Salt Water Gargle for Sore Throat: How to Do It and When It Helps

Quick answer

Gargling with warm salt water is a simple, inexpensive way to soothe a sore throat. The NHS includes it in its self-care advice for adults with a sore throat. The relief is temporary, and gargling does not cure the infection, but it can make swallowing more comfortable.

A few studies suggest regular gargling (with water or salt water) might reduce the chance of getting colds or shorten them slightly, but this research is limited. Gargling is not suitable for young children, who may swallow the water.

Why it might help

Salt water may ease a sore throat in a few ways:

• Drawing fluid out of swollen tissue. A salt solution can pull excess fluid from inflamed throat tissue, which may reduce swelling and discomfort for a while.
• Loosening mucus so it is easier to clear.
• Rinsing away irritants and some of the viruses and bacteria on the surface of the throat.
• Warmth itself is soothing for many people.

What the research says

• A 2005 Japanese randomised trial of nearly 400 healthy adults found that people who gargled plain water three times a day had about a third fewer upper respiratory infections over 60 days than those who didn't gargle. Gargling with an antiseptic solution didn't do better than water.
• A 2019 Scottish pilot trial (ELVIS) found that people who started salt-water nasal rinsing and gargling early in a cold had colds that were about two days shorter, used fewer medicines, and were less likely to pass the infection on to household members. This was a small study and needs confirmation.
• There are few trials of salt-water gargling for sore throat pain specifically, but it is low-risk and widely recommended for comfort.

How to gargle with salt water

1. Mix the solution. Dissolve half a teaspoon of salt (about 2.5 to 3 grams) in one cup (about 240 ml) of warm water. The water should be comfortably warm, not hot.
2. Take a mouthful, tilt your head back, and gargle for about 30 seconds, making an "ahh" sound to move the water around the back of your throat.
3. Spit it out. Don't swallow it.
4. Repeat with the rest of the cup.
5. Do this several times a day, for example every 3 to 4 hours, as needed.

Other things that help a sore throat:

• Drink plenty of fluids, especially warm drinks and cool water
• Suck lozenges, ice chips or ice lollies (adults and older children)
• Take paracetamol or ibuprofen if needed, following the label
• A spoonful of honey for adults and children over one year
• Rest and avoid smoking or smoky environments

Possible side effects

Salt-water gargling is very safe for most people. Possible issues:

• Swallowing too much salt water can cause nausea and, rarely, is a concern for people who need to limit salt (such as some people with heart failure or high blood pressure). Spit the water out.
• Using too much salt can irritate or dry the throat. Stick to half a teaspoon per cup.
• Very hot water can scald the mouth and throat.

Who should be careful

• Young children who cannot gargle and spit reliably
• People who have trouble swallowing or a high risk of choking
• People on a strict salt-restricted diet should be especially careful to spit out the solution

When to see a doctor

Most sore throats are caused by viruses and get better within a week without antibiotics. See a doctor if:

• Your sore throat lasts more than a week or keeps coming back
• You have a high fever (above 38.5 °C), or fever lasting more than three days
• You have white patches or pus on the tonsils with fever and swollen, tender neck glands, especially without a cough, which can be signs of strep throat that may need antibiotics
• You have a weakened immune system, for example due to chemotherapy or certain medicines
• You develop a rash with your sore throat
• Pain is mostly on one side, with difficulty opening your mouth or a muffled voice, which can be a sign of an abscess

Get emergency help if you or your child has:

• Difficulty breathing, noisy breathing, or drooling and unable to swallow saliva
• Severe swelling of the throat or tongue
• A stiff neck with fever and headache

Frequently asked questions

How often should I gargle with salt water?

Every three to four hours while your throat is sore is reasonable. There's no strong evidence for a specific number of times.

Is sea salt better than table salt?

No. Any salt works. Iodised table salt is fine.

Can I add baking soda or honey?

Some people add a quarter teaspoon of baking soda, which is generally safe. Honey is better taken by mouth than gargled, as it's swallowed to coat the throat.

Does salt water kill bacteria in the throat?

Salt water may reduce the number of germs on the surface briefly, but it doesn't cure an infection. Strep throat, for example, may need antibiotics.

References

• NHS. Sore throat. https://www.nhs.uk/conditions/sore-throat/
• Satomura K, et al. Prevention of upper respiratory tract infections by gargling: a randomized trial. American Journal of Preventive Medicine, 2005.
• Ramalingam S, et al. A pilot, open labelled, randomised controlled trial of hypertonic saline nasal irrigation and gargling for the common cold. Scientific Reports, 2019.
• National Institute for Health and Care Excellence (NICE). Sore throat (acute): antimicrobial prescribing, guideline NG84. https://www.nice.org.uk/guidance/ng84