A wisdom tooth extraction is a common procedure requiring specific pre-operative instructions. Preparing for this type of oral surgery means understanding the proper steps to take on the morning of the procedure. The guidance provided by the oral surgeon is designed to ensure both the success of the surgery and the patient’s safety, particularly concerning anesthesia. Clarifying these rules helps prevent unnecessary stress and last-minute delays. This article details precise oral hygiene methods, explains fasting restrictions, and provides a readiness checklist for the day of your surgery.
Oral Hygiene Guidelines for Surgery Morning
The answer to whether you can brush your teeth is a definitive yes, but with important modifications. Good oral hygiene is encouraged because a clean mouth reduces the overall bacterial load, which helps minimize the risk of post-operative infection. However, the act of cleaning must be separated from swallowing, which is strictly prohibited due to anesthesia protocols.
To safely clean your teeth, use a soft-bristle toothbrush and a minimal amount of toothpaste. Gently brush all surfaces of the teeth, gums, and tongue, focusing on mechanical removal of plaque. The most critical step is managing the toothpaste and water: you must meticulously spit out all residue and avoid swallowing any water or foam.
Flossing is generally safe to perform. Many surgeons advise against using traditional mouthwash, especially those containing alcohol, as these can irritate the mouth or be inadvertently swallowed. If a mouth rinse is used, it should be a mild, non-alcoholic variety, and the patient must let the rinse passively fall into the sink rather than spitting forcefully. Always confirm with your surgeon if they have specific restrictions on pre-operative flossing or mouthwash use.
Understanding Anesthesia Safety and NPO Rules
Strict limitations on swallowing relate directly to the use of IV sedation or general anesthesia, common for wisdom tooth removal. These methods temporarily depress the body’s protective reflexes, including the gag reflex and the ability to cough effectively. The primary concern is pulmonary aspiration.
Pulmonary aspiration occurs when stomach contents, such as food, liquid, or stomach acid, enter the lungs. If the stomach is not empty, muscle relaxation during anesthesia can cause contents to be regurgitated and inhaled. This can lead to severe respiratory distress, pneumonia, or potentially life-threatening complications. This risk makes the rule of NPO (nil per os, or “nothing by mouth”) non-negotiable.
For most patients, the cut-off time for food and non-clear liquids is eight hours before the scheduled arrival time. Some protocols allow clear liquids, such as water or apple juice, up until two to four hours before the procedure. Always strictly follow the specific fasting instructions provided by your oral surgeon, as these are tailored to your safety. Taking routine medications with only a tiny sip of water is usually the only exception, but this must be explicitly approved by the surgical team.
Essential Pre-Operative Checklist
Beyond oral hygiene and fasting, several logistical and physical preparations must be completed before arriving. A responsible adult must accompany the patient, remain in the office for the entire procedure, and drive the patient home afterward. Due to the effects of sedation, patients cannot drive or operate machinery for a full 24 hours following the surgery.
Clothing and Personal Items
Patients should wear comfortable, loose-fitting clothes. A short-sleeved shirt is specifically requested so the sleeves can be rolled up past the elbow to easily allow for the placement of an IV line and monitoring equipment. Jewelry, including all piercings, must be removed. Patients should also avoid wearing makeup, especially eye makeup, and nail polish.
These external preparations are necessary because makeup and nail polish can interfere with monitoring devices, such as the pulse oximeter, which measures blood oxygen saturation. Required documentation, such as insurance cards, identification, and payment, should be organized ahead of time for a smooth check-in process. Any prescribed pre-medication, such as antibiotics, should be taken exactly as instructed by the surgeon, using only the smallest necessary sip of water.