Wisdom tooth extraction is a common oral surgery procedure that requires careful preparation to ensure patient safety and a successful outcome. Adherence to all pre-operative instructions provided by the surgeon is extremely important, especially since the procedure often involves intravenous sedation or general anesthesia. Understanding the rules surrounding eating, drinking, and hygiene helps minimize risks associated with the anesthesia process. These guidelines are designed to make the extraction as safe and comfortable as possible.
Oral Hygiene Rules on Surgery Day
The query of whether you can brush your teeth before getting wisdom teeth out has a specific answer: yes, but with limitations. Maintaining good oral hygiene is generally encouraged on the morning of the procedure to help reduce the bacterial load in the mouth before surgery. This simple step can contribute to a lower risk of infection following the extraction.
However, the brushing technique must be modified to prevent swallowing anything, which directly relates to the fasting requirements. You should brush your teeth gently, using a minimal amount of toothpaste. You must spit out all the paste and water without swallowing any of it. Aggressive rinsing or swishing is discouraged, as it can be difficult to control and may lead to inadvertent ingestion.
Flossing is typically permitted, following the same strict rule of not swallowing any water or residue. Conversely, most surgeons advise against using commercial mouthwash on the day of surgery. Many contain alcohol or other agents that could potentially interfere with the procedure or healing process. If you are unsure about any hygiene product, confirm with the surgical office beforehand.
Mandatory Fasting and Anesthesia Safety
Fasting, known medically as Nil per os (NPO), is a non-negotiable instruction that takes precedence over nearly all other pre-operative concerns. For procedures involving deep sedation or general anesthesia, patients must abstain from all food and liquid for a specific period before the scheduled appointment. This fasting period is usually eight hours for food, but can range from six to twelve hours depending on the surgeon’s protocol.
The stringent requirement for an empty stomach is directly tied to the risk of pulmonary aspiration during anesthesia. When a patient is sedated, the body’s protective reflexes, such as the gag reflex, are temporarily suppressed. If there is food or liquid in the stomach, it can be regurgitated and then inhaled into the lungs, causing a severe and potentially life-threatening condition called aspiration pneumonitis.
Even clear liquids, including water, must be stopped, often six to eight hours before the procedure. Some practices allow a small amount of clear fluids up to two hours prior. If a patient fails to adhere to the NPO rule, the surgery will be postponed to protect their safety from this serious complication. Patients who take daily medications are often instructed to take them with only the smallest sip of water possible, after confirming this with their surgical team.
Essential Pre-Surgery Logistics
Beyond the rules for eating and hygiene, several logistical steps are necessary to prepare for the day of the procedure. Due to the effects of sedation, a responsible adult must be arranged to drive the patient to the office, remain there during the surgery, and transport them home afterward. The patient will be unable to safely operate a vehicle for at least 24 hours following the administration of anesthesia.
Patients should wear loose-fitting, comfortable clothing, ideally a short-sleeved shirt to allow easy access for an intravenous (IV) line. It is also necessary to remove all jewelry, contact lenses, and excessive makeup or nail polish before arriving. Items like nail polish can interfere with the function of monitoring devices, such as the pulse oximeter, which measures blood oxygen levels during the surgery.
A final preparatory step involves reviewing all prescribed medications with the surgeon, including which ones to take or avoid before the procedure. Having a recovery area set up at home, stocked with soft foods and ice packs, allows for a smoother transition immediately following the extraction.