What are wisdom teeth and why do they need to be removed?
Wisdom teeth are the third and final set of molars located at the far back corners of the mouth. They are referred to as the “wisdom” teeth because they typically emerge later in life between the ages of 17 to 25 years old, after a person has grown to full maturity and attained more wisdom.
Most people have 4 wisdom teeth – one in each corner. They are the last teeth to erupt since the jawbone and facial muscles are essentially fully developed by this age. The wisdom teeth are designated as the third molars, following the first and second molars that emerge earlier.
While some wisdom teeth can emerge properly aligned and functional, many people have wisdom teeth that become impacted or only partially emerge in the mouth. Partially impacted wisdom teeth do not have enough room to fully break through the gums due to lack of space in the jaws or improper positioning. Fully impacted wisdom teeth remain trapped under the gums and do not erupt at all.
According to research, up to 85% of people have at least one wisdom tooth that becomes impacted or fails to properly emerge. Wisdom teeth pressing against the neighboring second molars can damage the roots of those teeth. Partially erupted wisdom teeth create openings where bacteria can enter around the gum line and potentially cause infections. This is why dentists often recommend extraction or surgical removal of problematic wisdom teeth.
Extracting wisdom teeth is advisable when they are:
- Impacted against neighboring teeth, causing damage
- Partially erupted and prone to bacteria entering and infecting
- Pressing on nerves, causing pain and swelling
- Causing recurrent infections, cysts or tumors
- Causing decay or gum disease in neighboring teeth
- Causing orthodontic issues or crowding of teeth
The most common time to extract wisdom teeth is between ages 17 to 25 before complications arise. Removing symptomatic wisdom teeth can prevent more complex problems in the future.
Why can’t you eat or drink before the surgery?
Most wisdom tooth extractions are performed under intravenous (IV) sedation or general anesthesia to fully numb the oral cavity and prevent any pain or discomfort during the procedure.
As a safety precaution, your dentist or oral surgeon will provide instructions to refrain from eating or drinking anything for 6-8 hours prior to your wisdom tooth removal surgery.
Here are the main reasons fasting is required before anesthesia:
Prevent vomiting and aspiration of stomach contents
When general anesthesia is administered, it causes the throat and stomach muscles to relax. This reduces the gag reflexes that normally prevent vomit from coming up the esophagus.
With relaxed throat muscles under sedation, there is risk of stomach contents or vomit being accidentally inhaled or aspirated down into the airway and lungs. This poses a serious health risk as food particles, liquids or stomach acid that reach the lungs can cause infections, injury, pneumonia or even death from asphyxiation.
By avoiding all foods and liquids for 6-8 hours before surgery, the stomach contents have time to empty and the volume is reduced. This significantly decreases risks of vomiting and potential aspiration if reflexes are relaxed from anesthesia.
Allow for proper absorption of anesthetic gases
Some anesthetic gases used for general anesthesia are absorbed faster by the body on an empty stomach. Eating food right before surgery can delay the absorption and action of anesthesia gases, preventing them from taking full effect once the procedure starts.
Without fasting beforehand, anesthesia absorption can be unpredictable. The lack of food allows anesthesiologists to accurately calculate doses of anesthesia and achieve optimal loss of sensation for surgery.
Reduce the volume of stomach contents
When food and liquids are consumed, it adds bulk and volume to the digestive contents in the stomach. Higher volumes require higher doses of anesthesia medications to take full effect.
Lower volumes of stomach contents allow for more controlled administration of anesthesia. Fasting leads to more predictable calculation of anesthesia volumes needed based on the patient’s weight and body size. This prevents complications from too much or too little anesthesia for the patient.
Prevent delays or cancellation of the procedure
In non-fasting patients, the risk of vomiting under anesthesia increases. If a patient vomits during wisdom tooth surgery, the dentist may abort the procedure early for the patient’s safety.
Showing up to oral surgery shortly after eating a full meal also poses aspiration risks if vomiting occurs once anesthesia is administered. To avoid emergency scenarios, the dentist may delay or cancel the surgery until the patient’s stomach has had time to empty.
By adhering to the 6-8 hour fasting period, the chances of procedure delays, surgery cancellation or aspiration are significantly reduced. This allows the oral surgery to proceed safely as scheduled.
In summary, fasting before anesthesia minimizes risks to the patient, allows better drug absorption, improves calculations for proper anesthesia dosing and prevents delays or cancellation of wisdom tooth extraction procedures.
What can happen if you eat or drink before surgery against medical advice?
Consuming any food, liquids or medications shortly before wisdom tooth extraction under anesthesia can jeopardize the patient’s safety. This includes water, candy, food, procedural sedatives or other substances.
Going against medical advice and eating or drinking too soon before surgery can lead to the following risks and complications:
- Asphyxiation – Food particles or vomit inhaled into airway causes choking.
- Aspiration pneumonia – Stomach contents entering lungs can cause infection.
- Delayed anesthesia – Absorption of anesthetic gases slowed by food.
- Insufficient anesthesia – Higher dose needed with food in stomach.
- Nausea and vomiting – More likely with a full than empty stomach.
- Prolonged recovery – Anesthesia-related illness prolongs post-op recovery.
- Throat spasms – Can be triggered under anesthesia after recent food intake.
- Tooth fragments aspiration – Increased gag reflex risks tooth segment aspiration.
- Bleeding – Higher chances of bleeding with increased vomiting.
To prevent the above dangerous risks such as aspiration pneumonia and delayed anesthetic absorption, oral surgery patients are strictly advised to consume nothing by mouth after midnight or for at least 8 hours before procedures under IV sedation or general anesthesia.
What should you do to prepare the night before surgery?
To get ready for your upcoming wisdom tooth extraction, follow these guidelines the night before your scheduled procedure:
- Finish eating and drinking at least 8 hours before your required arrival time at the oral surgery office. This includes no food, water, mints, gum, candy, coffee, juice or other oral intake.
- Set an alarm to wake up early enough to get ready without needing any food or liquids before your appointment.
- Avoid all alcohol for at least 24 hours prior to surgery, as alcohol can interact with anesthetic agents.
- Wash and care for your face as normal before bedtime. Remove any makeup, lipstick, fragrances, facial oils that are not easily washed off.
- Take any medications your dentist instructed, such as prophylactic antibiotics or a sedative to relax you before surgery.
- Get ample sleep of at least 7-8 hours to be well-rested. Set backup alarm clocks to avoid accidentally sleeping in.
- Make transportation arrangements with a friend or family member who can safely drive you to your surgery and back home after.
Following these steps the night before prepares you to start your surgery day with an empty stomach and ready for your extraction procedure.
What can you do on the morning of surgery before arriving?
On the actual morning of your wisdom tooth removal, follow these pre-operative guidelines:
- Do not eat any breakfast or consume anything by mouth. Your stomach must remain completely empty.
- Take only medications your dentist has approved such as heart or blood pressure prescriptions. Take with just a small sip of water.
- Brush and floss teeth as normal to freshen breath, but try not to swallow water or toothpaste.
- Dress in comfortable, loose-fitting clothing that can be easily slipped on and off over your head.
- Do not apply lotions, cosmetics or fragrances that could interact with sterilized surgical site.
- Arrive early at the oral surgeon’s office for necessary paperwork and pre-operative preparation.
- Notify staff immediately if you accidentally consumed anything that morning.
- Expect an IV line to be placed to administer medications, anesthesia and fluids.
By adhering to the overnight fasting period, you will arrive for your oral surgery relaxed, nausea-free and ready to safely undergo anesthesia.
What can you expect during recovery following wisdom tooth removal?
Once your wisdom tooth extraction procedure is completed, here is what you can expect during the initial recovery period:
- You will remain in the dental office for 1-2 hours under observation until effects of anesthesia and medications wear off. Do not attempt to drive or leave unaccompanied.
- Your mouth and tongue area will likely feel numb for several hours afterward due to anesthetic agents. Take care not to bite, scratch or burn your mouth when numb.
- Bleeding from the surgical sites is normal and can persist for the first 24 hours. Change gauze pads placed by the oral surgeon as needed.
- Facial swelling around the extraction sites often develops and peaks in 2-3 days before gradually improving by days 5-7.
- Pain and general discomfort in the mouth is common while healing. Take prescribed pain relief medications as directed.
- Only consume soft, lukewarm foods for the first 24-48 hours like broth, smoothies, applesauce, yogurt, mashed potatoes or oatmeal.
- Carefully rinse mouth with salt water starting 24 hours after surgery. Avoid forceful spit or swishing.
- Limit physical activity for at least 24 hours following anesthesia. Avoid drinking with straws, spitting or rinsing forcefully.
- Schedule a follow up visit if you have concerns about bleeding, worsening pain or excessive swelling.
With proper post-operative care, your mouth and wisdom tooth sites should heal within 7-10 days following extraction.
Frequently Asked Questions
Why can’t I drink water before oral surgery?
Even water must be avoided for 8 hours pre-procedure because any fluids or particles in the stomach raise risks of aspiration if vomiting occurs under anesthesia. Stomach contents must be minimized.
Can I take my routine medications before surgery?
You may take prescribed medications like heart tablets or blood pressure pills at least 2 hours beforehand with a sip of water only. Check with your dentist about medication safety before your wisdom tooth extraction.
What if I accidentally eat or drink something the morning of surgery?
Inform your oral surgeon’s office immediately if you accidentally consume anything except medications approved by your dentist on the morning of surgery. Your procedure may need to be postponed for your safety.
Is it okay to brush my teeth before the extraction?
Yes, you may brush your teeth as normal to freshen breath, but try to avoid swallowing any toothpaste or water. This will lower oral bacteria before the surgical procedure.
Will I be completely unconscious?
You may feel drowsy depending on the type of anesthesia, but most patients remain responsive. With IV sedation you are numb but not fully unconscious as with general anesthesia. Discuss options with your dentist.