling), diabetes mellitus (3–4x higher complication rates), immunosuppression, involvement of multiple deep fascial spaces, and mediastinal extension.
Ludwig's angina mortality has improved dramatically from historical rates of 50% (pre-antibiotic era) to 2–5% with modern management, but airway loss remains the primary cause of death. Descending necrotizing mediastinitis carries 20–40% mortality despite aggressive treatment.