An upper gastrointestinal endoscopy (EGD or gastroscopy) uses a flexible tube with a camera to examine the lining of the esophagus, stomach, and the first part of the small intestine. To ensure a clear view and reduce the risk of aspiration (inhaling stomach contents) during sedation, the stomach must be completely empty. This strict requirement often leads patients to question whether brushing their teeth is permitted during the mandated fasting period.
Is Brushing Your Teeth Permitted?
You are generally permitted and even encouraged to brush your teeth the morning of your endoscopy. Maintaining good oral hygiene is not considered a violation of the fasting protocol. The act of brushing does not introduce food or significant liquid into the stomach. The primary concern is the total absence of solids and liquids in the digestive tract, which minimizes the risk of complications during sedation.
The allowance to brush is based on the understanding that only negligible amounts of toothpaste and water will be ingested if proper technique is used. Brushing is a simple way to increase comfort and cleanliness without compromising the integrity of the fast.
Safe Brushing Techniques and Rinsing Rules
The most important rule when brushing is to avoid swallowing any water or toothpaste residue. Use a minimal amount of toothpaste, or choose to brush with a dry or lightly dampened brush only. Use only a small sip of water to wet the brush, and take care to spit out all remnants, ensuring no liquid travels down the esophagus.
The goal is to physically clean your mouth without introducing any volume into your stomach. Medical facilities typically advise against using mouthwash entirely. Many commercial products contain alcohol or sugar, which can stimulate digestive processes or technically break the fast. These substances could also be ingested accidentally.
Maintaining the Fast: Other Oral Restrictions
Patients must remain vigilant about other common oral habits that can inadvertently stimulate the digestive system and compromise the fast. Strictly avoid chewing gum, breath mints, hard candies, or lozenges in the hours leading up to the endoscopy. The mechanical action of chewing or sucking stimulates the production of digestive juices, including saliva and stomach acid, which can be problematic during the procedure.
For patients with removable dental appliances, such as dentures, partial plates, or retainers, specific instructions apply. You may wear these items to the hospital or clinic, but they must be taken out immediately before the procedure begins. This step is necessary to prevent them from becoming a choking hazard once sedation takes effect and to ensure a clear pathway for the endoscope.