Mouth and Throat Care After Surgery

Having surgery can cause issues with the mouth and throat, especially in the days immediately following surgery.  You may wake up from surgery and find that your throat is sore or even feeling raw, and your mouth may be dry.  Some even find that they have bad breath after surgery.  Don’t worry, this things are easily remedied and often pass very quickly with minor interventions.

Why Are My Lips, Mouth and Throat a Mess After Surgery?

Surgery, especially general surgery, can cause some serious irritation in and around your mouth and even in your throat.

  There are several reasons for this.  The first reason is that general anesthesia requires that a patient be intubated and placed on a ventilator.  This is typically done immediately after sedation is given, and the surgery begins immediately after the patient is placed on the ventilator.  

While the breathing tube remains in place, the mouth is partially open and typically very dry.  While you are awake, your saliva is constantly coating your mouth and keeping it moist, but the placement of a breathing tube means that your mouth, teeth and gums are often very dry.  

In addition, the breathing tube is resting in your mouth, extending into your throat and into your windpipe.  This foreign object in your mouth and throat can be very irritating to sensitive tissues, even though you are not awake and aware of it.  

Your lips may also suffer. It is very common to come out of surgery with chapped lips, that feel dry and irritated.

  This can be from having your mouth open during surgery, or from the tape or straps used to keep the breathing tube securely in place.  

Who is At Risk For Sore Throat After Surgery?

Patients who have general anesthesia are at the highest risk for sore throat after surgery as they will have a breathing tube that has the potential to irritate the throat.

  Women are more likely than men to have an issue, possibly because women have a smaller airway then men, so the breathing tube is more likely to rub against sensitive areas of the throat. The size of the breathing tube, which is something that patient has no control over, can also influence the likelihood of sore throat as larger bore tubes are associated with increased frequency of postoperative sore throats. 

Dry Lips After Surgery

Dry lips are easily fixed.  If your lips are very dry or scaly feeling, start with a gentle scrubbing with a moist washcloth to remove any dead skin.  After that, a generous application of lip balm or even Vaseline will help soften and return your lips to their normal state.  Frequent reapplication, along with drinking ample fluids, should return your lips to their normal state quickly.

General Mouth Care After Surgery

Good mouth care after surgery is especially important for the patients who remain on the ventilator after surgery, rather than being extubated (having the breathing tube removed) immediately after surgery.

  For patients on a ventilator, mouth care may be performed as often as every 2 hours, as this is known to help Ventilator Acquired Pneumonia (VAP).  

Good mouth care is important for patients who are not on the ventilator as well.  After surgery, a thorough brushing of the teeth, gargle with mouthwash and brushing of the tongue with a toothbrush can help return your mouth to its normal state quickly. 

Sore Throat After Surgery

A sore throat is a very common issue after surgery, and usually passes within a few days.  Longer surgeries typically cause a more irritated throat as the breathing tube is in place longer for these procedures.  Start with mouth care as described above, with a good brushing of your teeth and tongue.  Once you have done that, lozenges, particularly those with Benzocaine as an ingredient, can help soothe the throat as well as numb it slightly.  Throat spray, such as Chloraseptic, can also coat the throat and help minimize irritation.  

This type of sore throat should only last a day or two, and should be notably improved from day to day.  A sore throat that does not improve should be examined, as another problem, such as strep throat, could potentially be present.  

Bad Breath After Surgery

Saliva does the heavy lifting when it comes to minimizing bacteria in your mouth.  When your mouth is dry for an extended period of time, such as during surgery, bacteria can multiply rapidly and make for some seriously stinky breath.  This usually passes after a good brushing, but may linger for a day or two for some.  Mouthwash is the quickest way to get rid of any extra bacteria that may be present.  

Bad breath can also be caused by some medications used after surgery that tend to dry out the mouth. Rinsing your mouth frequently with water, even if you don't swallow, can be helpful. 

Losing Your Voice After Surgery

Most people may be a bit hoarse after general anesthesia, but don’t actually lose their voice like a true case of laryngitis.  Any hoarseness that you experience after surgery should show significant improvement in the first few days after surgery.  The breathing tube does cause irritation to the throat, which results in a sore throat and some hoarseness, but damage to the vocal cords is a rare complication.  

Hoarseness that shows no signs of improvement, worsens over the days following surgery, or a loss of the ability to speak should not be ignored in case a vocal cord injury has occurred. In some cases, an ear, nose and throat specialist may be appropriate. 

Source:

Postoperative sore throat: cause, prevention and treatment. Anaesthesia. Accessed May, 2015.  http://onlinelibrary.wiley.com/doi/10.1046/j.1365-2044.1999.00780.x/full