GLP-1 agonist fasting guidelines before dental surgery
For dental procedures requiring deep sedation or general anaesthesia, most patients taking a GLP-1 receptor agonist may continue the drug under updated risk-stratified guidance; higher-risk patients may require a 24-hour liquid diet, anaesthetic-plan modification, and point-of-care gastric ultrasound when concern exists. Journal of Clinical Me…For conscious dental sedation, fasting and fluid instructions should be individualized to the procedure, medical assessment, and sedation technique; modifying food or drink intake may or may not be appropriate. European Archives of P…Food and fluid intake on the day of dental sedation should be confirmed and recorded after individualized assessment. European Archives of P…Dental clinicians arranging sedation for patients using GLP-1 receptor agonists should coordinate with the anaesthesia team and prescriber and follow current institutional protocols, because the evidence for a specific drug-holding interval remains incomplete. Journal of Clinical Me…
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1Oral Health Implications of GLP-1 Receptor Agonists and Other Incretin-Based TherapiesBijoch J · Journal of Clinical Medicine · 2026Narrative review
10. Perioperative and Sedation Considerations
Because GLP-1 RAs delay gastric emptying, they raise concern for retained gastric contents and aspiration during sedation or general anaesthesia, a consideration directly relevant to dental procedures requiring deep sedation or general anaesthesia. Guidance has evolved. The 2023 American Society of Anesthesiologists (ASA) consensus recommended holding weekly agents for one week and daily agents on the day of the procedure [33]. In October 2024, updated multi-society guidance (ASA with the American Gastroenterological Association, the American Society for Metabolic and Bariatric Surgery, and others) shifted towards a more permissive, risk-stratified stance: most patients may continue their agent, with higher-risk patients following a 24 h liquid diet, anaesthetic plan modification, and point-of-care gastric ultrasound where concern exists. Dental practitioners arranging sedation should therefore coordinate with the anaesthesia team and prescriber and follow current institutional protocols, recognising that the evidence base for any specific holding interval remains incomplete [34].
What this supports
- For dental procedures requiring deep sedation or general anaesthesia, most patients taking a GLP-1 receptor agonist may continue the drug under updated risk-stratified guidance; higher-risk patients may require a 24-hour liquid diet, anaesthetic-plan modification, and point-of-care gastric ultrasound when concern exists.
- Dental clinicians arranging sedation for patients using GLP-1 receptor agonists should coordinate with the anaesthesia team and prescriber and follow current institutional protocols, because the evidence for a specific drug-holding interval remains incomplete.
Oral Health Implications of GLP-1 Receptor Agonists and Other Incretin-Based Therapies. © 2026 by the author. Creative Commons Attribution 4.0 International (https://creativecommons.org/licenses/by/4.0/).
2Best clinical practice guidance for conscious sedation of children undergoing dental treatment: an EAPD policy documentEuropean Academy of Paediatric Dentistry, Ashley P, Anand P, et al. · European Archives of Paediatric Dentistry · 2021Clinical guideline
Fasting
Fasting prior to sedation continues to be a controversial topic and each country’s legislation for this must be followed according to the local guidance. There is only low evidence available for this (NICE 2010; IACSD 2015; SDCEP 2017). For conscious sedation, an individual assessment needs to be made on the basis of the dental procedure, patient’s medical assessment and the sedation technique being used. Depending on the circumstances, it may or may not be appropriate for the patient to modify food and drink intake before sedation. After carefully considering all factors for a patient: It is advisable to confirm and record food and fluid intake on the day of sedation.
What this supports
- For conscious dental sedation, fasting and fluid instructions should be individualized to the procedure, medical assessment, and sedation technique; modifying food or drink intake may or may not be appropriate.
- Food and fluid intake on the day of dental sedation should be confirmed and recorded after individualized assessment.
Best clinical practice guidance for conscious sedation of children undergoing dental treatment: an EAPD policy document. © The Author(s) 2021. Creative Commons Attribution 4.0 International (https://creativecommons.org/licenses/by/4.0/).
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