Wisdom teeth removal is a common outpatient surgery, typically performed under intravenous sedation or general anesthesia. The strict nature of pre-operative rules often leads to anxiety and clarification questions about natural bodily functions. Adherence to these guidelines is important for both the procedure’s success and your safety. Following the directions provided by your surgical team is the best way to ensure your procedure proceeds as scheduled and without complication.
Swallowing Saliva: The Direct Answer
The answer to whether you can swallow your saliva before wisdom teeth removal is yes; this is completely permissible and expected. Saliva is an internal bodily fluid that your glands produce continuously, which your body naturally manages through swallowing. Fasting concerns relate exclusively to the external intake of food and liquids. The small, continuous volume of saliva and mucus that enters your stomach is not considered a violation of the fasting rules. Attempting to constantly spit out saliva is not recommended and would only cause unnecessary stress before the procedure.
Understanding Pre-Operative Fasting Guidelines
The rules for fasting, known as NPO (Nil per os), focus on restricting what you consume externally. Generally, solid food and non-clear liquids must be stopped about six to eight hours before the procedure, as these items take the longest time to leave the stomach. This category includes milk, cream, juice with pulp, and any solid meal.
Current guidelines from organizations like the American Society of Anesthesiologists (ASA) allow for some intake of clear liquids closer to the procedure time. Clear liquids, such as water, black coffee, plain tea without milk, and clear apple juice, can often be consumed up to two hours before the scheduled arrival time. The stomach processes and empties these thin liquids quickly, minimizing the risk associated with having liquid volume present. However, you must follow the specific instructions provided by your oral surgeon, as their guidance supersedes any general recommendation.
Why Anesthesia Requires Strict NPO Rules
The reason for strict fasting rules is to minimize the risk of pulmonary aspiration during anesthesia. When a patient receives intravenous sedation or general anesthesia, protective airway reflexes, such as the cough and gag reflexes, become suppressed or temporarily inactive. Anesthesia can also cause the lower esophageal sphincter, a ring of muscle at the entrance to the stomach, to relax.
If the stomach contains undigested food or a large volume of liquid, these contents can potentially regurgitate up the esophagus and enter the windpipe and lungs. This event, known as pulmonary aspiration, can cause severe lung damage, chemical pneumonitis, or aspiration pneumonia. By ensuring the stomach is empty, the fasting protocol significantly reduces the volume of material available to be aspirated. This safety precaution is the primary medical reason why adherence to the NPO rules is mandatory for any procedure involving sedation.