The Doctor Is In: How To Battle A Sore Throat

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(KPLR) - Dr. Sonny Sagger talks with Christine Buck about sore throats. The doctor explains the difference between a viral sore throat and Strep Throat. He says if the sore throat lasts more than three days, it is most likely you will need antibiotics. Dr. Sagger also suggest changing your tooth brush after a sore throat to prevent any reoccurring symptoms.

You can also connect with Dr. Sonny Saggar
via Twitter @DoctorIsInSTL
Facebook: DoctorIsInSTL

You can also connect with Dr. Saggar, the Medical Director at St. Louis Urgent Cares, and ask him any questions you like

1. What causes a sore throat?

  • common cold (viral)
  • throat irritation as a result of low humidity (dry)
  • smoking (dry)
  • air pollution (dry and dusty)
  • yelling (dry)
  • nasal drainage down the back of the throat (mucus)
  • breathing through the mouth when you have allergies or a stuffy nose. not sudden or painful; chronic mild irritation (drying up)

There are other less common causes for a sore throat, which can include strep throat, mononucleosis (otherwise known as “mono” or the “kissing disease”) or tonsillitis.

sharing saliva, coughing from another, hands touching and then touching mouth, sharing cups and spoons etc. with someone sick

2. How can you tell between a viral sore throat and a bacterial infection like Strep Throat?

Viral throat                                       Bacteria (Strep throat)

1-2 days                                          3+ days

Runny, stuffy nose                          Swollen tonsils, Lymph nodes in neck

Cough, cold symptoms                  Fever > 101

Antibiotics no help*                         Antibiotics work (PCN)

Age less than 3 years old               Known contact with strep throat

Multiple symptoms

  • Dry is bad: leads to infection!
  • Humidifier
  • Throat spray
  • Slippery Elm lozenges
  • Ibuprofen

Pus is bacterial

Red and inflamed - could be either viral or bacterial

Green mucus - could be either viral or bacterial but more often bacterial


If associated cold-like symptoms (coughing, sneezing, runny nose, stuffy nose) then it’s less likely to be a bacterial sore throat (aka strep throat) and more likely to be a viral pharyngitis.

Usually with a bacterial infection, you’ll get swollen tonsils and lymph nodes you can feel and often see on the neck.

Usually with a viral throat, symptoms last less than 3 days; with a bacterial pharyngitis, they last more than 3 days. Similarly, with a viral infection, you can get a low-grade fever, but you might suspect a bacterial infection, with a temperature over 101 F

3. Home remedies

ANTISEPTIC: salt water gargling with 8 ounces warm water. If you can get your child to do this, it works great! Gargling at least once an hour with warm salt water to reduce swelling and discomfort.

FOR THE PAIN: Anesthetic throat gargle. Chloraseptic can work well, but only if your child is old enough to not swallow it.

FOR THE PAIN: Drinking hot fluids such as tea or soup. Hot fluids soothe the throat and help thin sinus mucus. This allows better drainage and decreased stuffiness.

TO REDUCE DRYNESS: Stop smoking and avoid secondhand smoke.

HYDRATION: Adults should consider taking nonprescription medications such as Slippery elm throat lozenges; decongestants (REDUCE MUCUS); acetaminophen or even anti-inflammatory drugs such as ibuprofen (REDUCE INFLAMMATION).

Watchful waiting is appropriate if your sore throat occurs with symptoms like those of a cold such as sneezing, coughing, and a runny or stuffy nose. In general, the more cold-like symptoms you have, the less likely it is that your sore throat is caused by a strep infection. You can try home treatment if your sore throat is not severe and you have other symptoms of a cold.

4. So When are we supposed to Call the Doctor?

Do not run your child to the doctor at the first sign of a sore throat. Wait a day or two, or more if your child is not acting ill.

It’s time to see your doctor if:

  • a severe sore throat and a fever over 101 degrees lasts longer than one to two days
  • you have difficulty sleeping because your throat is blocked by swollen tonsils or adenoids
  • a red rash appears that feels like sandpaper, which could be a symptom of Scarlet Fever

Repeat bacterial throat infections within a relatively short period of time a physician may recommend a tonsillectomy

A tonsillectomy (the surgical removal of the tonsils) may also be recommended if abscesses of the tonsils do not respond to drainage; there is a persistent foul odor or taste in the mouth that is caused by tonsillitis and does not respond to antibiotics; or a biopsy is needed to evaluate a suspected tumor of the tonsil. 

A tonsillectomy should always be the last resort for treating sore throats. The best treatment for a sore throat is prevention (hydration).

Replacing your toothbrush every month and tossing an old toothbrush once you’ve recovered from a sore throat to prevent re-infection. You should also stop smoking, which can be abrasive to the throat. 

Wash your hands often, eat right and get plenty of sleep to help ward off illness

Call 911 or other emergency services immediately if a severe sore throat (pain being an 8 or 9 on a scale of 1 to 10) occurs along with the following symptoms, especially in a small child:

  • Drooling
  • Difficulty breathing
  • Head pushed forward to breathe

Call a doctor if the following symptoms develop 1 to 2 weeks or longer after a strep throat infection. These symptoms may indicate rheumatic fever.

  • Weakness
  • Shortness of breath
  • Joint pain
  • Raised red rash or lumps under the skin
  • Uncontrolled, jerking movements of the arms or legs

Call a doctor if:

  • Sore throat is the main symptom and you have no improvement after 2 to 3 days.
  • Signs of strep throat are present.

Whom to See

The following health professionals can evaluate a sore throat, do quick tests or throat cultures, and prescribe antibiotic treatment if needed:

  • Pediatrician
  • Family doctor
  • Nurse practitioner
  • Physician assistant
  • Internist
  • Otolaryngologist (ear, nose, and throat specialist)

If surgery to remove chronically enlarged or infected tonsils or adenoids is suggested, you may be referred to an otolaryngologist.

5. How long is someone contagious from a sore throat?

For strep throat treated with antibiotics, your child is no longer contagious after 24 hours of antibiotics (it used to be 48 hours, but was recently changed to 24 hours).

For viral sore throat, your child is no longer contagious once he has been fever free for 24 to 48 hours (without any medication to hide the fever).

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