Wisdom teeth removal is a common oral surgery often performed using procedural sedation or general anesthesia. This surgery requires careful preparation to ensure the patient’s well-being. Following all pre-operative instructions precisely is important for a safe and successful experience. Preparation guidelines, particularly those related to eating and drinking, are designed to mitigate specific physiological risks associated with anesthesia.
Required Fasting Timelines
The time you must stop eating before your procedure depends directly on the type of food or liquid consumed. Standard guidelines, such as those issued by the American Society of Anesthesiologists, specify different fasting windows for solids and clear liquids. For a light meal, such as toast, a minimum of six hours of fasting is required. If you have eaten a meal containing fried, fatty, or heavy foods, you will need to fast for eight hours or more, as these items take longer to exit the stomach.
The rules are different for clear liquids, which are fluids you can easily see through. Examples include water, plain apple juice, black coffee or tea without cream or milk, and certain sports drinks. You are permitted to consume these clear liquids up to two hours before the scheduled time of your sedation. This shorter window helps maintain hydration without increasing the risk of complications. Always follow the specific instructions provided by your oral surgeon.
The Safety Reason Behind Fasting
Fasting is mandated because sedation and general anesthesia affect the body’s protective mechanisms. When sedative medications are administered, natural reflexes, including the gag and cough reflexes, become relaxed or inactive. These reflexes normally prevent stomach contents from entering the respiratory tract.
If food or liquid is in the stomach during this relaxed state, there is a risk of regurgitation and subsequent inhalation into the lungs, known as pulmonary aspiration. Aspiration of even a small volume of gastric contents can lead to severe pulmonary complications. These complications include aspiration pneumonia or Acute Respiratory Distress Syndrome (ARDS), a life-threatening condition. Ensuring the stomach is empty minimizes the volume of contents available for aspiration, reducing this safety risk.
Other Necessary Pre-Procedure Preparations
Beyond abstaining from food and drink, several other preparations are necessary to ensure the procedure proceeds safely. You should discuss all prescription and over-the-counter medications with your surgeon beforehand. While many routine medications can be taken with a small sip of water on the morning of surgery, some agents may need to be stopped up to two days prior. These include aspirin, non-steroidal anti-inflammatory drugs (NSAIDs), and certain blood thinners, which minimize the risk of excessive bleeding.
Restrictions Before Surgery
It is forbidden to use chewing gum, mints, or hard candies on the day of surgery, as these stimulate stomach acid production and violate the fasting protocol. You must also avoid smoking, vaping, and consuming alcohol for at least 24 to 48 hours before the procedure. Using tobacco products impedes the healing process and increases the likelihood of complications like dry socket.
Day-of Logistics
On the day of the procedure, you must arrange for a responsible adult to drive you to and from the appointment and remain in the office during the surgery. Due to sedation effects, you will be unable to drive or make important decisions for 24 hours afterward. You should wear comfortable, loose-fitting clothing with short sleeves for easy access for an intravenous line. Jewelry, contact lenses, and makeup or nail polish should be removed before you arrive.