Patients' perception of recovery after third molar surgery

Purpose: This study evaluated patients' perceptions of recovery after third molar surgery. Methods: Two hundred forty-nine patients (age 13 to 37 years) at 2 clinical centers were enrolled in a prospective study before the surgical removal o f third molars. Each patient was given a 21-item Health-Related Quality of Life instrument (HRQOL) to be completed each postoperative day (POD) for 14 days. The instrument was designed to assess patients' perception of recove ry: pain, oral function, general activity measures, and other symptoms. Pai n dimensions were recorded with a 7-point Likert-type scale; all other cond itions were measured on 5-point Likert-type scales. The impact of each pred ictor variable such as age, gender, and length of surgery on recovery was a ssessed with Cochran-Mantel-Haenszel statistics, controlling for clinical c enter. Results: After the 14-day postoperative period, 201 of the original 249 pat ients returned the completed HRQOL instrument; the 48 patients who did not return their diary had third molar conditions and surgery similar to the 20 1 patients who responded. On POD 1, 63.5% of patients reported their worst pain as severe (score, 5 to 7/7) at some time during the day. By POD 7, onl y 15% of patients reported their worst pain as severe. Average pain levels were much less; 29% reported their average pain as severe (score, 5 to 7/7) on POD 1, decreasing to 5.5% by POD 7. Patients experienced substantial in terference in oral function; chewing, 85%; mouth opening 78.5%, and speakin g 37.5% on POD 1. By POD 6, oral function had improved; chewing, 19%, mouth opening, 15%; and speaking, 1.5%. General measures also were affected on P OD 1; social activity, 61.5%; recreation, 70.5%; and daily routine, 60%. Pa tients assumed a more normal lifestyle by POD 5. Swelling seemed to be at i ts maximum on PODs 1 and 2 (day 1, 53%; day 2, 61%) and decreased markedly by POD 5 (10%). Food collection in the surgical sites posed the biggest pro blem for patients on POD 9 (20%). Age was not a predictor of prolonged reco very. However, surgery time 30 minutes or longer, or having all third molar s below the occlusal plane, did prolong recovery. Females also reported a l onger recovery period. Conclusions: This information is valuable to patients deciding on third mol ar surgery and to clinicians providing informed consent.