Fruit and Vegetable Supplementation and Morbidity After Third Molar Surgery

Objectives: The FAVOURITE (Fruit And Vegetable and Outcomes after removal of impacted third molars) trial is a monocentre, randomised, double blind, placebo controlled, 2 arm clinical trial to investigate the efficacy of adjunctive encapsulated fruit and vegetable powder concentrate (Juice plus®)(F&V) to reduce post-operative morbidity and improve quality of life (QoL) after lower third molar surgery.


Methods: Male and female patients aged 18-60 years requiring the surgical removal of one unilateral mandibular third molar were eligible. Patients were randomised into the 2 study groups by block randomisation with variable block size. The study consisted of four visits: baseline (week 0), surgery (week 10), 2 day and 7 day postoperative review (week 11). Patients took F&V or placebo supplements throughout the study for 11 weeks.
Morbidity was assessed by evaluating QoL (PoSSe scale during first postoperative week - primary endpoint), pain (patients’ Visual Analogue Scale (VAS) rating on each post-operative day for one week), analgesic consumption and trismus (clinical interincisal distance measured on postoperative day 2 and 7 and daily self-assessment for one week).

Results: 240 patients were randomised, of which two withdrew consent and 45 did not attend surgery and 10 did not attend a follow-up. Postoperative follow-up data were available for 183 patients (71 males, 112 females). Patients in the F&V group had significantly better QoL (primary endpoint PoSSe score: 32.9) compared to patient receiving placebo (39.1), adjusting for age, gender, ethnicity, smoking and BMI at baseline (p=0.01). Patients in the F&V group had on average 3.4mm less trismus on postoperative day 2 compared to patients in the placebo group (p=0.02).
Conclusions: Adjunctive encapsulated fruit and vegetable powder concentrate may reduce postoperative morbidity after lower third molar surgery and improve quality of life.