Your Pre-Operative Checklist.

Conscious sedation explained
01.

Fasting

Reflux and inhalation of stomach contents is possible under any kind of anaesthetic, including conscious sedation. There is ample research showing the benefits of fasting before anaesthesia and Dr Ayling adheres to the standards developed from that research. If there is any doubt as to your fasting status, Dr Ayling will perform a gastric ultrasound examination (just an ultrasound probe placed on the outside of the abdomen) to look at the stomach contents directly. If there is anything other than digestive liquid in the stomach, your procedure may be delayed for some hours or postponed until a later date.

Therefore, before your dental sedation, you must not have eaten any solid food or dairy (including milk in tea or coffee) for six (6) hours prior to the scheduled start time. It is usual not to eat after midnight for morning procedures.

You may drink moderate volumes (150mL per hour) of water up to one (1) hour prior to the scheduled start time. If you are having a morning procedure, then don’t drink after 6am. But do start the day with a glass of water.

Unless told otherwise, please take all medications with a sip of water at the usual time, even if you are fasting.

1a: GLP Medications - special precautions.

Many people inject these medications for diabetes or weight management. You must tell your dentist if you are using them or have used them in the preceding 90 days.

These include: semaglutide (Ozempic and Wegovy needles and Rybelsus tablets), Tirzepatide (Mounjaro), Trulicity (dulaglutide) and liraglutide (Saxenda, Victoza and Xultophy).

Part of the reason they tend to result in weight loss is that they signal the stomach to slow down (our natural GLP does that to enable digestion to start). As such, the stomach can remain full after six hours’ fasting, for up to three months after the last dose of these medications.

Therefore, to reduce the risk of anything coming up and being inhaled, we ask that you observe a clear fluid diet for 24 hours before your procedure. Your dentist will give you specific instructions from the anaesthetic college on what you can and cannot consume.

We all have a lot on our minds and sometimes we forget things. If that’s you and you have accidentally eaten dinner the night before but still missed breakfast, depending on your own circumstances, Dr Ayling may perform a bedside gastric ultrasound to look at your stomach to see if it is empty. People vary, so a quick (cost free) scan can verify if your stomach is empty.

If your stomach is not empty on the day, then it will not be best practice to continue at that appointment. So it is recommended to set a calendar reminder an hour or so before dinner time the night before, to remind you not to eat food or drink milk.

To view and download the Anaesthetic College guidelines on pre-operative fasting for patients prescribed GLP medications, please click here

02.

Blood-thinning medications

Your dentist may wish you to stop certain medications such as blood thinners and will consult with Dr Ayling should a specific regime be required, such as for patients with coronary stents.

If you take any blood thinning medications of any kind, please be sure to inform your dentist at least 10 days before your operation so that optimal preparations may be made to maximise your safety.
03.

Diabetes

Please phone Dr Ayling (02 87950892) and he will give you instructions on what diabetic medications to take and/or inject to cover the fasting period.

Injectable insulin is tailored to each patient.
04.

Smoking

There is never a better time than “right now” to quit. But if you still smoke, there are advantages even from abstinence for 24-48 hours before any surgical procedure - more so if any kind of sedation or anaesthesia is used. Circulation to peripheries is impaired by nicotine in the blood; carbon monoxide can also impede access by oxygen to binding sites in red blood cells.

As a result, smoking can make wound healing slower and infection more likely; it can also make respiratory complications of sedation more likely. So please abstain from smoking for a minimum of 24-48 hours prior to your procedure.
05.

Clothing, height and weight

Please be sure to wear a loose-fitting shirt, blouse or T-shirt so that monitoring equipment can be easily applied.

You will also need to know your weight (in kg) and height (in cm, not feet) so they can be entered into medication infusion pumps. Each dose is tailored to the individual.

06.

Post-Operative

Following sedation, you should not drive, operate machinery or make legal agreements for 24 hours.

You should also have someone responsible to take you home and to be with you for 24 hours.

Shaping the sedation experience

Every procedure is different. Every patient is, too. What stays the same is a structured, reliable approach to anaesthesia and perioperative care – and a commitment to guiding the experience as it unfolds.
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