Patient's Pain Perception and Mouth Opening after Third Molar Surgery

Objectives: Patients requiring third molar removal frequently ask about postoperative pain, swelling and loss of oral function. Clinical information available has been gathered from studies of Goldberg (1985), Osborne (1985) and Dionne (1999) and focusses on clinical outcome, but did not quantify short-term outcomes of third molar surgery with regard to loss of oral function. Patients frequently ask about the ability to masticate and function in the immediate post surgical phase and are often sent for ultrasound and low level laser to improve mouth during the immediate period after surgery. The aim of this prospective study is to quantify patient's perception of pain and post operative mouth opening after third molar surgery with adjunctive physical therapy. Methods: After ethical approval, 50 patients were enrolled in a prospective study prior to surgical removal of third molars under general anaesthesia. Each patient was given a questionnaire to complete, designed to assess patients' perception of pain post operatively. Mouth opening was recorded by daily measurement during the first seven days post operation. Predictor variables such as age, gender, medication taken and length of recovery were assessed. Results: Using 3 methods of pain assessment, 20 % of patients reported pain as severe on post op day 1 and 90% of patients reported no pain at day 7. A 25% increase in mouth opening was measured in those patients who used physical therapy post operatively. Stastical analysis of results is in progress. Conclusions:Postoperative pain after third molar surgery is short lived and mouth opening is greatly improved with adjunctive physical therapy.