Some patients go to the dentist to have invasive work done and wake up with a sore, scratchy throat. This discomfort can be quite frightening, but it has harmless origins most of the time. Regardless of whether the soreness is immediate or develops in the following days, the majority of cases resolve by themselves.
Being aware of the possible causes, including swelling of the tissues and anesthesia, dry mouth, and unrelated viral infections, can help you relieve pain and know when to visit a medical professional. This article covers the reasons why the throat hurts after dental work.
Inflammation After Tooth Extraction
After a tooth extraction, especially that of impacted wisdom teeth, it is not unusual to have inflammation in the socket extend out into the surrounding tissues. This swelling may extend up to the oropharynx or even the deep neck spaces. This most often presents as soreness down the throat and swallowing difficulty, which usually reaches its peak 2-3 days after extraction and then slowly improves over a week.
In uncommon situations, the inflammation can extend to the deep cervical fascial spaces, which can cause severe complications like deep neck infections. Although rare, odontogenic infections, which start in the teeth, may be manifested by swelling, throat pain, fever, and even airway obstruction
Pain radiating to the throat and neck can also be worsened by socket inflammation, for example, dry socket or alveolar osteitis. Though not contagious, dry socket is seen mainly in lower wisdom tooth extractions and is often accompanied by throbbing pain that radiates to the ear, temple, and occasionally the throat 2-4 days following extraction.
Intubation under General Anesthesia
In cases where dental operations under general anesthesia necessitate safe airway management, the placement of an endotracheal tube, usually through orotracheal or nasotracheal intubation, may be needed. This process may accidentally traumatize throat tissues, causing postoperative sore throat (POST).
Various factors, such as cuff inflation, could lead to trauma. The resulting pressure can squeeze mucosal blood flow, injuring the lining of the trachea. Repeated or forceful attempts at insertion worsen another risk.
Surgery-related edema and mucosal trauma are potentiated in procedures such as oral and maxillofacial surgeries. Other irritants are throat packing, which is applied in dental surgery to avoid aspiration of blood and fluids. In a pediatric randomized trial, throat packs were associated with a significant reduction in postoperative nausea but a substantial increase in sore throat, affecting up to one-third of the subjects.
Typically, intubation-related sore throat usually appears soon after a person wakes up and goes away within 2-7 days. But in rare cases, chronic injury like laryngeal granulomas may develop, resulting in chronic hoarseness, cough, or sore throat.
Dental Infections or Abscesses
Sore throat following dental operations might not be necessarily due to local irritation alone—it might represent a deeper odontogenic infection, like a dental abscess. They are infections as a result of bacterial invasion of the tooth pulp or periodontal tissues. In a periapical abscess, the bacteria enter the root of the tooth, where they create a pus-filled pocket, which may cause pain in the throat and jaw. With time, swelling can spread to the nearby lymph nodes, resulting in tenderness in the neck and throat area.
Likewise, periodontal abscesses, an infection of the gum and supporting structures, may give rise to severe, throbbing pain that may refer to the throat and ear. These abscesses are fast to develop and usually need drainage and systemic antibiotics such as amoxicillin or clindamycin.
In addition to localized pus, complications arise when infection penetrates deep spaces. Many deep neck space infections, which include Ludwig angina and parapharyngeal abscesses, are caused by odontogenic infections. These are serious and life-threatening infections. An example is Ludwig angina, which may block the airway due to swelling that invades the tongue and neck. This is presented by sore throat, painful swallowing, and, in severe cases, respiratory distress.
More typical of primary care is a peritonsillar abscess, which, although occasionally connected with dental or tonsillar infections, is characterized by one-sided throat pain, a husky voice, and trismus. Dental infections, even treated ones, may spread beyond the tooth. They can begin locally as a toothache and then go on to produce prominent throat pain, swallowing problems, and systemic symptoms. Timely treatment, including drainage, specific antibiotics, and potentially hospitalization, is essential to avoid severe complications.
Dry Mouth During Treatment
Saliva is unwelcome during dental operations. To remove the excess moisture in the region under treatment, dentists often employ suction devices, rubber dams, or cotton rolls. Although this enhances visibility and accuracy, it decreases the production of saliva and causes a dry mouth, or xerostomia, instantly following. This transient xerostomia can result in an irritated, scratchy, or squeaky throat because saliva is essential in lubricating the oropharynx.
Saliva plays a critical role in the health of the mouth and throat—it keeps mucosal surfaces hydrated, washes away debris, neutralizes acids, and cushions soft and hard tissues. Its removal results in a thinning of the protective mucus layer of the throat, exposing the mucosa to friction and irritation. Dry mouth is clinically associated with such symptoms as a dry and sore throat and mild hoarseness.
Xerostomia occurrence has been reported to rise with aging because of several factors, including polypharmacy and altered salivary gland functioning. This type of post-dental dry mouth is generally temporary, lasting a few hours after treatment, but as long as the saliva production is low, the throat irritation can be more prolonged.
Patients should take frequent sips of water and suck sugar-free lozenges or gum to encourage saliva flow, and artificial saliva products may help if the dryness persists. Proper oral care also aids in preserving tissues until the saliva flow resumes its normalcy.
Irritation from Dental Tools
In dental practice, clinicians apply different instruments, including suction equipment, ultrasonic scalers, handpieces, mouth props, and rubber dams, to isolate working areas and control moisture. They are necessary to be precise, but sometimes these instruments may accidentally scratch the throat and the tissue around it.
The use of suction devices and high-speed handpieces in the vicinity of the back of the mouth can cause friction or pressure on the oropharyngeal mucosa, which the patient can experience. This touch may lead to minor trauma, making the throat sore or scratchy after the operation. Ultrasound scalers generate water-dense bioaerosols that have saliva, debris, or even fine particles of dental materials. When these aerosols are inhaled or ingested, they can cause microscopic abrasions or mild irritation of the lining of the throat.
Bite blocks or mouth props may be utilized in longer or more involved procedures, such as root canals or crown preparations, to avoid jaw fatigue. Nevertheless, the process of stretching to keep the mouth open may strain the jaw and throat muscles, resulting in muscle aches following the process. Also, rubber dams and related clamps, though infection control measures, can pinch gum or inner cheek tissue at the throat, sometimes resulting in slight discomfort or soreness.
A combination of instrument contact, extended mouth opening, and microparticle inhalation may lead to sore throat symptoms, which are usually mild and self-limiting yet can be annoying.
Local Anesthesia Draining Toward the Throat
When performing dental operations, particularly on molars or the back areas, there is a possibility that the local anesthetic injection will hit the tissues around the throat area accidentally. The pharyngeal mucosa may become numbed when an anesthetic solution penetrates outside the target region; this may occur through drip, diffusion, or volume. When the numbing wears off, patients usually feel a scratchy or sore throat in these tissues.
Moreover, topical edema may happen at the injection point and extend to the nearby areas like the tongue, pharynx, or larynx. This swelling could be due to mechanical trauma during injection, stasis caused by vasoconstrictors, or mild allergic and inflammatory reactions. This swelling, though usually short-lived—disappearing after a couple of hours—can intensify the throat discomfort as feeling returns.
Systemic absorption or misplacement into a blood vessel may cause more dramatic symptoms in rare cases, although these are unusual and usually accompanied by pain, hematoma, or transient paresthesia.
Inhalation of Debris
Aerosols and splatter, which contain microorganisms, saliva, blood, microscopic pieces of tooth, and dental restorative material, are produced during most dental procedures, including scaling, drilling, polishing, or air polishing.
The aerosol-generating instruments, such as high-speed handpieces and ultrasonic scalers, have the capability of releasing small particles (< 1.5 µm) that can stay suspended in the air for hours together and can be aspirated deep into the throat or the lungs. These microscopic bioaerosols may irritate the mucosal lining of the oropharynx, leading to slight soreness, scratchiness, or throat discomfort.
In addition to mechanical abrasion, there is also a risk of introducing bacteria or viruses into the throat by inhalation of contaminated droplets and droplet nuclei, which can cause low-level inflammation even without infection. Dental aerosols can cause respiratory symptoms, including nasal congestion, sore throat, or mild cough, in both patients and dental personnel after exposure, although severe infections are uncommon.
This is where infection control measures are essential. Research has demonstrated that high-volume evacuation (HVE) systems, rubber dams, antimicrobial mouth rinses, and adequate ventilation can significantly lessen aerosol generation and alleviate throat irritation.
Muscle Tension from Stress
The effects of stress and anxiety in dental operations are often physical, especially in clenching the jaw and hyperactivity of the muscles, which can spread to include muscles of the throat and neck. Anxiety causes unconscious bruxism, the clenching or grinding of teeth, both during the day and at night, which overloads the masticatory muscles. This stress may extend into the muscles that support the throat and cause soreness, tightness, or slight pain after the dental procedure is completed.
This connection is well seen in temporomandibular joint disorders (TMD). Emotional stress can start a vicious cycle: the anxiety causes the jaw muscles to contract, which causes pain and stiffness, which raises the stress levels and causes more tension. With time, the process may also include the muscles of the neck and throat, resulting in discomfort or soreness not only in the jaw but also in other areas.
In a 2020 observational study of dental students, it was found that elevated self-reported anxiety was substantially associated with greater masseter muscle tension, highlighting the impact of even short-term stress in dental environments on jaw muscle activity. In addition, the extended lip opening during therapy further stresses the same muscular system, increasing the chances of post-therapy soreness.
Current studies have approximated that between 10 and 20 percent of the entire world population is affected by bruxism. This condition is mainly caused by stress and can easily result in jaw pain, headaches, earaches, and muscle stiffness that radiates all the way to the throat. When unattended to, these symptoms can last a long time even after you have gotten out of the dental chair.
Allergic Reactions
Actual allergic conditions during or following dental operations are not very common; however, when they happen, they may involve the throat. The symptoms are mostly mild, but sometimes may be severe. Knowledge of these uncommon occurrences can assist clinicians and patients to be ready and know when to get assistance.
Forms of Allergens in Dentistry
Latex, local anesthetics, preservatives (sodium metabisulfite), topical esters (benzocaine), and several dental materials (resins, adhesives, impression agents) are the most frequent causes of triggers. Allergic reactions are classified into immediate (IgE-mediated) and delayed (T-cell mediated). True allergies to local anesthetics are highly uncommon, less than 1 in 1000, whereas topical anesthetics and preservatives of the ester type present a somewhat greater risk.
Incidence and Presentation
Epidemiologic studies done on a large scale affirm that fewer than 1 in every 1000 patients receiving dental anesthetics develops a veritable allergic reaction. Many so-called responses are due to anxiety or physiologic effects of vasoconstrictors, such as epinephrine, rather than to hypersensitivity.
Nevertheless, latex glove or rubber dam allergies occasionally result in itching, swelling, or throat tightness during breathing. Latex allergies are present in about 1% of the population and may cause throat symptoms such as hoarseness, wheezing, or, in severe cases, anaphylaxis.
Clinical Manifestations
Symptoms are dependent on severity and type of exposure. Mild responses are itchiness, redness, or dryness of the throat, whereas more severe manifestations can include swelling (angioedema), urticaria, wheezing, or tightness in the throat.
Ester-type topical anesthetics, such as benzocaine, have a higher potential of producing localized mucosal irritation and, infrequently, systemic reactions. Additives in the anesthetics that act as preservatives, like sodium metabisulfite, can also cause allergic reactions in susceptible individuals.
Find an Encino Dentist Near Me
Sore throat as an aftermath of a dental procedure is more likely to be a temporary and harmless condition than an indication of something more severe. The discomfort is in the majority of cases related to anticipated factors, such as inflammation of oral tissues, dehydration, or mucosal injury associated with intubation, which commonly subsides in a few days.
In uncommon cases, dental work may trigger more serious infections or allergies requiring urgent attention. Knowing all these different causes, and not only considering the throat-related ones, allows the patients to distinguish between the usual post-dental soreness and the symptoms that should be reported to the professional.
When your sore throat lasts more than a week or gets worse, or when accompanied by fever, trouble swallowing, severe swelling, or breathing issues, you should visit your dentist. Contact the Lasting Impressions Dental Spa in Encino at 818-751-5100 to determine if your sore throat is linked to dental work and receive appropriate treatment.
