Influence of oral hygiene and smoking on pain and swelling after surgical extraction of impacted mandibular third molars.

PURPOSE To assess the pain and swelling during the first week after surgical extraction of impacted mandibular third molars and the relationship with oral hygiene and smoking before surgery and during the postoperative period. MATERIALS AND METHODS A prospective study was performed on patients undergoing surgical extractions of impacted mandibular third molars. Pain was recorded on a visual analog scale from 1 to 10 and swelling on a 4-point descriptive scale at 2, 6, and 12 hours after surgery and daily during the first postoperative week. Oral hygiene and smoking before surgery and during the postoperative period were recorded. Statistical analysis was performed of all the variables. A P value less than .05 was considered statistically significant. RESULTS A total of 50 patients (27 men and 23 women) with a mean age of 26.3 years (range 18 to 39) underwent surgical extraction of an impacted third molar. The maximum pain occurred during the first day and the maximum swelling at 24 hours after surgery. The patients with a lower brushing frequency before surgery reported greater pain. Likewise, the patients who smoked more after surgery experienced greater pain at 24 hours postoperatively. The hygiene after surgery and smoking before the surgical intervention had no statistically significant relationship to the occurrence of pain (P > .05). Swelling had no relationship with the variables studied (P > .05). CONCLUSIONS Surgical extraction of an impacted third molar caused moderate pain and swelling during the first 24 hours after surgery. A lower brushing frequency before surgery and during the first postoperative week as well as smoking after surgery were related to greater pain scores.

[1]  Jerome Lindeboom,et al.  The effect of a separate consultation on anxiety levels before third molar surgery. , 2008, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[2]  V. Badner,et al.  The relationship of cigarette smoking to postoperative complications from dental extractions among female inmates. , 2007, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[3]  J. Bader,et al.  Developing a measure of patient perceptions of short-term outcomes of third molar surgery. , 1996, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[4]  J. Martínez-González,et al.  Influence of smoking upon the postoperative course of lower third molar surgery. , 2006, Medicina oral, patologia oral y cirugia bucal.

[5]  J. Frame,et al.  Factors affecting the onset and severity of pain following the surgical removal of unilateral impacted mandibular third molar teeth , 1988, British Dental Journal.

[6]  J. Bagan,et al.  Oral hygiene and postoperative pain after mandibular third molar surgery. , 2001, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[7]  L Montebugnoli,et al.  Extraction of impacted third molars. A longitudinal prospective study on factors that affect postoperative recovery. , 1994, Oral surgery, oral medicine, and oral pathology.

[8]  D. Tong,et al.  Influence of two different flap designs on incidence of pain, swelling, trismus, and alveolar osteitis in the week following third molar surgery. , 2007, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[9]  L. Majem,et al.  Manual de odontología preventiva y comunitaria , 1991 .

[10]  S. Rogers,et al.  The effect of smoking on immediate post-extraction socket filling with blood and on the incidence of painful socket. , 1988, The British journal of oral & maxillofacial surgery.

[11]  Marija J. Norusis,et al.  SPSS 16.0 Statistical Procedures Companion , 2003 .

[12]  F. Al-Belasy,et al.  The relationship of "shisha" (water pipe) smoking to postextraction dry socket. , 2004, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[13]  H. Yuasa,et al.  Clinical postoperative findings after removal of impacted mandibular third molars: prediction of postoperative facial swelling and pain based on preoperative variables. , 2004, The British journal of oral & maxillofacial surgery.

[14]  C. Maiorana,et al.  Assessing postoperative discomfort after third molar surgery: a prospective study. , 2007, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.