Yes — you can continue sublingual immunotherapy (SLIT) when you’re having dental or oral surgery, but timing matters. Most patients should pause SLIT 24 hours before the procedure and restart 24–72 hours after, once the mouth has healed and bleeding or soreness is minimal. This prevents irritation of the oral mucosa and reduces the chance of local side effects. Always follow your allergist’s instructions, especially if the procedure involves cuts, stitches, or extractions.

What Is SLIT, and Why Does Timing Matter for Oral Surgery?

Sublingual immunotherapy (SLIT), also known as allergy drops, is a proven treatment for allergies, allergic rhinitis, and seasonal triggers. Drops are held under the tongue for 1–2 minutes, where allergens enter the body through the oral mucosa.

During dental work or oral surgery, that same mucosa is often irritated, scraped, cut, or stitched. Because SLIT interacts directly with the mouth, timing around procedures matters.

Why the pause is recommended

Leading guidelines from the AAAAI/ACAAI practice parameter (2017) show that SLIT is generally safe, but they emphasize avoiding use when the mouth has:

• Open sores
• Bleeding
• Irritation
• Dental trauma
• Post-surgery wounds

Even small cuts or inflammation can increase local reactions such as:

• Tingling
• Burning
• Swelling
• Itching
• Soreness under the tongue

Pausing temporarily protects healing tissues and reduces irritation.

Quick Answer!

How Long Should You Stop SLIT Before Dental or Oral Surgery?

Most patients should stop SLIT 24 hours before the procedure.

This applies to:

• Dental cleanings with gum irritation
• Fillings
• Crown work
• Root canals
• Tooth extractions
• Deep cleanings
• Gum procedures
• Oral biopsies
• Implants or grafting

If you are unsure how extensive your procedure will be, ask your dentist or oral surgeon:

“Will there be cuts, stitches, or significant gum irritation?”

If yes → follow the 24-hour pause.

If the procedure is extremely minor (e.g., X-rays only), it is safe to continue SLIT.

H2: When Can You Restart SLIT After Oral Surgery or Dental Work?

Restart SLIT 24–72 hours after the procedure, depending on healing.

Use this guide:

Signs you’re safe to resume SLIT:

• No active bleeding
• No deep soreness under the tongue
• No open wounds
• No new ulcers
• You can swallow comfortably

When in doubt, book a quick telemedicine visit with a HeyAllergy allergist to confirm your timing.

Why Pausing SLIT Briefly Does NOT Harm Your Progress

Many patients worry that skipping 1–3 days will set them back. Fortunately:

• SLIT works through long-term immune training, not daily intensity.
• Short pauses are common and acceptable.
• AAAAI evidence shows long-term outcomes remain effective even when occasional doses are missed.

Your allergist may adjust your dose slightly when restarting if you paused for more than 7–14 days.

What If You Have Asthma or Allergic Rhinitis?

SLIT is commonly used to treat:

• Allergic rhinitis
• Dust mite allergy
• Grass and ragweed allergy
• Pet allergies
• Asthma triggered by allergens

Pausing SLIT for a procedure will not worsen asthma or allergic rhinitis symptoms.

Still, if you have a history of moderate or severe asthma, it’s smart to schedule a telehealth check-in before major oral surgery.

Step-by-Step Guide: SLIT Timing Around Dental or Oral Surgery

Step 1 — Tell your dentist you are taking SLIT

They need to know because they may create small incisions that require mucosa to heal.

Step 2 — Pause SLIT 24 hours before

Take your last dose the morning before the procedure.

Step 3 — Complete your dental procedure

Follow your dentist’s or oral surgeon’s immediate instructions.

Step 4 — Monitor how your mouth feels

Pain, bleeding, swelling, or cuts = delay SLIT longer.

Step 5 — Restart 24–72 hours after

Use the timing tiers in the table above.

Step 6 — Check devices, appliances, or sutures

If you have stitches, implants, or gum grafts, wait the full 72 hours or until cleared.

Step 7 — Resume SLIT at your normal dose

If you paused >7 days, ask your allergist whether to step down and re-titrate.

You can book online in minutes:
➡️ https://www.heyallergy.com/book-appointment

When NOT to Take SLIT Around Oral Surgery

Avoid SLIT if you have:

• Open sores or ulcers
• Recent tooth extraction
• Ongoing bleeding
• Gum infection
• Swelling under the tongue
• Pain that makes holding drops difficult
• Mouth trauma from dental appliances
• Canker sores

SLIT relies on healthy mucosa to absorb allergens safely.

Decision Table — Should You Pause SLIT?

What To Do Next (Action Box)

Book a fast, same-week telehealth allergy appointment to get personalized SLIT timing, prescription refills, and a customized plan around your procedure.

Start Here:

✔ Book an online appointment → https://www.heyallergy.com/book-appointment
✔ Learn about allergy drops (SLIT) → https://www.heyallergy.com/heypak

When to See an Allergist (Triggers)

Seek an allergy appointment if:

• You have ongoing oral irritation every time you take SLIT
• You paused SLIT for more than 7 days
• You are having repeated dental procedures
• You had a reaction after restarting SLIT
• You have asthma that worsens around procedures
• You have questions about dose timing, adjustments, or restarts

You can meet a board-certified allergist online:
➡️ https://www.heyallergy.com/book-appointment

FAQs

1. Can I take SLIT on the same day as my dental cleaning?
‍Usually yes, but if your gums were irritated or bleeding during cleaning, wait 24 hours before taking your next SLIT dose.

2. Why do I need to pause SLIT before oral surgery?
‍SLIT interacts directly with oral tissue. Pausing reduces irritation, supports proper healing, and avoids discomfort when the mucosa is inflamed or cut.

3. Will skipping a few days of SLIT reduce its effectiveness?
‍No. Long-term SLIT benefits come from months and years of exposure. A brief pause does not harm progress.

4. How do I know if my mouth is healed enough to restart SLIT?
‍No bleeding, no deep soreness, and no open wounds are the key signs. Waiting 24–72 hours after most procedures is safe for most patients.

5. Do I need to lower my dose when restarting SLIT?
‍Not for a short pause. If you skipped more than 1–2 weeks, ask your HeyAllergy allergist for a quick titration plan.

Author, Review & Disclaimer

Author:
Krikor Manoukian, MD, FAAAI, FACAAI — Board-Certified Allergist/Immunologist

Bio:
Dr. Manoukian is a board-certified allergist/immunologist specializing in telemedicine-enabled allergy care and personalized SLIT programs. He leads HeyAllergy’s clinical team and trains providers in safe immunotherapy.

Medical Review:
HeyAllergy Clinical Team (Board-Certified Allergists/Immunologists)

Disclaimer:
This article is educational and not a substitute for personalized medical advice. Always consult your clinician about your medications and treatment options.

References

• AAAAI/ACAAI. Sublingual Immunotherapy Practice Parameter Update, 2017.
• AAAAI. Ask-the-Expert: Safety of AIT in various conditions.
• NIH/NIAID. Allergic Rhinitis and Immunotherapy Guidance.
• Peer-reviewed literature on SLIT safety and oral mucosal absorption pathways.