Getting your wisdom teeth removed is a common procedure that many people undergo at some point in their lives. If your dentist or oral surgeon has recommended removing your wisdom teeth, you may be wondering whether you need to fast beforehand since you will be receiving local anesthesia.
Fasting before surgery, including wisdom tooth extraction, used to be standard protocol. The thought was that having an empty stomach would reduce the risk of aspiration if anesthesia caused nausea or vomiting. However, research has shown that fasting is not necessary for procedures done under local anesthesia and may actually be detrimental.
What the Research Says
Multiple studies have found no increase in the risk of aspiration when patients undergoing procedures with local anesthesia eat and drink beforehand. This includes a study published in Anesthesia Progress in 2002 that looked at over 13,000 dental procedures done with local anesthesia. They found no difference in aspiration rates between patients who fasted and those who did not.
Another study published in the British Dental Journal in 2005 examined over 4,500 wisdom tooth extractions done under local anesthesia. Again, there was no increased aspiration risk for patients who ate and drank as usual before their procedure compared to those who fasted.
Based on this evidence, many oral surgeons no longer require fasting for wisdom tooth removal with local anesthesia. Since there is no evidence showing fasting reduces complications but potential downsides to prolonged preoperative fasting, the current guidelines state fasting is unnecessary for local anesthesia.
Potential Downsides to Fasting
Requiring fasting before procedures with local anesthesia not only lacks evidence showing benefits but may negatively impact patients in a few ways:
- Hypoglycemia risk in diabetics – Going long periods without eating can cause low blood sugar in diabetic patients.
- Dehydration – Fasting leads to fluid loss, which can cause dehydration if patients are not allowed to drink water.
- Patient discomfort – Hunger and thirst can cause discomfort, nausea, dizziness, and irritability.
- Delayed healing – Adequate nutrition and hydration supports healing. Fasting may impede the recovery process.
Allowing patients to eat and drink normally before wisdom tooth removal with local anesthesia avoids these unnecessary downsides of preoperative fasting.
Exceptions Where Fasting May Be Required
While most oral surgeons following the current guidelines will not require fasting for wisdom tooth extraction with local anesthesia, there are some exceptions where fasting still may be recommended:
- If you are also having intravenous (IV) sedation – IV sedation introduces risks of sedation-related nausea/vomiting and aspiration, so fasting may be required.
- If you have certain medical conditions – Such as reflux, delayed gastric emptying, or obesity. These increase aspiration risk so your surgeon may still recommend fasting as a precaution.
- If you are undergoing a more complex procedure – Extracting impacted or difficult to remove wisdom teeth may require deeper sedation, increasing aspiration risk.
Talk to your oral surgeon about whether fasting is necessary for your specific situation. Follow their recommended instructions.
Guidelines If Fasting Is Not Required
If your oral surgeon determines fasting is not necessary for your wisdom tooth removal with local anesthesia, here are some general guidelines regarding eating and drinking beforehand:
- Have a light meal up to 3 hours before your procedure – To avoid feeling nauseated, don’t have a large, heavy meal right before. Stick to light foods.
- Avoid fatty, greasy foods – These are harder to digest and sit in the stomach longer, increasing nausea potential.
- Eat soft, easy to chew foods – Things like eggs, oatmeal, yogurt, apple sauce, mashed potatoes.
- Stay well hydrated – Drink plenty of water and avoid alcohol and caffeinated beverages, which cause dehydration.
- Stop chewing gum a few hours before – Chewing gum increases swallowing of air, which can cause stomach discomfort.
Following these common sense dietary guidelines will help make your experience comfortable while avoiding preoperative fasting.
What to Do the Night Before
Preparing properly the night before your wisdom tooth removal will help ensure things go smoothly:
- Eat a light dinner – Don’t overeat or have anything too heavy or greasy.
- Have a light snack before bed – This stabilizes blood sugar and prevents morning hunger.
- Drink a glass of water before bed – Staying hydrated is key.
- Set alarm to wake up early enough to eat – Schedule ample time to have a light meal before your procedure.
- Prepare a shopping list and stock up on soft, nutritious foods – Items like yogurt, soup, eggs, mashed potatoes, apple sauce.
Properly preparing the night before eliminates morning stress and ensures you follow the guidelines for eating and drinking beforehand.
Food and Drinks to Avoid
While fasting is not necessary, there are some specific foods and drinks you’ll still want to avoid before wisdom tooth removal with local anesthesia:
- Crunchy or hard foods – Foods requiring extensive chewing increase swallowing of air and gas production, which can cause abdominal discomfort.
- Spicy foods – Heavily spiced foods can cause nausea and stomach upset.
- Acidic foods – Such as citrus fruits and tomato-based products. The acidity can upset an empty stomach.
- Fatty and greasy foods – High-fat foods like bacon, sausage, fried foods. These digest more slowly and sit in the stomach longer.
- Fibrous foods – Like raw veggies, popcorn, nuts, seeds. Fibrous foods can cause gas and bloating.
- Carbonated beverages – The bubbles in soda, sparkling water, etc. can cause belching and stomach distention.
- Alcohol – Alcohol dehydrates and slows digestion, increasing nausea, dizziness.
- Caffeine – Like coffee, tea, energy drinks. Caffeine causes dehydration and agitation.
- Dairy – Milk and other dairy products increase production of mucus and phlegm.
What to Eat Before Wisdom Tooth Removal
Sticking to a light meal of easily digested, nutritious foods is your best bet before wisdom teeth removal. Good options include:
- Eggs – Boiled, poached, or scrambled eggs are a great source of protein. Avoid greasy preparations like fried eggs.
- Oatmeal – Oatmeal provides filling fiber and complex carbs to help maintain blood sugar.
- Bananas – Bananas are easy to chew and digest. The potassium helps prevent cramps.
- Applesauce – Pureed apples are gentle on the stomach and provide hydration.
- Smoothies – Blended drinks without seeds, pulp, or dairy are easy to swallow.
- Mashed potatoes – Soft, smooth mashed potatoes digest easily and offer carbohydrates for energy.
- Rice – Plain white rice digests easily and helps settle the stomach.
- Toast – Toast made from white bread is gentle and absorbs stomach acid.
Focus on soft, low-fiber foods that won’t cause stomach upset. Steer clear of problem causing foods and drinks.
Hydration Guidelines Before Wisdom Teeth Removal
Properly hydrating before your wisdom tooth extraction is just as important as eating light. Follow these tips:
- Drink at least 8 ounces of water upon waking up
- Sip on water consistently, around 4-8 ounces every hour leading up to your procedure
- Avoid alcohol, juices, soda, coffee, tea, and other caffeinated/carbonated beverages
- Stop drinking clear liquids 2 hours before your appointment
- Avoid chewing gum, mints, hard candies. Opt for softer candies if needed for dry mouth.
- Dehydration increases anesthesia side effects, so proper hydration is key.
Be sure to drink plenty of plain water before and the morning of your extraction. other beverages can cause dehydration and stomach irritation.
Tips for the Day of Your Wisdom Teeth Removal
Follow these tips the day of your wisdom teeth extraction to ensure everything goes smoothly:
- Set your alarm to wake up early enough to hydrate and eat a light meal
- Stick to easy foods recommended by your oral surgeon – Usually soft, low-fiber options
- Avoid dairy, caffeine, alcohol, and all restricted foods/drinks
- Bring a small bottle of water to sip on the way to your appointment
- Take any medications you normally take in the morning unless otherwise instructed
- Arrive early to your appointment to avoid feeling rushed
- Wear comfortable clothing you can easily maneuver in
- Have someone drive you to/from your procedure for safety
Properly preparing on the day of your surgery will minimize discomfort and support a smooth, uneventful wisdom tooth removal process.
Recovery Diet Tips
Following your wisdom teeth removal, you’ll need to stick to a soft food diet during the initial days of healing. Here are some tips:
- Focus on cold and room temperature foods since hot foods can cause discomfort in surgical areas
- Choose soft, smooth textures that require little chewing like yogurt, pudding, applesauce
- Get nutrients from protein shakes, smoothies, and pureed soups
- Avoid very hard, crunchy, chewy, spicy, or acidic foods that can irritate the surgery site
- Stay hydrated by drinking water, electrolyte drinks, milkshakes, smoothies
- As healing progresses you can slowly begin reintroducing normal foods
- Stick to a soft food diet for at least the first week after surgery
Following these postoperative diet guidelines will support healing and recovery after wisdom teeth removal.
The Bottom Line
Preoperative fasting is no longer recommended for wisdom tooth extraction with local anesthesia. Current guidelines state patients should be allowed to eat and drink normally before their procedure. This avoids potential downsides of prolonged fasting with no evidence showing fasting reduces complication risk.
However, your oral surgeon may still advise fasting if you are higher risk due to medical conditions or if you are also receiving IV sedation. Otherwise, you can generally follow a regular diet before wisdom tooth removal as long as you avoid heavy, greasy foods that are slow to digest and stick to adequate hydration.
With local anesthesia alone, eating and drinking beforehand does not appear to increase aspiration risks. Avoid problem causing foods and drinks, but fasting is typically unnecessary and often discouraged.
