Dental Procedures in Ramadan: What Breaks the Fast?
Question
Assalamu Alaikum. The following questions are always presented to dentists from Muslim patients.
Does any of the following break someone’s fast during Ramadan?
Swallowing some water during a hygiene or dental visit.
Swallowing blood after a dental extraction.
Getting dental numbing, whether topical or via injection, for mouth ulcers.
Using an inhaler, in case of a dental emergency at the office.
Using laughing gas during dental procedures.
IV sedation for a dental procedure.
Is using a dental mouthwash with alcohol allowed?
For certain dental surgical procedures, animal products need to be used, like animal bone. Is that allowed? This may be sourced from cows or pigs.
Are dental cosmetic procedures allowed in Islam?
Botox
Dental veneers
Orthodontics for aesthetic reasons
If it’s not permissible to do a certain procedure but a patient wants it, is it wrong for us to do irrespective if the patient is in the wrong Islamically?
If a patient got dental work done at a dentist and, after a fact, states that he cannot pay the balance, can that same dentist make the payment on their behalf and count it as from their Zakat?
Does shaking hands with a patient, out of professional courtesy, invalidate one’s wudu if it’s of the opposite gender?
Part of dentistry involves doing head and neck exams. If that is done on the opposite gender, does that invalidate one’s wudu?
Answer
Alhamdulillah, wassalatu wassalamu ala rasulillah, wa ala alihi wa sahbihi ajmain.
Below are answers limited strictly to the fasting and prayer related issues.
Dental Procedures and Fasting
1. The Shari Context
Fasting requires abstaining from food and drink from true dawn until sunset.
“Eat and drink until the white thread of dawn becomes distinct from the black thread of night.”
Surat al Baqarah 2:187
The fast is invalidated by intentional intake of nourishment or substances that reach the stomach through a recognized passage.
2. Scholarly Discussion
The four madhahib agree that swallowing food, drink, or anything that reaches the stomach intentionally invalidates the fast.
They also agree that unintentional swallowing does not invalidate the fast.
Contemporary jurists distinguish between nutritional and non-nutritional medical interventions.
3. Application to the Question
Swallowing water intentionally during a dental visit breaks the fast.
If swallowed unintentionally despite effort to avoid it, the fast remains valid.
Swallowing blood:
If a small amount mixes with saliva and is not intentionally swallowed, the fast remains valid.
If one intentionally swallows noticeable blood that reaches the stomach, it invalidates the fast.
Dental numbing (topical or injection):
Local anesthesia does not break the fast, as it is not nourishment and does not enter through the stomach.
Inhaler use:
Most contemporary scholars hold that inhalers do not invalidate fasting.
Laughing gas (nitrous oxide):
It does not break the fast because it is inhaled gas and not nourishment.
IV sedation:
If it is non-nutritional sedation, it does not break the fast.
If IV fluids contain nutritional substances, it invalidates the fast.
4. Relevant Usul Principle
الحكم يدور مع علته وجودا وعدما
The ruling revolves around its effective cause
The cause of invalidation is the intentional entry of nourishment into the body. If that cause exists, the fast is invalidated. If it does not, the fast remains valid.
المشقة تجلب التيسير
Hardship brings about facilitation
If a medical emergency requires breaking the fast, Sharia permits it, and the day is made up later.
Final Ruling
Intentional swallowing of water or blood breaks the fast. Unintentional swallowing does not. Local dental anesthesia, laughing gas, and non-nutritional IV sedation do not break the fast. Inhalers and nutritional IV fluids invalidate the fast. Medical necessity allows breaking the fast with later makeup.
Shaking Hands and Wudu
1. The Shari Context
Wudu is invalidated by specific nullifiers mentioned in the Quran:
“Or one of you comes from relieving himself…”
Surat al Ma’idah 5:6
Physical touch is discussed in the verse:
“Or you touched women…”
Surat al Ma’idah 5:6
2. Scholarly Discussion
The madhahib differ:
Hanafi: touching does not invalidate wudu unless accompanied by discharge.
Maliki and Hanbali: invalidates wudu if accompanied by desire.
Shafii: invalidates wudu with direct skin contact regardless of desire.
3. Application to the Question
Shaking hands with the opposite gender does not invalidate wudu according to the Hanafi position and according to Maliki and Hanbali if there is no desire.
Head and neck exams do not invalidate wudu according to the same principles unless accompanied by desire (according to some schools).
4. Relevant Usul Principle
الحكم يدور مع علته وجودا وعدما
The ruling revolves around its effective cause
Where desire is considered the effective cause, wudu is invalidated only if that cause exists.
Final Ruling
Shaking hands or performing medical examinations of the opposite gender does not invalidate wudu according to the Hanafi school and according to Maliki and Hanbali if no desire is present. According to the Shafii school, direct skin contact invalidates wudu.
And Allah knows best.