Impact of third molar removal on demands for postoperative care and job disruption: does anaesthetic choice make a difference?

A prospective cohort study was undertaken to investigate the influences of anaesthetic modality and surgical difficulty on social reintegration and de mands on health services after third molar removal. The study was undertake n at the Oral and Maxillofacial Surgery Department, Cardiff Dental Hospital . Of 444 patients, 266 (60%) had their third molars removed. The main outco me measures included anaesthetic modality, surgical difficulty (WHARFE scor es), utilisation of health services, effects on work, school and home life. In all, 101 (40%) patients were treated under local anaesthesia (LA), +/- i ntravenous (iv) sedation and 165 (60%) under general anaesthesia (GA); 81 ( 49%) as inpatients and 84 (51%) as day cases. Of these patients, 38 (14%) r eturned to the hospital and 74 (28%) utilised primary care services postope ratively in addition to a standard review appointment. Patients treated und er GA made more demands on primary care services (chi(2) = 6.41, df = 2, P< 0.05) and took more time away from work (P<0.05). Patients underestimated t he time they needed to recover. There was similar disruption to job, colleg e and home life. There were no links between disruption and particular anae sthetic modalities and surgical difficulty. Surgery under GA was linked to increased post-operative demands on primary care, but not secondary care, and to longer job disruption. This could not fully be attributed to surgical difficulty.