Thank you. Yours is a great response as well. It adds so much perspective for us (without medical knowledge) who aren’t really exposed to cases and outcomes albeit reading online articles without much context. My question was indeed very ingenuous and honest after reading some nasty cases which required amputation. So, if other areas can be exposed to Strep A and develop necrotizing fasciitis, I wondered why wasn’t the mouth where the bacteria lives more prone to infections. I think I know have a clear understanding thanks to both of you.

This is an excellent explanation and what I was looking for. I did a little research before asking out of curiosity and was shocked by the antibacterial properties of the saliva and the continue blood flow in the mouth to cauterize quickly any lacerations which explains why it’s difficult for the bacteria to thrive if there is a constant flow of white cells. The only cases I found where strictly related to ludwig angina after tooth extractions on people with existing comorbidities such as diabetes or a terminal deseas like cancer where the immune system is somehow compromised. Thanks for the reply.

Not sure I understand your point. Strep A can cause necrotizing fasciitis usually in other parts of the body when it enters the blood stream. However, cases of necrotizing fasciitis in the face and neck are very rare (albeit necrotizing fasciitis is extremely rare already). The only cases reported where due to dental infections and ludwig angina. So, my question is if the bacteria is on our throats (there are silent carriers) and we have lacerations in our mouth where the bacteria could enter the blood stream, why isn’t it more common? The only explanation I found is the saliva and the blood flow in the mouth to quickly cauterize any laceration in the mouth.